Nursing homes serving minorities offering less care than those housing whites

By Jeff Kelly Lowenstein

Nursing homes serving blacks, Latinos provide less daily registered nurse care than those housing whites.

Excerpts from this story referencing "Houston":

"… acilities where black people made up the majority of patients, Chicago and Houston had notably low registered nurse staffing levels relative to majority-whit …"

Poorly rated nursing homes got HUD-guaranteed mortgages anyway

By Jeff Kelly Lowenstein

Hundreds of poorly rated facilities received mortgage guarantees.

Excerpts from this story referencing "judge":

"… according to state records. But the facility was able to stay open after a judge ruled that the state had botched its chance to close the home, according t …"

Analysis shows widespread discrepancies in staffing levels reported by nursing homes

By Jeff Kelly Lowenstein

Analysis shows staffing levels lower than what's reported on public website.

Excerpts from this story referencing "Health":

"… air, she'd wheel over to try to help other residents in the Chenal Heights Health and Rehabilitation Center in Little Rock. Irvin had been placed there by …"

"… ior vice president of quality and regulatory affairs for the American Health Care Association, the nursing home industry’s largest professional organ …"

"… after Sanders moved her from the Chenal Heights facility to the Sandalwood Healthcare nursing home in Little Rock in July 2012. Ultimately, Sanders filed s …"

"… ned the facility for its lack of staffing. Sean Mathis, a lawyer for Hope Healthcare, the firm that owns Sandalwood, said Sandalwood will “vigorously def …"

Methodology for our nursing homes investigation

By Jeff Kelly Lowenstein and Ben Wieder

Center compared self-reported staffing numbers with Medicare data

Excerpts from this story referencing "Nursing":

"… the results of that calculation with 2012 data it had downloaded from the Nursing Home Compare website and calculated which dataset reported the higher staf …"

"… r of standard survey inspections for each year from 2008 to 2012, and used Nursing Home Compare to compute the difference in the number of Nursing homes in t …"

"… Center identified those homes which received a 5-star overall rating from Nursing Home Compare and which had less than a 10 percent difference between the s …"

"… ich had less than a 10 percent difference between the staffing levels from Nursing Home Compare and the daily average calculated through the cost reports for …"

Running a five-star nursing home

By Jeff Kelly Lowenstein

Top-rated homes had more nurses, less turnover

Excerpts from this story referencing "Texas":

"… he homes analyzed. Bita Kash, professor of Health Policy and Management at Texas A & M University, said Medicaid’s comparatively low reimbursements h …"

More scrutiny coming for Medicare Advantage, Obamacare

By Fred Schulte

New round of audits coming; Obamacare too.

Excerpts from this story referencing "Congress":

"… Advantage program has grown rapidly under the risk-scoring formula, which Congress enacted in 2003. Officials expect Medicare Advantage to cost taxpayers as …"

Another whistleblower suit alleges Medicare Advantage fraud

By Fred Schulte

California litigation alleges 'house calls" yielded false claims

Excerpts from this story referencing "judge":

"… lth plans. The suit, filed in August 2013 in California, was unsealed by a judge late last month. The suit also names four Medicare Advantage insurance pl …"

GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Excerpts from this story referencing "health":

"… ssional committee has taken aim at waste in the popular Medicare Advantage health insurance program for seniors, ordering an extensive audit of billing erro …"

"… ces (CMS), which runs the senior care program, to ensure the privately run health plans are paid accurately and that any overpayments are recovered for taxp …"

"… everything is on the table,” said James Cosgrove, who heads the GAO’s health care division. “This is not something we have focused on before.” The …"

"… June, which showed that the government has struggled for years to stop the health plans from charging too much. The series found that federal officials mad …"

Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

Excerpts from this story referencing "California":

"… we get it through an employer or buy it on our own. But unless you live in California, chances are you won’t find much information about how satisfied people …"

"… cal performance information and complaint ratios is a lot more difficult. California is the only state I know of where you can find data on both, but it’s no …"

"… le of seeking it out. Back in 2000 when Democrat Gray Davis was governor, California began operating an agency called the Office of The Patient Advocate (OPA). …"

"… The most recent report card was released last Wednesday. If you’re a Californian and care as much about good customer service as you do about how much you …"

A call for more scrutiny of private Medicare Advantage plans

By Fred Schulte

Researchers say aggressive billing by private plans may require more scrutiny

Excerpts from this story referencing "Humana":

"… utives of the two biggest Medicare Advantage plans, UnitedHealth Group and Humana, vowed to fight any further rate cuts. The two insurers control about 40 p …"

Obamacare helps millions, but falls short in many ways

By Wendell Potter

The Affordable Care Act has reduced the ranks of the uninsured, but cost of care must be addressed.

Excerpts from this story referencing "Barack Obama":

"… ot just those who have become newly insured over the past year. President Barack Obama cited some of the impressive statistics last Thursday, the day after the o …"

New types of health care delivery are improving the 'patient experience'

By Wendell Potter

Commentary: eliminating role of insurers could improve health care delivery.

Excerpts from this story referencing "Insurance":

"… ue to drive it. Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and …"

'Zombie' homes haunt Florida neighborhoods

By Alison Fitzgerald and Jared Bennett

Neighborhoods devastated by thousands of abandoned homes as banks fail to follow through on foreclosures.

Excerpts from this story referencing "Medicare":

"… forming her that her disability payments, those of her daughter, and their Medicare benefits were being cut off. The Social Security Administration said she l …"

Docs, drug companies, insurers drive up Medicare costs

By Wendell Potter

Commentary: reform drove down hospital costs, creating Medicare savings, but insurers, doctors and drug companies escaped cuts.

Excerpts from this story referencing "health":

"… While it’s uncertain how much of that good news can be attributed to the health care law, some of the provisions aimed at slowing Medicare spending, such …"

"… to cover physician fees, prescription drugs and to provide incentives for health insurance companies to participate in the Medicare Advantage program and a …"

"… uence of the lobbyists who represent doctors, pharmaceutical companies and health insurers. Some lawmakers, including Rep. Henry Waxman, D-Calif., and Sen. …"

"… re physicians in the United States, but it has also contributed to soaring health care costs, especially for Medicare. Congress has also allowed health ins …"

Medicare Advantage patients find themselves in regulatory limbo

By Fred Schulte

States lack oversight but feds are struggling to keep with fast-growing health plans.

Excerpts from this story referencing "Medicare":

"… sota retiree Doug Morphew needed surgery last year, he expected his Humana Medicare Advantage plan to step up and pay the lion’s share of the bill. Morphew …"

"… t Morphew’s formal complaint, and about two dozen others, to Centers for Medicare and Medicaid Services (CMS) administrator Marilyn B. Tavenner. Swanson ask …"

"… .” CMS said it is satisfied that Humana has largely fixed any problems. Medicare pays the privately run health plans — an alternative to traditional Medi …"

"… care pays the privately run health plans — an alternative to traditional Medicare — a set monthly rate for each patient. About 16 million Americans have s …"

Dire predictions of endless waits for a doctor have proven unfounded

By Wendell Potter

Commentary: Obamacare has not resulted in long waits for a doctor.

Excerpts from this story referencing "president":

"… is suffering from a doctor shortage,” wrote Forbes blogger Sally Pipes, president of the Koch brothers-funded Pacific Research Institute, a think tank advoc …"

Ten major findings from our investigations so far this year

By Jared Bennett and Sarah Whitmire

Investigations from the first half of 2014

Excerpts from this story referencing "Medicare":

"… ut reporting to the state. Keep reading 6. About a third of all people on Medicare are covered by health plans that are susceptible to billing abuse Americ …"

"… ealth insurance plans are simply claiming they are. Our investigation into Medicare Advantage found that billions of tax dollars are wasted every year through …"

"… nd that billions of tax dollars are wasted every year through leakage of a Medicare payment tool called a “risk score.” The formula is supposed to pay hea …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "medicine":

"… scores reveal how “financial incentives” can improperly influence how medicine is practiced. “The problem seems significant,” he said. The new stud …"

Feds seek new authority to recoup Medicare Advantage overcharges

By Fred Schulte

Impact: Feds act to recoup overcharges following Center investigation.

Excerpts from this story referencing "Medicare":

"… lic. The case is pending. …"

"… ally, are seeking new power to recover excessive charges. The Centers for Medicare and Medicaid Services says its wants to set up “a formal process to reco …"

"… Center for Public Integrity investigation published last month found that Medicare paid the health plans nearly $70 billion in “improper” payments — mo …"

"… verstating the health risks of patients — from 2008 through 2013 alone. Medicare expects to pay more for sicker patients and less for those in good health …"

Saving the penny makes cents for zinc-backed front group

By Erin Quinn

'Broad-based' group created to save the penny from extinction turns out to be backed by a company that supplies metal to make the coins.

Excerpts from this story referencing "New York Post":

"… coin blanks that are made into currency. In addition, over the years the New York Post, Chicago Tribune, New York Times and CNN have failed to mention American f …"

Medicare Advantage plans require more scrutiny

By Fred Schulte

Government inspector says private Medicare plans difficult to investigate due to lack of access to data.

Excerpts from this story referencing "medicine":

"… erseeing Medicare Advantage and Medicare Part D, which covers prescription medicines. Cantrell cited “limited data availability” and “difficulties with …"

Praise for UK-style health system vindicates spurned nominee

By Wendell Potter

Former Medicare chief's support for UK's health care system may win votes in race for governor of Massachusetts.

Excerpts from this story referencing "Massachusetts":

"… . a central part of his campaign for another high-profile job: governor of Massachusetts. Last week, Berwick got closer to that goal during the state’s Democrat …"

"… nvention when he became one of three candidates to qualify for the Sept. 9 Massachusetts primary. State Treasurer Steven Grossman and Attorney General Martha Coakl …"

"… d try to get a copy of the Commonwealth Fund report in the hands of every Massachusetts voter. And he might be tempted to send an “I told you so” note to a fe …"

Health insurance lobby keeps Medicare Advantage overpayments flowing

By Wendell Potter

Commentary: program bills are excessive, but don't expect reforms.

Excerpts from this story referencing "Medicare":

"… te House, regardless of who is sitting in the Oval Office. The Center’s Medicare Advantage Money Grab investigation, led by veteran reporter Fred Schulte, …"

"… Federal officials made nearly $70 billion in “improper” payments to Medicare Advantage plans from 2008 to 2013, mostly overbillings, by manipulating or …"

"… lans from 2008 to 2013, mostly overbillings, by manipulating or misusing a Medicare payment tool called a “risk score.” From 2007 through 2011, Medicare …"

"… Medicare payment tool called a “risk score.” From 2007 through 2011, Medicare Advantage risk scores rose more than twice as fast as the average for peop …"

Get involved: Help Medicare Advantage investigation go further with donations and news tips

Join us in finding problems with Medicare Advantage billing, “risk scores”, or home visits.

Excerpts from this story referencing "Medicare":

"… y Gordon Witkin.      …"

"… ls that billions of tax dollars are wasted every year through leakage of a Medicare payment tool called a "risk score". Get involved   If you are a hea …"

"… are a health professional or medical coder and have a story to tell about Medicare Advantage billing issues or “risk scores”, please send Fred Schul …"

"… res”, please send Fred Schulte an email. If you are a patient in a Medicare Advantage plan and have been scheduled for a “home visit” let us know …"

Home is where the money is for Medicare Advantage plans

By Fred Schulte

Medicare Advantage home visits may not improve health, but boost risk scores and cost taxpayers billions.

Excerpts from this story referencing "information technology":

"… s, an investment firm whose managing partner and CEO is former Bush health information technology czar Dr. David Brailer, has a stake in CenseoHealth, which does more …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "Medicare Advantage":

"… ng their policies.” …"

"… thanked by industry surrogates for their help in killing some of the same Medicare Advantage cuts he’d previously supported so forcefully. By most accounts it was a …"

"… rs of Congress and the Obama administration, and a forceful flexing of the Medicare Advantage industry’s growing political might in Washington. John Gorman, a top Me …"

"… ge industry’s growing political might in Washington. John Gorman, a top Medicare Advantage consultant, hailed the lobbying victory in early 2013 as a “direct refle …"

Skyrocketing salaries for health insurance CEOs

By Wendell Potter

Commentary: soaring compensation, rising stock prices don't justify higher premiums.

Excerpts from this story referencing "managing director":

"… because they probably haven’t seen this quote, attributed to Paul Dorf, managing director of Compensation Resources Inc., from the May 19 edition, in reaction to in …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "health":

"… plans hundreds of millions of dollars to treat seniors in especially poor health. The findings signaled that billing errors could be deeply rooted within …"

"… le who may require expensive care. But the auditors concluded that all six health plans they visited couldn’t justify the money they took in for 40 percen …"

"… $650 million for 2007 alone — just for those six plans. One major Texas health plan was paid to care for a man it said had brain cancer. But his medical …"

"… hat didn’t merit any added payment, auditors wrote.  In Arizona, a health plan collected thousands of dollars from Medicare to treat congestive hear …"

New audits may recover missing millions — or not

By Fred Schulte

Secretive audits target some Medicare Advantage plans.

Excerpts from this story referencing "Medicare Advantage":

"… ieves. …"

"… o top $150 billion this year. The government audits are targeting chronic Medicare Advantage billing errors that federal officials blame for billions of dollars in “ …"

"… recoup as much as $370 million from overpayments allegedly made to the 30 Medicare Advantage plans during 2011, according to CMS. However, that figure is well below p …"

"… ral, which acts as a watchdog over CMS, has done some of its own audits of Medicare Advantage. It estimated much higher losses in six plan audits it conducted starting …"

150 billion reasons Medicare Advantage matters

By Eleanor Bell

Reporter Fred Schulte discusses his investigation into billions of dollars misspent on Medicare Advantage plans.

Excerpts from this story referencing "Medicare Advantage":

"… should be some accountability. …"

"… llion this year, but our latest investigation found that manipulation of a Medicare Advantage payment tool called a “risk score” is adding billions to the program's …"

"… journalist Fred Schulte. For more than a year, he’s been investigating Medicare Advantage, the government-backed alternative to Medicare for seniors run mostly by p …"

"… out that in a moment, but firstly Fred, let’s start from the beginning: Medicare Advantage was introduced by Congress more than a decade ago to stabilize health care …"