GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

Excerpts from this story referencing "Health":

"… plans, you can go to Healthcare.gov, maintained by the U.S. Department of Health and Human Services, or a private online source like Healthinsurance.org, w …"

"… patient experience. They were followed by Blue Shield of California, Sharp Health Plan (in greater San Diego), and Western Health Advantage (in the Sacramen …"

"… hield of California, Sharp Health Plan (in greater San Diego), and Western Health Advantage (in the Sacramento area). All of those plans are also nonprofits …"

"… ts. The plans with the fewest stars were Aetna, Anthem Blue Cross, Cigna, Health Net and UnitedHealthcare of California, all for-profit companies. Convers …"

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 "Washington":

"… ect scam,” said Patrick Burns, co-director of Taxpayers Against Fraud in Washington. “You simply systematically up-code conditions and that results in massi …"

"… g involved, the Medicare Advantage payment dispute is the sort of issue in Washington that barely registers outside of a small circle of policy wonks and indust …"

"… y lobbyists, who often rule the day in influencing government policy. In a Washington meeting last week, executives of the two biggest Medicare Advantage plans, …"

How a coal miner's autopsy proved a top doctor wrong

By Chris Hamby

When a coal miner's lungs finally gave out, his autopsy proved a top doctor was wrong — giving hope to thousands of other miners.

Excerpts from this story referencing "Health":

"… -ray-reading program at the National Institute for Occupational Safety and Health (NIOSH), which licenses physicians such as Wheeler to examine films for bl …"

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 "Health":

"… s in It for Me? What Everyone Needs to Know About the Affordable Care Act. …"

"… fact, in some ways they have been part of the problem. Providence-Swedish Health Alliance, a not-for-profit, hospital-based accountable care organization ( …"

"… he Health insurance market are hiring companies like Chicago-based Valence Health, a fast-growing firm that offers services ranging from claims adjudication …"

"… in: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for M …"

Taking insurance companies out of health care

By Wendell Potter

If Boeing experiment flies, health care system could be transformed.

Excerpts from this story referencing "Health insurance":

"… and even to hospitals that are looking to operate their own health plans. Health insurance in this country was initially provider-based and community-rated. The firs …"

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 "Health":

"… out. To find out if the critics’ were prescient or way off base, Kaiser Health News reporter Phil Galewitz went looking for problems. He didn’t find ma …"

National Academy of Sciences agrees with EPA that formaldehyde causes cancer

By David Heath

To the chemical industry's chagrin, a National Academy of Sciences review found that formaldehyde causes cancer.

Excerpts from this story referencing "Formaldehyde":

"… he American Chemistry Council, said in a statement titled “The Safety of Formaldehyde is Well-Studied and Supported by Robust Science.” Part of the disparity …"

"… ademy concluded on Friday that Formaldehyde is indeed a known carcinogen. Formaldehyde is widely used in wood products and clothing. In a blog posting, Jennifer …"

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 "NBC Universal":

"… Back in 2011, Comcast wanted to ease federal approval of its merger with NBC Universal, so it promised to offer Internet access at a rate affordable to low-incom …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Insurance":

"… boost payment rates. Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group, said the higher billing resulted from …"

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 "Health":

"… luating the proposal,” said Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group. Congress created Medicare A …"

"… s were presented at a conference of the American Society of Health Economists in Los Angeles on June 25. “Our study is the first that can …"

"… late May, the Center for Public Integrity sued the Department of Health and Human Services to make its audits and other records public. The case i …"

Even low doses of arsenic trigger cancer in mice, study finds

By David Heath

Study by the National Institutes of Health found levels of arsenic similar to what some people consume caused cancer in mice.

Excerpts from this story referencing "United States":

"… he lowest dose is similar to amounts some people with private wells in the United States drink. The Center for Public Integrity recently exposed how lob …"

"… senic to which people are exposed. The current drinking-water limit in the United States is 10 parts per billion. “Although this is only one study, it adds to a …"

What to do if your drinking water contains arsenic

By David Heath

Millions of Americans unwittingly consume arsenic, a potent carcinogen also linked to IQ deficits in children, in their drinking water.

Excerpts from this story referencing "diabetes":

"… e include bladder, lung, liver and skin cancer, heart disease, strokes and diabetes. Recent studies have suggested that arsenic may cause IQ deficits in child …"

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 "Health":

"… or says. Gary Cantrell, a deputy Inspector General with the Department of Health and Human Services said reviews are “hampered by a lack of accurate, tim …"

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 …"

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 "chronic diseases":

"… rson a year, more for people in poor health, including those with multiple chronic diseases. The billing process is extremely complicated. More than 70 health condit …"

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 …"

Why Medicare Advantage costs taxpayers billions more than it should

By Fred Schulte, David Donald and Erin Durkin

Critics warned of billing abuse in Medicare Advantage health plans, but oversight is lagging.

Excerpts from this story referencing "Medicaid":

"… vantage has faced much less scrutiny. The federal Centers for Medicare and Medicaid Services didn’t try to recoup overpayments until 2012, eight years after …"

Whistleblower suit says health plan cheated government out of more than $1 billion

By Fred Schulte

Lawsuit: executives worried health plan would be ‘screwed’ if feds heard of overcharges.

Excerpts from this story referencing "Josh Valdez":

"… hile the potential liability to the government “remained unaddressed.” …"

Explaining Medicare Advantage, and why it matters to you

By Fred Schulte and Sarah Whitmire

Explaining risk scores, Medicare Advantage and what alleged overbilling could mean for the Affordable Care Act.

Excerpts from this story referencing "Medicare Advantage":

"… can answer it, we'll do so and add it here. …"

"… e will pay for. This option is called “fee-for-service.” By contrast, Medicare Advantage plans accept a set fee from the government for covering a person’s healt …"

"… nd eyeglasses and cost patients less out of pocket than standard Medicare. Medicare Advantage is growing rapidly and now serves about 16 million people, about a third o …"

"… hat are risk scores? A risk score is a formula the government uses to pay Medicare Advantage plans. The system is supposed to pay higher rates for sicker patients that …"

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

Excerpts from this story referencing "senior reporter":

"… ars every year. As part of a Center investigation into the billing issue, senior reporter Fred Schulte requested records from the Centers of Medicare and Medicaid S …"

A different way of thinking about health care

By Wendell Potter

Commentary: Canadians take pride in their health care system.

Excerpts from this story referencing "Medicare":

"… ensure the continued financial viability of their system, which they call Medicare, no one in Ottawa of any ideological stripe would dare suggest doing much …"

The Canadian health care system I disparaged

By Wendell Potter

Commentary: health care system up north is more efficient.

Excerpts from this story referencing "Medicine":

"… RAND Corporation found in a 2004 study published in the Annals of Internal Medicine that the VHA outperformed all other sectors of the U.S. health care system …"

American-style health care system pushed in Canada

By Wendell Potter

Canada's conservative Prime Minister Stephen Harper wants to remake nation's health care system.

The health care industry's campaign of fear, uncertainty and doubt

By Wendell Potter

Commentary: health insurers use a host of tactics to erode support for Obamacare.

Excerpts from this story referencing "California":

"… e advocacy organization, released the following statement in response to a California rally held by Michael Moore and a variety of advocates in support of a gov …"

Dental chain may be booted from Medicaid program

By David Heath

Small Smiles, under federal scrutiny for performing unnecessary dental treatments on children, could be barred from the Medicaid program.

Excerpts from this story referencing "Medicaid":

"… April 3, 2014: Small Smiles will no longer be allowed to serve patients on Medicaid started Sept. 30, affecting hundreds of thousands of children, the inspect …"

"… t doesn't plan to appeal the decision, which will bar the company from the Medicaid program for five years. Small Smiles, which has been under federal scruti …"

"… orming unnecessary dental treatments on children, could be barred from the Medicaid program beginning next month. The inspector general of the Department of …"

"… new dentist willing to treat them. Small Smiles will be excluded from the Medicaid program in early April unless it appeals the decision. The owner of the co …"

Dizzying array of options in Obamacare can lead to expensive mistakes

By Wendell Potter

Commentary: Health insurers offer a wide range of plans on exchanges, customers should pay attention to the details.

Excerpts from this story referencing "advocate":

"… her money over the Aetna plan she had last year. Donna is just as much an advocate for a single-payer system as she ever was, but she believes the Affordable …"

GOP megadonor Harold Simmons bankrolled liberal causes

By Dave Levinthal

The charitable foundation of the late Harold Simmons contributed big bucks to Planned Parenthood, other left-leaning causes in 2012.

CDC launches industry-financed studies of deadly kidney disease in Central America

By Sasha Chavkin

The CDC launches industry-funded research into a kidney disease killing thousands of Central American agricultural workers.

Excerpts from this story referencing "Medicine":

"… jective science,” said Dr. Cary Gross, a professor at the Yale School of Medicine and its Program for Biomedical Ethics. The “occupational illness” div …"

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