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":

"… lth system,” Dr. Elliott Fisher, director of the Dartmouth Institute for Health Policy and Clinical Practice, was quoted as telling The Seattle Times. “ …"

"… Health insurers are quickly diversifying. Just two weeks ago, Modern Healthcare noted that because Health insurers are now required to spend at l …"

"… expect to realize higher returns. The magazine cited as an example UnitedHealth Group’s Optum division, which works in technology and population Health …"

"… th in operating earnings. Meanwhile, in its core insurance business, UnitedHealth saw its 2013 operating margin decline to 6.4 percent, down from 7.6 percen …"

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 "American Chemistry Council":

"… eing declared a known carcinogen. The industry’s chief lobby group, the American Chemistry Council, has persuaded members of Congress that the findings of both the Environme …"

"… e 2011” report, Cal Dooley, president and chief executive officer of the American Chemistry Council, said in a statement titled “The Safety of Formaldehyde is Well-Studied …"

"… fer Sass, a scientist at the Natural Resources Defense Council, called the American Chemistry Council’s efforts “a vicious attack on government scientific assessments [mean …"

"… f the 2011 formaldehyde review. Forty-seven assessments are affected. The American Chemistry Council said in its statement that the academy “misses an opportunity to advance …"

Ten major findings from our investigations so far this year

By Jared Bennett and Sarah Whitmire

Investigations from the first half of 2014

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Health":

"… years. Analyzing government data never before made public, Department of Health and Human Services researchers found that many plans exaggerate how sick t …"

"… are and Medicaid Services, part of HHS. Kronick directs the HHS Agency for Healthcare Research and Quality, whose mission is to improve Health care delivery …"

"… said Dr. David Wennberg, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice who has studied Medicare billing trends. Hea …"

"… lth Policy and Clinical Practice who has studied Medicare billing trends. Health care fraud expert Malcolm Sparrow, a professor at Harvard’s Kennedy Scho …"

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.

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.

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 "Health":

"… a 2008 speech commemorating the 60th anniversary of the U.K.’s National Health Service (NHS). The headline of a story on the website of the conservative …"

"… out Berwick at the time: “CMS Nominee Favors Government-Run Rationing of Health Care.” The story went on to quote Berwick as having said in England, …"

"… several countries on dozens of performance measures, the U.K.’s National Health Service ranked No. 1 in the world. The U.S. didn’t come close to the top …"

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.

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 "Health":

"… mplications of diabetes to a history of heart trouble that’s flared up. Health plans can profit because Medicare pays them higher rates for sicker patien …"

"… ng to a report prepared for the insurance industry’s trade association. Health plans argue that home visits help them meet a patient’s total Health car …"

"… n Ignagni, president of the industry’s powerful trade group, America’s Health Insurance Plans, in a March 7, 2014 letter to CMS argued that the agency h …"

"… nment limits public access to billing data. But risk scores at one plan, XLHealth Corp., based in Maryland, jumped by at least 20 percent between 2007 and t …"

150 billion reasons Medicare Advantage matters

By Eleanor Bell

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

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 "Health":

"… their services. Clare Krusing, director of communications for America’s Health Insurance Plans, said that the industry trade group is “working together …"

"… cted overpayments to Health plans that date back as far as 2007. Excellus Health Plan, the Rochester, New York, Health plan that federal auditors said may …"

"… e data out,” said Dr. Brian Biles, a professor in the Department of Health Policy at George Washington University, whose Freedom of Information Act l …"

"… ugh it. There are always vested interests in protecting the status quo.” Health care politics The Affordable Care Act, or Obamacare, orders deep rate cut …"

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 "Health":

"… er government Health official claims, he discovered that the plans — MMM Healthcare and PMC Medicare Choice — had been cheating Medicare out of hundreds …"

"… ultant who headed the California regional office of the U.S. Department of Health and Human Services from 2001 through 2003 under President George W. Bush. …"

"… Aveta’s Puerto Rico Health plans and MSO are now operated by InnovaCare Health Solutions, according to the firm’s website. InnovoCare has the same Fort …"

"… ts 2012 annual financial report to insurance officials in Puerto Rico, MMM Healthcare stated that it had not been subject to a CMS payment audit. However, …"

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.

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

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 "Insurance":

"… eanwhile, back in the states, Karen Ignagni, the CEO of America’s Health Insurance Plans, claimed during a recent C-SPAN interview that people longed for the …"

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.

Excerpts from this story referencing "Insurance":

"… e campaign behind the scenes was the trade association, America’s Health Insurance Plans. With help from a right-wing Canadian outfit called the Fraser Insti …"

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 "Insurance":

"… re representatives of the industry’s big trade group, America’s Health Insurance Plans, and one of its PR firms, APCO Worldwide. The AHIP and APCO staffers …"

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.

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.

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 …"

Massachusetts tackles next phase of health care reform: controlling costs

By Wendell Potter

Massachusetts leading the way in effort to control costs.

A challenging two-step: cutting costs and covering the uninsured

By Wendell Potter

Commentary: the political challenges of both cutting costs and providing health care coverage.

Obamacare and emergency rooms: a bit of perspective needed

By Wendell Potter

Commentary: Oregon study cited by critics requires perspective.

Lauded public health researcher also worked for industry, revealing entanglements of science

By David Heath

A late UC Berkeley dean pushed public health reforms — while also working for industry, revealing the deep reach of corporate science.

Excerpts from this story referencing "Medicine":

"… well as a member of the National Academy of Sciences and the Institute of Medicine. She was also selected to serve on a panel during the Clinton administrat …"

Berkeley training helps researchers 'work around' potential conflicts

By David Heath

New NIH conflict rules don't do enough, senator says, to weed out conflicts between researchers and industry: A UC Berkeley case study.

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