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About the 'Cracking the Codes' project

By The Center for Public Integrity

Behind the reporting

Excerpts from this story referencing "Palantir Technologies":

"… ive Reporters and Editors, but the Center then received pro-bono help from Palantir Technologies, a Silicon Valley software company specializing in integrating, visua …"

Judgment calls on billing make 'upcoding' prosecutions rare

By Fred Schulte

Authorities typically settle, and doctors often continue treating Medicare patients

Excerpts from this story referencing "Medicaid":

"… consultant who spent three decades at the federal Centers for Medicare and Medicaid Services and served as its acting administrator in the early months of the …"

"… April of next year.The indictment alleges that Chirban billed Medicare and Medicaid, the government health plan for the poor, for tens of thousands of patient …"

"… most lucrative billing codes.The doctor billed more than 57,000 claims to Medicaid alone between September 2006 and April 2010. Prosecutors allege that most …"

Hospitals grab at least $1 billion in extra fees for emergency room visits

By Joe Eaton and David Donald

Center probe suggests facilities have taken advantage of government’s failure to set billing standards.
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OPINION: Center series demonstrates dangers of 'captured' regulators

By Wendell Potter

Center series demonstrates dangers of special interest influence

Excerpts from this story referencing "Medicaid":

"… affecting them. In many regards,  the Centers for  Medicare and Medicaid Services (CMS) has become a “captured agency” as a result of decisions …"

OPINION: Who wins with Medicare Advantage?

By Wendell Potter

Medicare Advantage plans are profit centers for private insurance companies because of government incentives to participate.

OPINION: a bit of truth-telling on Obamacare

By Wendell Potter

The rhetoric has obscured the Affordable Care Act's many benefits

Excerpts from this story referencing "Medicaid":

"… n is not going to add trillions to the deficit, even though it will expand Medicaid and provide subsidies to low-income individuals and families to buy privat …"

"… million if all the states agree to accept federal dollars to expand their Medicaid programs.That said, Obamacare is not a panacea for all that ails the U.S. …"

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Blistering inspector general report says feds are failing to fight Medicaid home care fraud

By Joe Eaton

Report says feds not doing enough to root out fraud in Medicaid personal services

Excerpts from this story referencing "Medicaid":

"… home to be homebound to.” …"

"… heila McDonald, for the job. In 2011, McDonald received almost $5,000 from Medicaid for six months of care she provided to Foreman.These personal care service …"

"… General (OIG) report scheduled to be released today faults the Centers for Medicaid and Medicare Services (CMS) for inadequate oversight of personal care serv …"

"… costs are shared by states and the federal government, as is the norm for Medicaid.  The report, which brings together six years of OIG investigations a …"

Hospitals request government help in curbing possible billing abuses

By Fred Schulte

Federal help sought to create billing guidelines and oversee electronic medical records

Excerpts from this story referencing "Medicaid":

"… als. The letter suggests AHA should work with the Centers for Medicare and Medicaid Services to “establish a set of national hospital…guidelines.”Althou …"

Medicare paid $3.6 billion for electronic health records but didn't verify quality goals were met

By Fred Schulte

Medicare paid providers billions to adopt electronic records without checking to see they're meeting quality goals

Excerpts from this story referencing "Medicaid":

"… hem to improve the quality of health care.But the Centers for Medicare and Medicaid Services has since paid out more than $3.6 billion to medical professional …"

Hospital 'facility fees' boosting medical bills, and not just for hospital care

By Fred Schulte

Medicare budget-cutters are targeting extra charges by hospitals

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