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 "consultant":

"… ping patients who were ill,” said Laurence Bishoff, a Boston health care consultant. Congress thought it saw a remedy in the Medicare Modernization Act of 20 …"

"… a former federal health official who is now a prominent Medicare Advantage consultant. Others blame the sheer complexity of risk-scoring for causing confusion …"

The other Washington could hold the key to Medicare's cost crisis

By Joe Eaton

Washington state won't pay for medical procedures that don't work. Why can't Medicare do that?

Excerpts from this story referencing "Arkansas":

"… decision advisory project with 13 member states as diverse at New York and Arkansas. States, which are required to balance their budgets “can’t say, ‘we …"

Eyelid lifts skyrocket among Medicare patients, costing taxpayers millions

By Joe Eaton and David Donald

Medicare paying more and more as critics question rationale for procedure that's often cosmetic.

Excerpts from this story referencing "California":

"… cosmetic.” Dr. Bruce Quinn, who served as Medicare medical director of California’s Medicare Part B program from 2004 to 2008, said monitoring blepharopla …"

"… uinn said although the explosion of blepharoplasty caught his attention in California, it was “pretty slippery to get a handle on.” In most cases, Medicare …"

"… ims, instituted a pre-payment probe of functional eyelid surgery claims in California, Nevada, Hawaii and the Pacific Islands. In California, where the probe is …"

"… d surgery claims in California, Nevada, Hawaii and the Pacific Islands. In California, where the probe is complete, Palmetto denied nearly 62 percent of claims …"

How doctors and hospitals have collected billions in questionable Medicare fees

By Fred Schulte and David Donald

Center investigation suggests cost from upcoding and other abuses likely tops $11 billion.

Excerpts from this story referencing "California":

"… . In May 2011, Medicare contractor Palmetto GBA notified more than 11,000 California doctors that it would begin auditing their claims for office visits after …"

"… icare patients if the government doesn’t back off. In December of 2011, California Medical Association president Dr. James T. Hay fired off a letter to feder …"

OPINION: Guess who would benefit from privatizing Medicare?

By Wendell Potter

Privatizing Medicare would help insurers, not seniors.

Excerpts from this story referencing "chief actuary":

"… ause of those overpayments, according to Congressional testimony by CMS’ chief actuary. That’s why, despite intense lobbying by the insurance industry, Congres …"

Top health information technology firms prefer 'revolving door' lobbyists

By Josh Israel

Top health information technology firms want lobbyists with Capitol Hill or executive branch experience

Excerpts from this story referencing "Obama":

"… h. The American Recovery and Reinvestment Act (ARRA) of 2009 — President Obama’s economic stimulus bill — contained more than $27 billion to promote …"

Washington lobbying giants cash in on health reform debate

By Joe Eaton, M.B. Pell and Aaron Mehta

While patients, taxpayers and lawmakers debate the impact of the health care reform law President Obama signed on Tuesday, one result of the

Excerpts from this story referencing "administrator":

"… byists to push their clients’ agendas, including Thomas Scully, a former administrator of the Centers for Medicare and Medicaid Services under President George W …"