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 "Medicare Advantage":

"… s need to do a better job ferreting out billing errors and overpayments to Medicare Advantage plans — mistakes which are estimated to cost taxpayers billions of dolla …"

"… that seem to diagnose much higher-than-expected rates of patient illness. Medicare Advantage plans that have been “significantly more aggressive than average in repo …"

"… group, spent nearly $5 million lobbying on a variety of issues, including Medicare Advantage, from January through June of 2014, according to the Senate records. But …"

"… least three whistleblower lawsuits pending in federal courts have accused Medicare Advantage plans of “upcoding” by overstating how sick patients are to boost prof …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "diabetes":

"… billing for an inordinately high number of patients with complications of diabetes. Despite its broad implications for Medicare spending, the study by HHS r …"

"… . Even more striking, according to the study, is how much higher reported diabetes rates have been in certain health plans than others. The study tracked rap …"

"… began, up to last year, and made them public for the first time. Overall, diabetes with serious complications, which pays higher rates, was reported as much …"

Critic of artificial sweeteners pilloried by industry-backed scientists

By Chris Young

Any criticism of the artificial sweetener industry is met with a barrage of criticism, often from questionable sources.

Excerpts from this story referencing "diabetes":

"… be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease.” Seizing on the “opinion” tag, the foo …"

"… ted them with short- and long-term health problems, including weight gain, diabetes, cardiovascular disease — even cancer. The conflicting studies have spar …"

"… f sugary foods and beverages that are more clearly tied to weight gain and diabetes. But when it comes to long-term health effects, he says, “There is some …"

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 "Water":

"… risk-management decision that was made by U.S. EPA under the Safe Drinking Water Act that takes into account the health effects but also the cost of mitiga …"

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 "Medicare Advantage":

"… itizens who called Arizona insurance agent Denise Early wondered why their Medicare Advantage health plans were eager to send a doctor to visit them at home. A few wor …"

"… e cottage industry is flourishing as federal officials struggle to prevent Medicare Advantage plans from overcharging the government by billions of dollars every year, …"

"… has found. Medicare made nearly $70 billion in “improper” payments to Medicare Advantage plans from 2008 through 2013, mostly overbillings based on inflated risk s …"

"… ons posed in writing. Limiting the house calls could have cut payments to Medicare Advantage plans by nearly $3 billion a year, according to a report prepared for the …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "Medicare Advantage":

"… indings signaled that billing errors could be deeply rooted within private Medicare Advantage plans — which contract with the federal government to care for nearly 16 …"

"… eturned. The Center for Public Integrity’s yearlong investigation of the Medicare Advantage industry found that federal officials over the past decade have missed mul …"

"… s C. Hill said insiders have known of “significant problems” with Medicare Advantage billing practices for years. But they’ve received scant public notice be …"

"… ive to do more to earn more. Medicare adjusts the risk scores used in the Medicare Advantage program based on more than 70 conditions and their severity. That can mean …"

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 "lobbyist":

"… nally tried to overpay them a little bit,” said Scully, now a Washington lobbyist with numerous health care industry clients. Health status was added to ot …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

Excerpts from this story referencing "diabetes":

"… Medicare Advantage plans that enroll people with chronic diseases such as diabetes and take other steps to manage their care. …"

Health care costs will mushroom as injured veterans age

By Jessica Wilde

News21 investigation finds injured veterans returning from Iraq, Afghanistan will need costly care for decades.

Excerpts from this story referencing "diabetes":

"… s likely will lead to other medical issues, ranging from heart disease to diabetes, for example, as post-9/11 veterans age. “So we have the same phenomeno …"

"… smoking, substance abuse, depression, anxiety, heart disease, obesity and diabetes. Amputations are associated with obesity, cardiovascular disease, osteoart …"

"… eight at age 30 to 40, rather than treating his coronary artery disease or diabetes at age 50,” Geiling, Rosen and Edwards wrote. “Society is not yet con …"

OPINION: smoothing out Medicaid's 'churn'

By Wendell Potter

Proposed legislation would protect folks from briefly losing benefits.

Excerpts from this story referencing "Medicaid":

"… That’s because it only affects the poorest among us who are eligible for Medicaid. The problem is referred to by policy wonks as “churn.” Because of th …"

"… problem is referred to by policy wonks as “churn.” Because of the way Medicaid is administered by the states, millions of Americans enrolled in the progr …"

"… m the rolls simply because they can’t take time off from work to go to a Medicaid office to re-verify their incomes every three months, which some states re …"

"… rance industry jargon — are eventually reinstated. Their eligibility for Medicaid never changed. They lost coverage solely because of paperwork requirements …"

In India, verdant terrain conceals clues to a fatal kidney disease

By Sasha Chavkin

How a rare kidney disease is killing laborers and vexing researchers in three countries.

Excerpts from this story referencing "India":

"… t his family. “If the disease continues, no one will be here.” …"

"… villagers of this remote agricultural belt in the state of Andhra Pradesh, India. In some villages, the disease has impacted from 24 to 37 percent of the p …"

In Sri Lanka, breakthroughs, setbacks and a spiritual touch

By Sasha Chavkin and Anna Barry-Jester

How a rare kidney disease is killing laborers and vexing researchers in three countries.

Excerpts from this story referencing "diabetes":

"… a. Its victims are mostly male agricultural workers who do not suffer from diabetes or hypertension, the usual causes of the illness. The government and WHO c …"

As kidney disease kills thousands across continents, scientists scramble for answers

By Sasha Chavkin

How a rare kidney disease is killing laborers and vexing researchers in three countries.

Excerpts from this story referencing "India":

"… cept a kidney donation that offers his only chance of survival.In Uddanam, India, a reed-thin farmer named Laxmi Narayna prepares for the grueling two-day …"

"… cting thousands of people in rural, agricultural communities in Sri Lanka, India and Central America. The struggle to identify its causes is baffling resea …"

"… n cause, though other sources put the number more than double that. In the Indian state of Andhra Pradesh, more than 1,500 have been treated for the ailmen …"

"… logist at Harvard Medical School who is leading a study of the epidemic in India. “Our premise should be to first look for common causes.”The response …"

Report: Too little mental health care for boomers

By The Associated Press

Aging boomers to face hard time finding mental health care; report urges geriatric training

Excerpts from this story referencing "diabetes":

"… side, older adults with untreated depression are less likely to have their diabetes, high blood pressure and other physical conditions under control — and c …"

Health care options for young, healthy and broke

By The Associated Press

Insurance options for those with lots of health, little wealth: Is the cheapest choice best?

Excerpts from this story referencing "Medicaid":

"… take time to sort through the complicated law. Many will get Medicaid coverage at virtually no cost. Others will qualify for private insurance a …"

"… overage this way. CONSIDER Medicaid Right now, Medicaid mostly covers children and low-income adults who are disabled, pregnant or …"

"… egnant or raising kids. But the health care law will push states to expand Medicaid to also cover other adults with incomes up to around $15,000, adjusted for …"

"… tly ruled that the federal government can't coerce states into joining the Medicaid expansion. Some states may decline to add people to their rolls. …"

ANALYSIS: Why the insurance industry needs Obamacare to stay in business

By Wendell Potter

The insurance industry is banking on the individual mandate.

Excerpts from this story referencing "diabetes":

"… old, the chronically ill, and those with pre-existing conditions, such as diabetes.” And here’s what Larry English, the former president of Cigna He …"

Support our new investigation into a deadly disease killing agricultural workers

By Ellen Weiss

Support our investigation of a disease that is killing workers around the world.

Excerpts from this story referencing "diabetes":

"… dney disease is a manageable illness that mostly affects older people with diabetes and high blood pressure. But in Central America, each year thousands of ag …"

ANALYSIS: Slogans versus substance in the battle over ObamaCare's future

By Wendell Potter

Tea Party slogans distort the Affordable Care Act.

Excerpts from this story referencing "diabetes":

"… re born with disabilities or who developed life-threatening illnesses like diabetes or cancer. It was perfectly legal for them to refuse to sell coverage to a …"

ANALYSIS: This just in, insurers required to speak plain English

By Wendell Potter

Obamacare rule requires health insurers to speak plain English

Excerpts from this story referencing "diabetes":

"… xamples — like what and how much a particular plan will cover if we have diabetes or if we get pregnant and how much we’ll have to pay out of our own pock …"

Brominated battle: Soda chemical has cloudy health history

By Brett Israel

Experts now urge a closer look at a chemical, banned in other countries, now popping up in U.S. sodas.

Excerpts from this story referencing "Brominated flame retardant":

"… case of flame retardants, slows down chemical reactions that cause a fire.Brominated flame retardants lately are under intense scrutiny because research has shown that they ar …"

ANALYSIS: Despite GOP claims, U.S. health care nowhere near 'best' in the world

By Wendell Potter

Americans pay more for health care than anyone in the world, but our system is not the best

Excerpts from this story referencing "Chile":

"… s, per 1,000 people.In terms of life expectancy, we rank 28th, just behind Chile. The average age of death in the U.S. is 78.2, well below the average of 7 …"

ANALYSIS: Losing the public relations war

By Wendell Potter

ObamaCare backers are being outhistled

Excerpts from this story referencing "diabetes":

"… worse than Americans when it comes to surviving cancer, being treated for diabetes, getting a hip replacement when needed and getting an appointment with a s …"

ANALYSIS: Obama plan helping those with pre-existing health conditions

By Wendell Potter

Obama health plan will prevent insurance firm denials for pre-existing conditions

Excerpts from this story referencing "diabetes":

"… .The list for automatic denial is long. It includes heart disease, cancer, diabetes, multiple sclerosis, muscular dystrophy and stroke and even allergies and …"

Podiatrists have their foot in the door

By Josh Israel and Kimberly Leonard

Podiatrists are taking advantage of payments for installing electronic health records

Excerpts from this story referencing "Medicaid":

"… providers,” Christina said. In May, the Centers for Medicare & Medicaid Services (CMS) released a list of the first 320 recipients of “meaningfu …"

Doctors skittish about health technology despite promise of big federal bucks

By Susan Jaffe

The federal government is paying physicians billions to adopt electronic health records, but doctors still aren't sure they want the cash

Excerpts from this story referencing "Medicaid":

"… patients in Medicare. Or, if she cares for a certain number of low-income Medicaid patients, she could earn as much as an extra $63,750 over six years.The do …"

"… payments to physicians and hospitals nationwide. Another $114.5 million in Medicaid bonuses has been distributed to health care providers through May 31)She …"

"… qualify for the bonus payments under that program. They may be eligible as Medicaid providers for the electronic health record bonus if at least 30 percent of …"

"… ronic health record bonus if at least 30 percent of their patients receive Medicaid. Their portion of Medicaid patients hovers around 26 to 30 percent. After …"

Nursing home patients put at risk by antipsychotic drugs, IG says

By Laurel Adams

Medicare claims for antipsychotic drugs given to nursing home patients in question

Excerpts from this story referencing "diabetes":

"… stem problem; tardive dyskinesia, a movement problem; high blood sugar and diabetes; and very low blood pressure resulting in dizziness and fainting.In 2009, …"

During Mitch Daniels’ decade at Eli Lilly, the drug giant paid billions in fines and settled thousands of lawsuits

By Joanne Kenen and Rochelle Sharpe

Eli Lilly paid billions in fines, settled thousands of lawsuits while Daniels was an executive at the drug giant

Excerpts from this story referencing "Indiana":

"… ews reporters Laurel Adams and Aaron Mehta contributed to this story.  …"

"… Woodley, financial analyst at Woodley Farra Manion Portfolio Management in Indianapolis.“He was an idea man, a thinker, and that’s why he ended up as hea …"

"… $2.6 billion, Woodley said.Cutting his teeth on politicsDaniels grew up in Indiana, and was in and out of politics, starting as a young aide to then-Indianap …"

"… Indiana, and was in and out of politics, starting as a young aide to then-Indianapolis Mayor Richard Lugar in the 1970s. He moved to Washington when Lugar w …"

Will digital technology reduce gap in health between rich and poor?

By Emma Schwartz

Two years ago, the Ethio American Health Center opened its doors in the nation’s capital, promising the country’s largest community of Ethio

Excerpts from this story referencing "diabetes":

"… spitals and clinics. They also have higher rates of chronic illnesses like diabetes and hypertension, conditions that some research has shown digital technolo …"

"… are uninsured, and many learn for the first time they have hypertension or diabetes. “It makes a difference to put money in prevention than waiting until pe …"

Are new digital networks part of the cure?

By Emma Schwartz

Targeting the chronically ill, Obama Administration bets millions

Excerpts from this story referencing "Congressional Budget Office":

"… dherents among some of the nation’s largest health care plans.In 2005, a Congressional Budget Office report found “insufficient evidence” to conclude the programs reduce h …"

Can Cleveland clinic be a model for digital medicine?

By Emma Schwartz

Hospital’s success with electronic records raises hope and caution

Excerpts from this story referencing "Toronto":

"… s throughout the city's suburbs as well as campuses in Florida, Las Vegas, Toronto and Abu Dhabi.While the majority of the hospital's clients come from close …"