3:37 pm
Thu July 30, 2015

Meet The California Family That Has Made Health Policy Its Business

Peter Lee, executive director of Covered California, (left) poses with his uncle, Philip Lee, and father Peter Lee (seated) at the younger Peter Lee's home in Pasadena, Calif., in 2013.
Gina Ferazzi LA Times via Getty Images

Originally published on Thu July 30, 2015 6:24 pm

If there's such a thing as the first family of health care, the Lees may be it.

Five decades ago, two brothers helped start Medicare. Their father inspired them and they, in turn, have inspired the next generation.

To mark the anniversary of President Lyndon Johnson signing Medicare into law on July 30, 1965, three Lees sat down to reflect on the U.S. health care system.

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10:58 am
Wed July 29, 2015

Progress For Bill To Bolster Medicare Patients' Hospital Rights

Hospitals can call people who stay overnight outpatients, a classification that can have surprising financial consequences.

The Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but haven't been admitted to the hospital as inpatients.

The distinction is easy for patients to miss — until they get hit with big medical bills after a short stay.

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11:15 am
Tue July 28, 2015

Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier

A Yale University study analyzed the experience of 60 million Americans covered by traditional Medicare between 1999 and 2013, and found "jaw-dropping improvements in almost every area," the lead author says.
Ann Cutting Getty Images

Originally published on Thu July 30, 2015 8:49 am

Here's a bit of good news for Medicare, the popular government program that's turning 50 this week. Older Americans on Medicare are spending less time in the hospital; they're living longer; and the cost of a typical hospital stay has actually come down over the past 15 years, according to a study in the Journal of the American Medical Association.

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12:05 pm
Mon July 27, 2015

Experiment In Coordinated Care For Medicare Failed To Show Savings

Coordinating care for high-risk patients was expected to save money and improve quality of care. A Medicare experiment didn't pan out.
Roy Scott Getty Images/Ikon Images

A $57 million experiment to provide better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money, says a government report on the project.

The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services' innovation center.

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3:13 pm
Thu July 16, 2015

Home Health Agencies Get Medicare's Star Treatment

Choosing a home health agency can be even more difficult than picking a nursing home.

The federal government released on Thursday a new five-star rating system for home health agencies, an effort to bring clarity to a fast-growing but fragmented corner of the medical industry where it's often difficult to distinguish good from bad.

Medicare applied the new quality measure to more than 9,000 agencies based on how quickly visits began and how often patients improved while under their care. Nearly half received average scores, with the government sparingly doling out top and bottom ratings.

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5:03 am
Fri July 10, 2015

Federal Audits Of Medicare Advantage Reveal Widespread Overcharges

Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients.

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12:03 am
Tue June 23, 2015

Fraud Still Plagues Medicare's Prescription Drug Program


Originally published on Tue June 23, 2015 11:39 am

Fraud and abuse continue to dog Medicare's popular prescription drug program, despite a bevy of initiatives launched to prevent them, according to two new reports by the inspector general of Health and Human Services.

Their release follows the arrests of 44 pharmacy owners, doctors and others, who last week were accused of bilking the program, known as Part D.

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The Two-Way
12:59 pm
Fri June 19, 2015

Doctors, Nurses Among 243 Charged In Million-Dollar Medicare Schemes

Attorney General Loretta Lynch speaks about a federal crackdown on Medicare fraud. With her are HHS Inspector General Daniel R. Levinson (from left), HHS Secretary Sylvia Mathews Burwell, FBI Director James B. Comey and Assistant Attorney General for the Criminal Division Leslie R. Caldwell.
T.J. Kirkpatrick Getty Images

Originally published on Fri June 19, 2015 2:59 pm

Federal agents have arrested 243 people — including 46 doctors, nurses and other medical professionals — who are accused of running up more than $700 million in false Medicare billings. Charges range from fraud and money-laundering to aggravated identity theft and kickbacks.

Attorney General Loretta Lynch calls it "the largest criminal health care fraud takedown in the history of the Department of Justice."

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5:03 am
Wed June 17, 2015

Documents Reveal Secret Legal Battle Over Medicare Overbilling

Originally published on Fri June 19, 2015 11:46 am

Federal officials have spent years locked in a secret legal battle with UnitedHealth Group, the nation's biggest Medicare Advantage insurer, after a government audit detected widespread overbilling at one of the company's health plans, newly released records show.

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8:40 am
Tue June 9, 2015

Highest-Charging U.S. Hospitals Are For-Profit And Concentrated In Florida

Originally published on Tue June 9, 2015 11:01 am

Talk about sticker shock: Some U.S. hospitals charge patients more than 10 times the rates paid by Medicare.

Of the 50 U.S. hospitals with the highest charges, 49 are for-profit institutions, 20 operate in Florida, and half are owned by a single chain, according to a study published in the journal Health Affairs Monday.

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