Medicare Advantage Billing Errors Cost Taxpayers Billions

This story was published by The Center for Public Integrity, a nonprofit, nonpartisan investigative news organization in Washington, D.C.

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

Foot Care Professionals Call for Increased Investment in Prevention

Two-thirds of amputations nationwide are paid for by Medicare – but reimbursement for basic foot care services is complex

People with diabetes are 50 times more likely to develop a foot ulcer than those without, and diabetes-related foot problems are a leading cause of hospital admissions among people with diabetes. It’s the number one cause of medical amputations, which run a total cost of $80,000, including the surgery itself, wound care, prosthetic fitting and follow up treatment, according to the Centers for Disease Control and Prevention.

Wyden Wants Kitzhaber’s Reforms Applied to Medicare

The Lund Report
Oregon’s senior U.S. senator explained at a Sunday townhall that legislation released last week would offer global payments to primary care homes that pledge to care for the chronic illnesses of Medicare clients.

Teams of doctors, physician assistants, nurses and community health workers would be encouraged to work more closely to treat chronically sick Medicare patients under a bipartisan proposal being pushed in Congress by U.S. Sen. Ron Wyden of Oregon.

Nine Oregon Hospitals Rewarded for Quality Care

The Lund Report
Medicare’s bonuses top out at 0.39%, while most hospitals receive penalties instead
Oregon’s hospital leaders often complain that Medicare doesn’t pay enough to cover their costs. But nine hospitals in the state are about to start receiving more money for treating Medicare patients, as a reward for providing high-quality care and reducing hospital readmissions.

Lobbying Congress for Medicare Reimbursement

The Lund Report
Bipartisan consensus that funding formula is broke – question is how to fix it


July 29, 2013 -- Just removed from a whirlwind trip to the nation’s capital, Bend-based physical therapist and consultant Tannus Quatre reported encouraging news in the struggle to reform Medicare reimbursement practices in the U.S.

Uninsured Charged Much More Depending on the Clinic

The Lund Report
The prices for cataract surgery for an uninsured patient vary from $2,500 to more than $8,000 depending on whether the clinic is located in Bend, Portland or Salem

February 25, 2013 -- At 63 and self-employed, I'm too young for Medicare, I make too much money to qualify for Medicaid, but I don't make nearly enough to afford an individual insurance policy.

Don Berwick: Medicare Payments Favor Hospitals

The Lund Report
The former administrator of the Centers for Medicare and Medicaid Services speaks at a conference in Portland next week

December 6, 2012 – Dr. Don Berwick believes the Triple Aim is critical to the success of healthcare reform over the next few years. That means better care for individuals, better health for populations and lower healthcare costs.

“The fundamental flaw in American healthcare is fragmentation,” said the former administrator of the Centers for Medicare and Medicaid Services, who appears in Portland next Thursday to keynote the 2012 State of Reform Conference.

Private insurers have cost Medicare $282.6 billion in excess payments since 1985

The Lund Report
Researchers say privately run Medicare Advantage plans have undermined traditional Medicare’s fiscal health and taken a heavy toll on taxpayers, seniors and the U.S. economy

October 15, 2012 -- In the first study of its kind, a group of health policy experts has determined the amount of money that Medicare has overpaid private insurance companies under the Medicare Advantage program and its predecessors over the past 27 years and come up with a startling figure: $282.6 billion in excess payments, most of them over the past eight years.

That’s wasted money that should have been spent on improving patient care, shoring up Medicare’s trust fund or reducing the federal deficit, the researchers say.

Medicare annual enrollment starts Oct. 15

The Lund Report
State program offers one-on-one counseling

Oct. 11, 2012 — Oregon Medicare beneficiaries need to remember that annual enrollment this year is from Oct. 15 to Dec. 7. Any Medicare Advantage (MA) or prescription drug plan (Part D) changes must be made between these dates so that coverage begins without interruption on Jan. 1, 2013.


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