Auditors Getting a Portion of Medicare Payments Recovered
Private auditing firms have gotten back more than $690 million in overcharges paid by Medicare, and under a new program that's irking health care "providers," the companies that identify the overpayments are getting a portion of the monies they recover, the Wall Street Journal reported.
The program has identified about $1.03 billion in "improper" payments over three years, mostly in New York, California and Florida, the newspaper said. About $992.7 million was in overpayments.
Industry groups representing the providers, mostly hospitals, call the new program an overaggressive "bounty hunter" arrangement. Nonetheless, the Centers for Medicare and Medicaid Services (CMMS) said it is planning to expand the program nationwide, the Journal reported.
Just over $187 million has been paid to the auditors, and some $60 million more was reclaimed by providers who successfully challenged the auditors' findings. That left about $694 million that has been returned to Medicare, the newspaper said.
The CMMS said the auditors don't get paid if their findings are successfully appealed, and they are paid using the same formulas whether they identify Medicare overpayments or underpayments.
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Illinois Governor: Insurers Should Pay for Autism
Insurers in Illinois should be required to absorb the skyrocketing costs of diagnosing and treating autism, Gov. Rod Blagojevich proposed Sunday.
Under the proposal, insurance companies would be bound to pay up to $36,000 annually and cover an unlimited number of medical visits for autistic children until they turned age 21, the Chicago Sun-Times reported.
Some states set a higher monetary limit, but the Illinois proposal would amount to the most comprehensive guarantee for autistic children in the United States, Mike McRaith, insurance director of the Illinois Department of Financial and Professional Regulation, told the newspaper.
Some 26,000 state residents have been diagnosed with the mysterious neurologic disorder, he said. Currently, only people with policies from large-group insurers are covered in the state, the Sun-Times said.
Blagojevich made his proposal under his power to rewrite legislation. The proposal would become law if three-fifths of the state House and Senate support it, according to the newspaper.
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As Gas Prices Rise, U.S. Traffic Deaths Fall
A new study finds that the steep rise in the price of gas may be translating into fewer deaths on America's roads.
A study co-authored by Michael Morrisey of the University of Alabama and David Grabowski of Harvard Medical School found that for each 10 percent rise in gas prices between 1985 and 2006, there was a 2.3 percent decline in vehicular deaths. Young drivers fared even better: for every 10 percent rise in the price at the pump the decline in traffic deaths among drivers ages 15 to 17 has been 6 percent, and for ages 18 to 21, 3.2 percent.
Speaking to the Associated Press, Morrisey noted that the data used in the study only went to 2006, when gas was about $2.50 per gallon. With gas now reaching more than $4 a gallon, he expects a much greater drop in roadway deaths -- perhaps 1,000 fewer fatalities each month.
Morrisey noted that annual U.S. auto deaths now total between 38,000 and 40,000 per year, so a drop of 12,000 deaths would represent a third fewer fatalities annually.
"I think there is some silver lining here in higher gas prices in that we will see a public health gain," Grabowski told the AP.
Morrisey noted that the relation between gas prices and highway deaths can work in the opposite direction, too, with fatalities rising as gas gets cheaper. "When that happens we drive more, we drive bigger cars, we drive faster and fatalities are higher," he said.
One highway safety expert said the findings make sense.
"There are a whole bunch of factors that are influenced by higher gasoline prices -- teenagers don't have as much money, so you have the most risky drivers driving less; people are switching out of the bigger, older more dangerous vehicles, and people also know if they drive slower they're going to save gasoline," Clarence Ditlow, executive director of the nonprofit Cener for Auto Safety, told AP.
The findings were presented last month at a meeting of the American Society of Health Economists in Raleigh-Durham, N.C., last month. The study was funded by the Robert Wood Johnson Foundation.
Famed Heart Surgeon Michael DeBakey Dead at 99
Michael DeBakey, the man who first performed heart bypass surgery, died Friday night at Methodist Hospital in Houston at the age of 99 from natural causes, the Associated Press reported Saturday.
The renowned cardiovascular surgeon invented many devices to help the ailing human heart; while still in medical school in 1932, he designed the roller pump, which became a key part of the heart-lung machine and opened the door to open-heart surgery. He also was behind the first efforts to develop artificial hearts and heart pumps for those waiting for heart transplants.
In 2006, DeBakey even underwent a procedure that he himself had developed -- the surgical repair of a damaged aorta.
While at the Baylor College of Medicine, officials there said, he helped transform the school into a nationally respected medical institution.
"Dr. DeBakey's reputation brought many people into this institution, and he treated them all: heads of state, entertainers, businessmen and presidents, as well as people with no titles and no means," Ron Girotto, president of the Methodist Hospital System, told the AP.
Cardiovascular surgeon Dr. George Noon called his professional partner "the greatest surgeon of the 20th century," who "single-handedly raised the standard of medical care, teaching and research around the world."
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Is Your Grocer Involved in Meat Recall? USDA Will Name Names
The next time there's a serious recall of meat or poultry in the United States, the U.S. Department of Agriculture says it will tell you if your local grocer had once sold any of the affected product.
USDA Secretary Edward Schafer announced the policy change Friday, following the nation's largest-ever recall of 143 million pounds of beef produced at a California slaughterhouse, MSNBC reported.
The policy is to take effect next month, Schafer said. Up till now, there's been no federal edict requiring the government to reveal where potentially tainted meat was sold.
While consumer groups applauded the move, they noted that it only applied to the most serious Class I recalls, thought to pose the greatest health risk.
"We're pleased that USDA will no longer keep consumers in the dark about recalled meat," said a news release from Consumers Union, which publishes Consumer Reports magazine. "Up until now, when USDA announced a recall of contaminated meat, it would only tell the public the states where the product was distributed. The specific names and locations of stores that got the product -- the information that can actually help the consumer -- were kept confidential."
The California recall would not have been affected by the new rule, since it was designated a less-significant Class II recall, Consumers Union noted.
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