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Federal Government
Medicare Providers: Federal Government's Auditing Procedures Ineffective PDF Print E-mail
Federal Government
By Administrator   
Wednesday, 09 July 2014 14:06

MIAMI (AP) — Health care companies say they're losing millions of dollars that are tied up in appeals because of increasing numbers of Medicare audits. But the rise in the often duplicative audits has failed to reduce Medicare fraud, according to a report released Wednesday.

 
In recent years, the Obama administration has added manpower to investigate cases, increase audits and analyze more data to fight fraud in the taxpayer-funded Medicare program. Yet a report from the U.S. Senate Special Committee on Aging criticized the government for not targeting its resources more effectively.
 
Improper payments within Medicare's largest sector increased for the first time in five years, jumping from $30 billion to $36 billion, despite the Obama administration's all-out campaign to prevent fraud. Medicare fraud in the fee-for-service program had steadily declined since 2009, but improper payments rose between 2011 and 2012, according to the report that cites the most recent data available. During that same time, federal health officials launched a $77 million technology screening system designed to proactively prevent fraudulent providers from joining the system and prevent bogus claims from being paid in the first place.
 
But the committee expressed concern that the government's "strategy to reduce improper payments is actually a strategy aimed more at identifying and recovering improper payments that have already occurred," according to the report.
 
Federal health officials said in the report that new policy changes confused providers. They also noted the new screening technology prevented $210 million in fraudulent payments in its second year of operation.
 
The Medical Equipment Suppliers Association said some providers experienced between 24 and 228 audits in one year, according to a letter to federal health officials included in the report.
 
Ascension Health had 66,613 claims audited and about half were alleged to be improper payments. The company says the government withheld about $200 million in payments while it appealed. Less than one-fourth of appealed recoveries were upheld, according to the report. Catholic Health Initiatives said it's appealed 87 percent of cases and won the vast majority, but complained significant funds were withheld during the process.
 
"What has been created is an overly complicated system with duplication where virtually any (durable medical equipment) claim payment can be recouped," according to prepared testimony from Walter Gorski, head of Gorski Healthcare Group LLC, during a round table Wednesday with Sen. Nelson and health care stakeholders, including the American Hospital Association.
 
The report also blamed the federal government for lax oversight of its confusing maze of private fraud prevention contractors, noting a fundamental flaw in the way certain contractors are paid because they are paid based on the dollar amount of fraud they identify. Experts say a more effective system would incentivize contractors by paying them based on their ability to reduce fraudulent payment instead of merely identifying large amounts.
 
Medicare has been a highly sensitive political issue for the Obama administration partly due to a backlash from seniors over program cuts to help finance the president's health care overhaul. Top officials have since emphasized the administration's stewardship of Medicare, touting better benefits and oversight.
 
"Despite doing more audits than ever before, Medicare just isn't getting the job done when it comes to preventing payment errors," said committee Chairman Bill Nelson (D-FL).
 
Last Updated on Wednesday, 09 July 2014 14:06
 
On Heels Of CDC Anthrax Exposure, NIH Finds Vials Of Smallpox In Storage Room PDF Print E-mail
Federal Government
By Administrator   
Tuesday, 08 July 2014 13:53

ATLANTA (AP) — A government scientist cleaning out an old storage room at a research center near Washington made a startling discovery last week — decades-old vials of smallpox packed away and forgotten in a cardboard box.

 
The six glass vials of freeze-dried virus were intact and sealed with melted glass, and the virus might have been dead, officials at the Centers for Disease Control and Prevention said Tuesday.
 
Still, the find was disturbing because for decades after smallpox was declared eradicated in the 1980s, world health authorities believed the only samples left were safely stored in super-secure laboratories in Atlanta and in Russia.
 
Officials said this is the first time in the U.S. that unaccounted-for smallpox has been discovered.
 
It was the second recent incident in which a government health agency appeared to have mishandled a highly dangerous germ. Last month, a laboratory safety lapse at the CDC in Atlanta led the agency to give scores of employees antibiotics as a precaution against anthrax.
 
The smallpox virus samples were found in a building at the National Institutes of Health in Bethesda, Maryland, that has been used by the Food and Drug Administration since 1972, according to the CDC.
 
The scientist was cleaning out a cold room between two laboratories on July 1 when he made the discovery, FDA officials said.
 
Officials said labeling indicated the smallpox had been put in the vials in the 1950s. But they said it's not clear how long the vials had been in the building, which did not open until the 1960s.
 
No one has been infected, and no smallpox contamination was found in the building.
 
Smallpox can be deadly even after it is freeze-dried, but the virus usually has to be kept cold to remain alive and dangerous.
 
In an interview Tuesday, a CDC official said he believed the vials were stored for many years at room temperature, which would suggest the samples are dead. But FDA officials said later in the day that the smallpox was in cold storage for decades.
 
Both FDA and CDC officials said more lab analysis will have to be done to say if the germ is dangerous.
 
"We don't yet know if it's live and infectious," said Stephan Monroe, deputy director of the CDC center that handles highly dangerous infectious agents.
 
The samples were rushed to the CDC in Atlanta for testing, after which they will be destroyed.
 
In at least one other such episode, vials of smallpox were found at the bottom of a freezer in an Eastern European country in the 1990s, according to Dr. David Heymann, a former World Health Organization official who is now a professor at the London School of Hygiene and Tropical Medicine.
 
Heymann said it is difficult to say whether there might be other forgotten vials of smallpox out there. He said that when smallpox samples were consolidated for destruction, requests were made to ministers of health to collect all vials.
 
"As far as I know, there was never a confirmation they had checked in with all groups who could have had the virus," he said.
 
Smallpox was one of the most lethal diseases in history. For centuries, it killed about one-third of the people it infected, including Queen Mary II of England, and left most survivors with deep scars on their faces from the pus-filled lesions.
 
The last known case was in Britain in 1978, when a university photographer who worked above a lab handling smallpox died after being accidentally exposed to it from the ventilation system.
 
Global vaccination campaigns finally brought smallpox under control. After it was declared eradicated, all known remaining samples of live virus were stored at a CDC lab in Atlanta and at a Russian lab in Novosibirsk, Siberia.
 
The labs take extreme precautions. Scientists who work with the virus must undergo fingerprint or retinal scans to get inside, they wear full-body suits including gloves and goggles, and they shower with strong disinfectant before leaving the labs.
 
The U.S. smallpox stockpile, which includes samples from Britain, Japan and the Netherlands, is stored in liquid nitrogen.
 
There has long been debate about whether to destroy the stockpile.
 
Many scientists argue the deadly virus should be definitively wiped off the planet and believe any remaining samples pose a threat. Others argue the samples are needed for research on better treatments and vaccines.
 
At its recent annual meeting in May, the member countries of the WHO decided once again to delay a decision.
 
Last Updated on Tuesday, 08 July 2014 13:53
 
N.J. Democrat Sen. Menendez Wants Federal Probe Of Cuban Role In Allegations Of Impropriety PDF Print E-mail
Federal Government
By Administrator   
Tuesday, 08 July 2014 13:48

WASHINGTON (AP) — Sen. Robert Menendez said Tuesday that he has asked the Justice Department to investigate whether the Cuban government had a role in allegations against him that have made him a target of a federal probe.

 
Among the charges are so far unsubstantiated allegations that Menendez, D-N.J., flew on a plane provided by a friend and campaign supporter for rendezvous with prostitutes.
 
In an interview with The Associated Press, Menendez said his attorney has asked the Justice Department to investigate what he says were long-running rumors about a Cuban role in the allegations.
 
The lawmaker said he doesn't know if Cuba was involved. But Menendez, chairman of the Senate Foreign Relations Committee, cited his decades-long role as a persistent critic of the Cuban government as potential motivation for Havana to act against him.
 
"To the extent they'd like to see the United States engage them more on their terms, which is not to observe democracy and human rights, they probably feel that I'm the single most significant impediment to their goals," Menendez said.
 
He added, "It would not be surprising at all for the regime to hold the view that we have to do whatever we can" against him.
 
Menendez cited a Tuesday report in The Washington Post that the CIA obtained evidence linking Cuban agents to the claims about Menendez and prostitutes and to trying to persuade American news organizations to pursue those claims.
 
While declining to provide details about his attorney's letter, Menendez said, "It is clearly to ask them to investigate the charges, some of which appeared in Post."
 
Menendez said the Post story makes clear that the federal government has information about the Cuban connection. Initial reports of Menendez's problems surfaced before his 2012 re-election.
 
"They should pursue their information," he said about the federal government, "because I think it is incredibly troublesome that a foreign government would try to interfere either with a federal election or the seating of a senator on a specific committee in order to pursue its foreign policy goals. And that should be troublesome far beyond my circumstances."
 
Last Updated on Tuesday, 08 July 2014 13:49
 
Poll: More Than Half Of America Remains Opposed To The Affordable Care Act PDF Print E-mail
Federal Government
By Administrator   
Monday, 07 July 2014 11:03

RALEIGH, (SGRToday.com) - A new poll Rasmussen finds that just four out of 10 likely U.S. voters believes the federal government should require that every American buy health insurance of face a penalty -- the individual mandate provision of the federal Affordable Care Act.

 
More than half of likely voters -- 51 percent -- remain opposed to the program commonly known as 'Obamacare.'
 
The survey was conducted on July 6.
 
The results come in the wake of a major legal ruling that went against the Obamacare mandate for businesses. Last week the U.S. Supreme Court ruled that the the owners of the retail craft store chain Hobby Lobby do not have to provide insurance coverage to their employees for abortion-inducing drugs. 
 
The owners -- the Green family -- are devout Christians who oppose abortion. They argued that Obamacare violates their religious liberty.
 
The Greens were represented by the Becket Fund for Religious Liberty.
Last Updated on Monday, 07 July 2014 11:06
 
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