Damages Upheld For Medicare “Whistle-Blower” Employee
JANUARY 28, 2002 VOLUME 9, NUMBER 31 When Illinois anesthesiologist Michael Brandon was fired he was sure it was in retaliation for his efforts to uncover possible Medicare fraud. He sued his employer, Anesthesia & Pain Management Associates, Ltd., and won a jury verdict. That was not, however, the end of the legal wrangling. Dr. […]
States Vigorously Prosecute Medicaid and Medicare Fraud
JANUARY 14, 2002 VOLUME 9, NUMBER 29 According to the federal government, as much as 10% of the funding for the joint federal/state Medicaid program is lost to fraud, mostly on the part of medical providers. The Medicare program is also deeply concerned about the possibility of fraudulent costs. Although both the Medicaid and Medicare […]
Eligibility, Benefits Figures Increase With Cost of Living
OCTOBER 22, 2001 VOLUME 9, NUMBER 17 Each year Social Security benefits are raised automatically to keep up with the increased cost of living. Benefit increases are pegged to standard measures of inflation, and take effect on January 1. Social Security figures, however, are not the only automatic increases affecting seniors and the disabled. Beginning […]
Court Win For Innovative Drug Cost Control Program In Maine
AUGUST 6, 2001 VOLUME 9, NUMBER 6 Medicare is a federal program providing medical care to millions of seniors and disabled individuals. Although beneficiaries may pay some portion of their own care costs those contributions are in most cases modest. By any reckoning, however, there are two important medical needs not covered by the Medicare […]
California Court Says Patients Can Sue Medicare HMOs
JULY 16, 2001 VOLUME 9, NUMBER 3 George and Barbara McCall, California residents, sued their HMO and their primary care physician. They claimed that the HMO (PacifiCare of California) refused to refer Mr. McCall to a specialist when he needed a lung transplant, and that he was ultimately forced to disenroll from PacifiCare and seek […]
Medicare HMOs Continue To Cut Programs Across Country
NOVEMBER 20, 2000 VOLUME 8, NUMBER 21 Three short years ago Congress was pushing for increased use of “managed care” plans as one way to stave off a looming financial crisis for the federal Medicare program. Today the promise of managed care continues to be unmet—largely because of Congress’ own actions. The federal government picks […]
More On DHHS/HCFA Report Of Nursing Home Staff Shortages
AUGUST 7, 2000 VOLUME 8, NUMBER 6 Last week Elder Law Issues reported on a government study of nursing home staffing and safety. This week we continue that report. The full DHHS/HCFA report is now online.] As described last week, the Department of Health and Human Services report recommends minimum staffing levels for nursing aides, […]
State Court Declines To Act On Medicare HMO Denial Of Care
DECEMBER 27, 1999 VOLUME 7, NUMBER 26 Gilbert Levy, like many Medicare beneficiaries, was attracted by the promise of HMO coverage for his Medicare benefits. The California man shopped carefully, and only signed up with PacifiCare Health Systems after he was sure that he would be able to choose his own primary care physician, and […]
Federal Initiative Combats Medicare and Medicaid Fraud
NOVEMBER 1, 1999 VOLUME 7, NUMBER 18 Two programs—Medicare and Medicaid—provide the majority of acute medical and long-term nursing care for America’s senior citizens. In fact, those two programs provide over one third of all medical care for Americans of all ages. With the total cost of those two programs approaching $400 billion per year, […]
Bipartisan Commission Fails To Propose Medicare Reforms
MAY 17, 1999 VOLUME 6, NUMBER 46 The National Bipartisan Commission on the Future of Medicare sounded like a good idea. Seventeen Commission members met for the first time in March of last year, and were scheduled to make a truly bipartisan recommendation on how to “save” the Medicare program by March of this year. […]
