Pretty much every medical organization has told men to back off on screening for prostate cancer, because it can lead to unneeded treatment, including surgery that can leave a man incontinent and impotent. But it's hard to resist a robot. Men who have been diagnosed with low-grade prostate cancer increasingly choose expensive newer treatments including robotic surgery and a radiation treatment called intensity-modulated radiotherapy, or IMRT, even though they are not likely to benefit from those treatments, according to a in JAMA, the journal of the American Medical Association.
Overly aggressive practices of contractors charged with recovering inappropriate Medicare payments are causing headaches for hospitals and patients, hospital executives told the Senate Finance Committee Tuesday. Recovery Audit Contractors – or RACs – uncover and collect improper payments made to hospitals, physicians, clinics and other providers. In 2011 the audits resulted in the return of nearly a half a billion dollars to the Medicare Trust Fund. "We need to build on this success, but we can't overburden legitimate providers who play by the rules," Finance Committee Chairman Max Baucus, D-Mont., said Tuesday. "We need balance."
Sen. Charles Grassley a longtime member of the Senate Finance Committee and frequent critic of nonprofit hospitals, wants to know whose idea it was to pay hospital CEOs annual bonuses surpassing a million dollars in some cases. "Is the board in control?" he asked in an interview. "Is the board making these decisions and how do they make these decisions? Are they running the show or is the CEO running them?" The Iowa Republican was responding to a report by Kaiser Health News and ABC News that showed CEOs reaping bonuses for profit, revenue and other financial goals even as policymakers talk about the need to promote efficiency instead of volume.
All the outreach in the world won't count for much if the Obamacare ticket counter doesn't work. Behind the campaign to educate the uninsured about the Affordable Care Act is the assumption that software to sell the plans will be ready and user-friendly by Oct. 1, when enrollment is supposed to start. That assumption is not universally shared. Some wonder if systems will be tested and finished on time. Others worry the programs will lead consumers to make dumb insurance choices. Kaiser Health News got an early look at Obamacare software that will be deployed in Minnesota, Maryland and the District of Columbia.
SACRAMENTO, Calif. — The Obama administration on Wednesday broadened an exemption for American Indians from the new health care law's requirement that virtually every U.S. resident has health insurance starting next year. New rules clarify that people who are eligible to receive medical care through the federal Indian Health Service will be exempt from the requirement to have health insurance or face fines from the Internal Revenue Service. The Indian Health Service, a division of U.S. Health and Human Services, oversees a network of clinics that are required through treaty obligations to serve all patients of Indian ancestry, even if they cannot document their federal tribal status.
About a year and a half ago, Dr. Leslie Kernisan, 37, a geriatrician in San Francisco, decided she couldn't stand her medical practice any longer. Every day, she felt she was shortchanging her older patients. "What I had in the way of time and resources to meet patients' needs was so inadequate that it felt almost grotesque," she told me recently. At the time, Dr. Kernisan was working at a community clinic filled with caring, committed professionals. They weren't the problem. What was wrong, she felt, was a dysfunctional system of health care for seniors — and at the center of that was Medicare, the government's insurance program for seniors.