Cuyahoga County's new government leaders want MetroHealth Medical Center to take over medical services at the county jail to improve efficiency, but the county-owned hospital has resisted the move. MetroHealth trustees last year rejected a proposal to provide medical care at the jail, which houses around 2,000 inmates. The hospital balked because it does not have expertise in "correctional medicine," a spokeswoman said this week. But County Council members elected under the new charter government intend to press the issue, and have said they expect MetroHealth to justify its annual subsidy from the county, which this year is $36 million. Council's insistence reflects desire to assert greater authority over the MetroHealth system.
Social Security now doles out more money in benefit checks than it takes in from taxes, and its trust fund is projected to run out of cash in about 26 years. So this is a good model for healthcare reform? Yes, indeed, says Philip Bredesen, a former health insurance executive who just completed two terms as Tennessee's governor. In his book, "Fresh Medicine," he argues that a key element of meaningful healthcare reform is creation of a Social Security-like trust fund that would raise money from payroll taxes and issue vouchers to all Americans. Those vouchers would be used as cash to buy services directly from healthcare providers. Private insurers as intermediaries would largely disappear. Bredesen points out in his book, this approach would cover everyone (which is no small feat) and help rein in costs by making doctors and patients more aware---and more in control ---of treatment costs.
A former Needham doctor and his nurse practitioner caused the overdose deaths of at least six people they knew to be drug-addicted by systematically prescribing them medically unnecessary painkillers in order to make a profit, according to charges handed up yesterday in federal court in Boston.
Dr. Joseph P. Zolot, a specialist in nonsurgical orthopedics, and nurse practitioner Lisa M. Pliner were indicted on charges of conspiring to illegally distribute controlled substances — including methadone, oxycodone, and fentanyl — and six counts each of distribution of controlled substances resulting in deaths. If convicted, they each face a mandatory sentence of 20 years to life in prison.
A Florida judge has refused to order the government to stop implementing the healthcare reform law, handing the Obama administration at least a temporary victory in the ongoing legal battle over reform. U.S. District Court Judge Roger Vinson ruled in January that the healthcare reform law is unconstitutional, in a case brought by the attorneys general of 26 states. Four other judges have ruled on the law -- three have found it constitutional, and one has not. But after the Florida ruling, officials in two states, Florida and Alaska, said that they would take Judge Vinson's decision as a directive to stop implementing the law while the cases make their way to the Supreme Court -- where the issue seems almost certain to be debated. Last month, the Obama administration asked Judge Vinson to clarify his ruling and say whether he actually intended to halt implementation of the law.
Key members of the Blue Cross Blue Shield of Massachusetts board that gave the nod to then-CEO Cleve Killingsworth's controversial $11 million severance have been public advocates for trimming soaring healthcare costs --- even as they sat on a panel that quietly approved the departing CEO's golden parachute. Greater Boston Chamber of Commerce President Paul Guzzi, for example, has crusaded to lower healthcare costs in his day job representing the interests of local businesses, many of which struggle under the burden of rising premiums for their employee health plans. "Advancing payment reform to bring health-care costs under control" is one of the Greater Boston Chamber of Commerce's top policy agenda items, Guzzi said in a statement in January. Guzzi made $84,463 as the Blue Cross board chairman at the time of the Killingsworth vote.
Four years after an FBI raid brought to light accusations of Medicaid fraud at WellCare, a federal grand jury indicted five of the company's former executives, authorities announced this week. All five men are charged with conspiracy to commit Medicaid fraud and making false statements. They include former CEO Todd S. Farha, 42, of Tampa; former general counsel Thaddeus Bereday, 45, of Tampa; and former CFO Paul L. Behrens, 49, of Odessa. The indictment says WellCare, based near Tampa, took Medicaid money from Florida's Agency for Health Care Administration with the understanding that if it did not use 80% of the funds allotted for behavioral health services, the difference was to be returned to the state. But, prosecutors said, WellCare executives conspired to inflate what they actually spent to reduce the amount they had to return. The company paid $80 million in May 2009 and reached a civil settlement with the Department of Justice for $137 million in 2010. But whistle-blowers put profits of the alleged fraud between $400 million and $600 million.