A federal jury has convicted two Miami-Dade doctors and two medical assistants of plotting to submit millions of dollars in bogus bills to Medicare. The 12-person jury found David Rothman, MD, Keith Russell, MD, Eda Marietta Milanes, and Jorge Luis Pacheco guilty of conspiring to commit fraud and other charges for filing $5.3 million in false HIV-therapy claims with the nation's healthcare program.
A policy at Philadelphia's eight primary-care health centers—free care for everyone, with or without insurance—has recently raised questions of fairness and fiscal responsibility. The Philadelphia Department of Public Health has proposed new fees on a sliding scale for patients without health insurance. Officials say that the clinics have been free because most of their patients, even those with insurance, have little money. But they concede that the practice of not collecting co-pays must be revisited.
Private Medicare Advantage plans, already targeted for cuts by the Obama administration, are under more pressure in Congress. The latest critique comes from Glenn Hackbarth, chairman of MedPac, a commission created by Congress to advise lawmakers on Medicare. In testimony for the health subcommittee of the House Ways & Means Committee, Hackbarth said the private plans offer patients enhanced benefits, but those benefits aren't being paid for by the efficiencies of the private market. Instead, they come at a "high cost," Hackbarth said.
The Wisconsin Medical Society has filed an appeal to overturn a court decision upholding the state's 2007 withdrawal of $200 million from the Injured Patients and Families Compensation Fund.
The withdrawal from the fund, created by the state Legislature to help mitigate the costs to healthcare providers of insurance coverage for malpractice lawsuits, was used to help fill a budget gap for the 2007-2009 biennium. The Medical Society sued to stop the action in October 2007.
Large managed-care groups like Kaiser Permanente and Group Health Cooperative are increasingly using electronic medical-record systems to help get patients to take better care of themselves. The trend, known as information therapy, involves delivering reliable health information directly to patients to help them manage their conditions and make treatment choices. Health plans also are offering online self-management programs and virtual coaching sessions for a wide range of health issues.
The White House, seeking to engender political support for a healthcare overhaul later this year, brought its traveling health policy forum to Vermont on Tuesday. Governor Jim Douglas of Vermont, a Republican, and Governor Deval Patrick of Massachusetts, a Democrat, co-hosted a forum with about 400 people on the frontlines of healthcare about how to make sweeping changes to the existing system. The doctors, patients, business people, and government officials repeatedly emphasized similar themes: the need to prevent and manage chronic disease better, attract more primary care doctors, simplify bureaucracy, and find a way to get everyone access to treatment at an affordable price.