Medicare

s_falkow | Flickr

Four St. Louis-area residents are among hundreds across the nation facing charges of federal health care fraud.

The U.S. Department of Justice announced the allegations on Wednesday. All told, more than 300 people in 30 states, the District of Columbia and Puerto Rico have been accused of defrauding Medicare and Medicaid. The Justice Department called it the largest crackdown in history, both in terms of number of defendants and the amount of fraud alleged.

Tonya Sherry, right, goes over paper work with Mary Kay Fink at the MS Center of St. Louis.
Carolina Hidalgo | St. Louis Public Radio

A new Medicare proposal would cut the link between the cost of many medications that are given in an outpatient clinic and how much doctors are paid to administer them.

Under current Medicare rules, drugs that have to be administered in an outpatient setting — such as chemotherapy, injections or drugs taken after an organ transplant — are reimbursed for the cost of the drug, plus six percent of the drug's price to pay for storage and handling.

Medicare has proposed cutting the reimbursement rate to 2.5 percent more than the drug's sale price, plus a flat fee of $16.80 per dose. But because of automatic federal budget cuts, for a few years doctors would be reimbursed less.

(via Flickr/ellie)

Open enrollment for Medicare starts this month, on Oct. 15, and closes Dec. 7.  It is the only time of the year that plan beneficiaries have the ability to change their Medicare health and drug plans.

Plan costs and coverage benefits seem to change almost as soon as they are enacted. Around 1700 people in the St. Louis area alone will be impacted by their Medicare Advantage plan not renewing their contract with Medicare, making open enrollment an important part of the year to pay attention to.

stock photo
Kurhan | sxc.hu

U.S. Sen. Claire McCaskill, D-Mo., believes Medicare needs a few tweaks, but must remain to provide health care coverage to the tens of millions of Americans.

A panel largely made up of local medical experts agreed with her.  “Medicare has been very successful in achieving its basic mission,” said Brit Pim, Vice President & General Manager of Government Programs for Express Scripts Inc.

Adrian Clark | Flickr

Medicare open enrollment, which runs through Dec. 7, gives beneficiaries an opportunity to review and change their health and prescription drug plans. On Wednesday, “St. Louis on the Air” host Don Marsh sat down with Julie Brookhart, public affairs specialist for the Kansas City regional office of the Centers for Medicare and Medicaid Services, to learn more about open enrollment.

Do I need to sign up for a new plan?

You don’t necessarily need to, Brookhart said, but open enrollment does provide an opportunity to compare plans.

Maddak Inc. via Flickr

There are approximately 224,000 people with Medicare living in the greater St. Louis area.

This article first appeared in the St. Louis Beacon: The Centers for Medicare and Medicaid Services has released hospital data on average Medicare charges and payments for the 100 most common procedures and treatments. The data show wide variation in hospital billing across the nation, Missouri and the St. Louis area.

(via Flickr/Tax Credits)

For the first time, the federal government has released the prices that hospitals charge for the 100 most common inpatient procedures.

The prices for a given procedure can vary by tens of thousands of dollars.

When it comes to health care, the biggest of the big data are all about Medicare.

So, it's kind of a BIG deal when the government releases what individual hospitals charge Medicare — and what they actually get paid — for the most common diagnoses and treatments.

In a first, the Centers for Medicare and Medicaid Services made those figures from more than 3,000 hospitals public Wednesday.

This article first appeared in the St. Louis Beacon: WASHINGTON – A Chesterfield physician is deluged by faxes from companies claiming falsely that her patients had requested medical equipment. An elderly Missouri woman gets three or four calls a day from marketing firms trying to convince her to ask her doctor for equipment she doesn’t need or want.

Rosmary via Flickr

Host Don Marsh talks with Dr. David Ansell about his proposal to reform healthcare by fixing Medicare and providing it to all Americans.  Dr. Ansell is the Senior Vice President for Clinical Affairs and Chief Medical Officer at Rush University Medical Center in Chicago.  He is also the author of “County: Life, Death and Politics at Chicago’s Public Hospital." 

Physicians for a National Health Program in St. Louis are sponsoring talks by Dr. Ansell:

Medicare: Hot Topic Between Enyart, Plummer

Sep 28, 2012
(Chris McDaniel/St. Louis Public Radio)

Medicare has been a recurring topic of contention in the race for Illinois’ 12th Congressional district. Democratic candidate Bill Enyart introduced himself to senior citizens in East St. Louis to discuss his stance on the issue.

As this was the first time many of the senior citizens had ever seen Enyart, he took the time to link his name to a candidate that’s popular in the area.

Debt reduction talk attracts protesters

Sep 19, 2012
Chris McDaniel, St. Louis Public Radio

David Walker has given his lecture on reducing the national debt in 13 cities, but he says his appearance in St. Louis  was the first that attracted protesters. Walker was the Comptroller General of the United States from 1998 to 2008, serving in the Government Accountability Office.

Since then, Walker has written a book and toured around America to lecture on the increasing national debt. His lecture tour, titled "$10 Million a Minute", involves him speaking about a variety of areas in which he believes residents can combat the growing U.S. financial burden.

(via Wikimedia Commons/Bluelion)

Barnes-Jewish could lose millions in Medicare payments

One of Missouri's largest hospitals could face a cut in Medicare payments because too many Medicare patients are being readmitted soon after discharge.

The St. Louis Post-Dispatch  reports that Barnes-Jewish is one of just three hospitals in the country to perform worse than the national average in readmissions within 30 days for heart attacks, heart failure and pneumonia, for each of the last three years.

In the 8th District congressional contest, Democrat Tommy Sowers and Republican incumbent Jo Ann Emerson both have new TV ads on the air. Both spots go negative, which is unusual so far out before the Nov. 2 election.  

Candidates often wait until after Labor Day to take off the verbal gloves, in part because that's when voters are most likely to pay attention.

The ad attacks by Emerson and Sowers both fit in with their respective party line.