Medicare Agency Gets Scrutiny In Insider-Trading Investigation
Elsewhere, a whistleblower lawsuit alleges some false diagnoses were created to bilk the government of $1 billion or more.
The Wall Street Journal:
Insider-Trading Probe Focuses On Medicare Agency
The day Medicare officials began discussing whether to set new coverage limits on a costly new prostate-cancer treatment, the official in charge emailed three colleagues to put a “close hold” on the process. That meant: Keep quiet until an announcement later that month. Yet by the end of that same day, June 7, 2010, shares of the company that made the treatment, Dendreon Corp. , had plunged 10%. Before long, federal investigators took notice. (Mullins, Pulliam and Weaver, 10/28)
Center for Public Integrity:
Another Whistleblower Suit Alleges Medicare Advantage Fraud
A new whistleblower lawsuit accuses a California health care firm of diagnosing “false and fraudulent” medical conditions that several Medicare Advantage plans allegedly used to overcharge the federal government by $1 billion or more. The suit was filed by Anita Silingo, a former compliance officer for Mobile Medical Examination Services, Inc., or MedXM. The Santa Ana, California-based firm sends medical professionals to the homes of Medicare Advantage members to assess their health. (Schulte, 10/29)
Also, news on Medicare's enrollment season, and how what Medicare decides to cover could mean less treatment for ALS patients -
Kaiser Health News:
The Lowdown On Open Enrollment For Medicare Advantage And Part D
Kaiser Family Foundation’s Senior Vice President Tricia Neuman, who directs the KFF Program on Medicare Policy, and Kimberly Lankford, Contributing Editor of Kiplinger’s Personal Finance, spoke about the basics of the plans and answered common questions that consumers and journalists have. (10/28)
Kaiser Health News:
Medicare Changes Could Limit Patient Access To ALS Communication Tools
Starting Dec. 1, people with ALS – a disease that impairs motor function so people often can’t talk or even move – could lose access to technological advances that allow them to better communicate, thanks to a federal review of what Medicare is allowed to cover. ALS, which stands for amyotrophic lateral sclerosis, hit the national spotlight this summer with the viral “Ice Bucket Challenge.” But while public awareness about the disease soared, Medicare changes that could curtail coverage of communication tools were – by “sheer dumb luck” – already in the works, said Kathleen Holt, associate director at the Center for Medicare Advocacy. (Luthra, 10/29)