Former Insurance Executive Details How Companies ‘Rigged’ Medicare Payments
In an interview with The New York Times, former UnitedHealthcare official Benjamin Poehling talks about his allegations that Medicare Advantage plans would list patients as very sick to get better federal payments. In other Medicare news, some groups representing health care providers are asking federal officials to give more consideration to the process of removing Social Security numbers from Medicare ID cards and John Oliver uses his show to skewer a dialysis provider.
The New York Times:
A Whistle-Blower Tells Of Health Insurers Bilking Medicare
When Medicare was facing an impossible $13 trillion funding gap, Congress opted for a bold fix: It handed over part of the program to insurance companies, expecting them to provide better care at a lower cost. The new program was named Medicare Advantage. Nearly 15 years later, a third of all Americans who receive some form of Medicare have chosen the insurer-provided version, which, by most accounts, has been a success. But now a whistle-blower, a former well-placed official at UnitedHealth Group, asserts that the big insurance companies have been systematically bilking Medicare Advantage for years, reaping billions of taxpayer dollars from the program by gaming the payment system. (Walsh, 5/15)
Medicare ID Overhaul Sparks Fears Of Patients Being Denied Care
Providers warned the CMS on Thursday that its plan to remove Social Security numbers from Medicare ID cards could cause patients to be denied care. The American Medical Association, American Academy of Family Physicians and several other provider groups on Thursday called on the CMS to undergo a formal rulemaking process before changing Medicare ID cards so providers can weigh in on the transition plan. (Dickson, 5/15)
John Oliver Riffs On Dialysis Controversies On 'Last Week Tonight'
After imploring viewers to not press the “Dear God Literally Anything Else” button on their remotes, comedian John Oliver devoted most of Sunday’s “Last Week Tonight” to the for-profit dialysis industry. The segment focused on one of the country’s largest providers, DaVita, which has settled lawsuits about kickbacks to physicians, Medicare billing discrepancies, and the overuse of a medication. (Oliver also spends some time ruminating about DaVita CEO Kent Thiry’s personal eccentricities, such as making dramatic entrances riding a bicycle or horse while wearing a medieval costume.) (Sheridan, 5/15)
The Washington Post:
John Oliver On Kidney Dialysis, Taco Bell And Death
Megallan Handford, a former DaVita nurse who claims he was fired for trying to unionize its employees, told Oliver the company's focus “was all about numbers,” sometimes at the expense of patient safety. “When I was working at DaVita, the priorities for transitioning patients was to get them on dialysis and get the next patient on as soon as possible,” Handford told Oliver. “You would have sometimes 15, maybe 25 minutes to get that next patient on the machine, so you were not properly disinfecting.” (Wang, 5/15)