White House Restricts Health Care Services For Elder Citizens, Destroying Medicare

[From article]
Before Medicare, older folks languished in nursing homes or wheelchairs with crippling illnesses. Now, seniors dodge that fate, thanks to hip and knee replacements, cataract operations and heart procedures — all paid for by Medicare.
The American Journal of Public Health reports that a man turning 65 can expect to live almost five years longer than he would have in 1970 — and almost all of it in good health. What a priceless gift.
A gift Obama is snatching away.
The president’s Medicare reforms make it harder for seniors to get joint replacements. His new payment rules shortchange doctors, discouraging them from accepting Medicare in the first place. New ER rules clobber seniors with bills for “observation care.” Under ObamaCare, hospitals get bonuses for spending less per senior, despite having higher death rates and infection rates.[. . .]
Before Medicare, older folks languished in nursing homes or wheelchairs with crippling illnesses. Now, seniors dodge that fate, thanks to hip and knee replacements, cataract operations and heart procedures — all paid for by Medicare.
The American Journal of Public Health reports that a man turning 65 can expect to live almost five years longer than he would have in 1970 — and almost all of it in good health. What a priceless gift.
A gift Obama is snatching away.
The president’s Medicare reforms make it harder for seniors to get joint replacements. His new payment rules shortchange doctors, discouraging them from accepting Medicare in the first place. New ER rules clobber seniors with bills for “observation care.” Under ObamaCare, hospitals get bonuses for spending less per senior, despite having higher death rates and infection rates.
[. . .]



The new rules also make seeing Medicare patients a money loser. Annual fee increases for doctors are capped at a fraction of 1 percent — even though rents and other costs go up every year.
No wonder nine out of 10 solo practitioners admit they’ll avoid Medicare patients — right when 10,000 new baby boomers are joining each day.
Obama’s rules spell trouble for seniors with cancer. Doctors administering chemotherapy are getting a pay cut and being prodded to choose the cheapest drug, regardless of which medication is best for their patient. Dr. Debra Patt warned Congress this’ll hinder access to drugs like the immunotherapy that subdued former President Jimmy Carter’s cancer.
Another Obama rule penalizes hospitals for doing hip and knee replacements on patients likely to need rehab after surgery, causing hospitals to shun older patients with complex conditions. Grandma will have to settle for the painkiller as candidate Obama notoriously suggested.
[. . .]
During Obama’s 2012 re-election campaign, the president accused Republicans of plotting to “end Medicare as we know it.” A pro-Obama ad depicted a Republican pushing Granny’s wheelchair off a cliff.
Who’s really pushing Granny off the cliff? Obama himself, with Hillary’s helping hand.
Clinton proposes opening Medicare to people in their 50s. That would force seniors to compete with younger patients for resources — like in Britain and Canada, where seniors are labeled “bed blockers,” and certain treatments are reserved for younger patients with more life ahead.
Seniors beware.

http://nypost.com/2016/06/21/obama-is-gutting-medicare/

Obama is gutting Medicare
By Betsy McCaughey
New York Post
June 21, 2016 | 8:43pm

Feds Arrest Five for $86 million in Medicare and Medicaid Fraud

[From article]

Five people were busted for bilking Medicare and Medicaid in a yearslong, $86 million scam in which they paid kickbacks in order to bill for bogus procedures, an indictment filed in Brooklyn Monday charges.
Aleksandr Pikus, Mark Tsyvin, Maksim Vernik, Denis Satyr and Malvina Yablonskaya are charged with funneling more than $38 million worth of reimbursements on the $86 million in bills through several New York shell companies that purported to provide consulting, marketing and advertising services.



Between 2008 and 2016, the alleged scammers referred customers to medical clinics in exchange for illegal kickbacks, according to papers filed in federal court.
Some of the clinics were run by co-conspirators Oleg Dron, a licensed occupational therapist, and Eduard Noykhovich, a licensed physical therapist, the feds charge.
The group also gave cash to Medicaid and Medicare beneficiaries to subject themselves to unnecessary medical services, the feds allege.

http://nypost.com/2016/06/20/feds-bust-five-in-86m-scam-of-medicare-and-medicaid/

Feds bust five in $86M scam of Medicare and Medicaid
By Reuven Fenton, Yijun Wang and Lia Eustachewich
New York Post
June 20, 2016 | 11:04pm

White House Bait and Switch Health Care Lies

[From article]
States choosing to expand Medicaid take on additional costs due to more people on their Medicaid rolls. The federal government picks up the additional costs for the first few years, meaning it won’t cost states anything extra. Initially at least.
That’s the bait
Over time, however, the feds pay less of the expansion costs. By 2020, they will only cover 90 percent of the expansion cost, leaving the rest to the states. Assuming they keep their word on the 90 percent promise.
That’s the switch.



[. . .]
Medicaid pays physicians about two-thirds of what Medicare pays. The solution under ObamaCare was to raise the amount doctors get paid under Medicaid to the same level as Medicare.
That’s the bait.
Unfortunately, this was a temporary fix, lasting only two years. Beginning in 2015, doctors saw a 43 percent cut in Medicaid reimbursement.
That’s the switch.
[. . .]
“Medicare reimbursement rates are far too low to cover the costs of high-quality medical services, and Medicaid reimbursement is even worse,” according to Alan Reynolds, a senior fellow at the Cato Institute. Mayo Clinic wisely did not fall for the ObamaCare Medicaid bait and switch.
[. . .]



Is any of this a surprise? This was all part of ObamaCare from the beginning. Yet at that time, there was no debate and analysis. Few if any Members of Congress read the bill. Democrats rushed the bill into law cheered on by a giddy media.
Now we are left with a mess, confirming Abraham Lincoln’s admonition, “You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time.” The ObamaCare Medicaid bait and switch sure fooled and continues to fool many.

http://www.americanthinker.com/articles/2016/01/medicaid_expansion__bait_and_switch.html

January 20, 2016
Medicaid Expansion -- Bait and Switch
By Brian C. Joondeph

CBS News Study of Taxpayer Funded Back Surgeries

Uncounted are procedures by private insurers, and uninsured surgeries. Any idea how to estimate those figures? Noted is the potential for confusion, errors and miscellaneous errors in billing. Information is included of the benefits experienced by three patients. Four doctors are scrutinized. Of the 480,000 spinal fusions performed annually, it would be helpful for more extensive follow-up on a larger sample of patients. Are some lives better, some worse and some unchanged? On April 6, 2015 a number of news stories appeared about the Journal of the American Medical Association study about an increase in back surgeries.

[From article]
The attorney also objected to the use of billing codes to count spinal fusions for "degenerative" conditions that cause lower back pain. "It is simply not possible to discern the diagnosis(es) from the CPT code alone," she wrote.
It is true that the billing codes describe a technique - not a diagnosis. Some widely accepted fusions are billed for using these same codes. But while the data does not reveal whether any of the fusions that a doctor performed were inappropriate, experts say high numbers raise questions and serve as starting points for further investigation.
[. . .]
When we looked into Dr. Jimenez, we found that in 2006 he was suspended indefinitely by a network of five hospitals in Georgia. According to a confidential report obtained by CBS News, it concluded that he "pose[d] a threat to the life, health and safety of patients." There were concerns about, among other things, his "surgical competency and selection of procedures." Dr. Jimenez eventually left the hospital system and sued it for racial discrimination. He claimed the review committee made up lies to oust him and did not give him a hearing. The case was eventually dismissed.
[. . .]
Keith is now suing Dr. Alexander for allegedly aligning her neck crookedly and performing a more aggressive surgery than necessary. She has virtually no movement of her head, and it is stuck in a tilted position looking down and off to the right. Multiple doctors have said a corrective surgery would involve removing rods and screws that Dr. Alexander put in and entail significant risk. The case is ongoing.


Kimberly Keith's x-ray after surgery
Hilliard Munoz Gonzales LLP
[. . .]
Dr. Resnick added that Medicare, medical societies, and credentialing bodies (including state medical boards and the American Board of Medical Specialties) should use databases like the one in this story to follow practice patterns and patient outcomes. He said surgeons with the highest numbers should be closely looked at and asked to explain themselves. But he said that won't happen without a source of funding, as the work is time consuming and entails legal risk.
[. . .]
More than 480,000 spinal fusions are performed in U.S hospitals each year, making them more common than even hip replacements. The annual cost of these surgeries is more than $12 billion, according to the Agency for Healthcare Research and Quality. Experts disagree about how many may be unnecessary, but Dr. Richard Deyo, a critic of the procedure and professor at Oregon Health and Science University believes it could be as much as half. For Medicare and Medicaid patients, taxpayers foot the bill.


http://www.cbsnews.com/news/tapping-into-controversial-back-surgeries/

By Ben Eisler
CBS News
April 24, 2014, 6:30 AM
Tapping into controversial back surgeries

Release of Medicaid and Medicare Physician Data Cosmetic Act Keeping Patients Confused

[From article]
But the new policy will accomplish little beyond confusing patients and embarrassing physicians.
The problem is that patients cannot intelligently interpret the CMS data.
[. . .]
The CMS records won’t help patients assess the quality of the services provided or compare one doctor with another.
[. . .]
CMS’s release of the records will have at least one clear benefit: helping to identify fraud and abuse.
[. . .]
But these records are already available to law enforcement and regulatory authorities. In fact, many physicians with unusual billing patterns in the 2012 record release had already been disciplined by state medical boards and/or law enforcement. Yet, Medicare continued to pay physicians who had been sanctioned, lost their licenses, or had been convicted of fraud and theft and spent time in jail—a failure of the system’s fraud-detection procedures that won’t be solved by the public release of physician payment records.
[. . .]
But most physicians take their professional duties seriously. They make a good faith effort to perform services for the best interests of their patients and not for personal gain. They don’t deserve to be pilloried based on misleading information. Until Medicare payment records can be made useful and readily intelligible, CMS should suspend their release. If CMS insists on going ahead, it should at least help people understand what they’re looking at.

http://www.city-journal.org/2015/eon0224jz.html

JOEL ZINBERG
When Transparency Isn’t Transparent
A planned release of Medicare and Medicaid physician data will likely confuse patients and the public.
24 February 2015

Medcaid/Medicare Fraud Attracts Major Players in Florida

A Federal and state law enforcement official walks outside the office of Med-Care Diabetic and Medical Supplies company during a raid in Boca Raton, Florida, January 14, 2015.
Credit: REUTERS/Andrew Innerarity


[From article]
U.S. FBI agents on Wednesday raided the offices of Med-Care Diabetic & Medical Supplies Inc, a Florida medical device company whose executive vice president helped inspire the movie "The Wolf of Wall Street," according to two witnesses.
Dozens of agents from the FBI, Florida fraud department, and local police closed entrances to the building that houses Med-Care, and are removing boxes of files, one of the witnesses said.
Danny Porush is a top executive at Med-Care and inspired the character portrayed by actor Jonah Hill in "The Wolf of Wall Street," which told the story of defunct brokerage firm Stratton Oakmont Inc.
An FBI spokesman said the agency is conducting "law enforcement activity in the vicinity" when asked about witnesses' details, but declined further comment.

http://www.reuters.com/article/2015/01/14/us-fbi-wolfofwallstreet-idUSKBN0KN25Y20150114

Exclusive: FBI raids Florida offices of firm with 'Wolf of Wall Street' link - witnesses
WASHINGTON/BOCA RATON, FL.
Wed Jan 14, 2015 2:48pm EST

Elders and Poor Endangered By New Health Care Law

[From article]
Medicaid, the government program that ostensibly provides health coverage for the poor, imposes so much red tape and pays so parsimoniously that she simply cannot afford to treat these patients if she wishes to avoid bankruptcy.
[. . .]
“There’s a massive fallacy at the heart of Medicaid and therefore at the heart of Obamacare. It’s the idea that health insurance equals health care.” And, as is usually the case with the deliberately deceptive fallacies promoted by the Democrats, the target victims are poor Americans. Just as Obamacare’s Medicare Advantage cuts will be felt primarily by low-income seniors, its Medicaid fraud will hurt the country’s most vulnerable patients. It will restrict their access to doctors and reduce the quality of what little care they receive.
[. . .]

“It has gotten so bad that, in the average state, for every dollar that a private insurer pays a primary care physician to care for a patient, Medicaid pays 52 cents.” Many states pay even less. New York, for example, pays 29 cents.
[. . .]
The Democrat record regarding the underprivileged isn’t pretty. They defended slavery, enforced racial segregation, opposed women’s suffrage, and still chain low-income students to public schools that teach them virtually nothing. It shouldn’t be surprising, then, that the Democrats have created a health “reform” program that denies poor people access to decent medical care.

http://spectator.org/articles/57334/obamacare’s-medicaid-fraud

OBAMACARE’S MEDICAID FRAUD
Dooming the poor to third-rate health care.
By David Catron

1.6.14

Government Continues to Mislead Taxpayers

[From article]
The economics specialty that reveals this is known as the incidence of taxation. The burden of a tax is not necessarily borne by the party upon whom it is levied. The Joint Committee on Taxation held that "both the employee's and employer's share of the payroll tax is borne by the employee." The Congressional Budget Office "assumes — as do most economists — that employers' share of payroll taxes is passed on to employees in the form of lower wages than would otherwise be paid." Health insurance is not an employer gift, either.
Another part of Social Security and Medicare deception is that the taxes are officially called FICA, which stands for Federal Insurance Contributions Act. First, it's not an insurance program. More importantly, the word "contribution" implies something voluntary. Its synonyms are alms, benefaction, beneficence, charity, donation and philanthropy. Which one of those synonyms comes close to describing how Congress gets Social Security and Medicare money from us?

http://jewishworldreview.com/cols/williamns112013.php3#.UpJrtt00i6Y

Jewish World Review
Nov. 20, 2013/ 17 Kislev, 5774
Do Americans Prefer Deception?
By Walter Williams

Obama Warns SCOTUS

http://patriotupdate.com/22481/dictator-obama-issues-new-threat-to-supreme-court-over-obamacare#.T6W8pmbQiSA.email

Dictator Obama Issues New Threat To Supreme Court
Saturday, May 5, 2012
Patriot Update

Decreased Medicare Payments Threaten Finances of Doctors

[From article]
"Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue."

http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm?hpt=hp_t3&hpt=hp_c1

Doctors going broke
By Parija Kavilanz @CNNMoney
January 5, 2012: 12:37 PM ET

Medicare Fraud of $295 million

More lucrative than dealing drugs. Lesser penaltiies, lesser scrutiny and lesser concern from taxpayers, voters, pols and police. What's not to like about medicare fraud?

[From article]
"That particular scheme and other frauds, operated out of an entity called Biscayne Milieu, accounted for $50 million of the fraudulent Medicare claims, prosecutors said. It provided no legitimate services.
"It was a complete fraud," Ferrer said."

http://www.cbsnews.com/stories/2011/09/07/ap/cabstatepent/main20102867.shtml

September 7, 2011 4:07 PM
91 charged in Medicare fraud crackdown
CBS News
AP

Doctor Shortage

[From article]
"Roughly 13% of physicians will not accept Medicare patients today. Another 17% limit the number of Medicare patients they will see, a figure that rises to 31% among primary care physicians. The story is even worse in Medicaid, where as many as a third of doctors will not participate in the program.
[. . .]
The government’s own chief actuary says that reimbursement cuts could mean “reductions in access to care and/or the quality of care.”

http://www.nypost.com/p/news/opinion/opedcolumnists/doc_holiday_Nyb5JCHkWyejLq7dTjTs2J

Doc holiday
Behind the coming physician shortage
Michael D. Tanner
New York Post
Last Updated: 4:52 AM, May 1, 2011
Posted: 11:01 PM, April 30, 2011

Hospice Industry Exploits Medicare

Massachusetts wants to imitate the horrific law that exists in New York State. One more example of medical industry lobbyists corrupting the legislature for profit.


http://www.nypost.com/p/news/opinion/opedcolumnists/stop_telling_us_where_to_die_CwyJwzRLHuo7G7PCCIucwO

Stop telling us where to die
Betsy McCaughey
New York Post
Last Updated: 5:00 AM, March 17, 2011
Posted: 10:33 PM, March 16, 2011

ObamaCare Is as Bad As Opponents Said

[From article]
"The leaders of the American Medical Association (that pathetic organization of bureaucrats and lobbyists) sold its support for President Obama's health-care "reforms" for a promise to permantently repeal these cuts -- and was promptly disappointed. The so-called "doctor fix" didn't make it into the reform law because it cost too much by Washington's eccentric accounting standards."

http://www.nypost.com/p/news/opinion/opedcolumnists/why_docs_are_running_from_medicare_C77TdmTjY1SNqFxSHWlb9M

Why docs are running from Medicare
By MARC K. SIEGEL
New York Post
Last Updated: 12:23 AM, November 24, 2010
Posted: 11:16 PM, November 23, 2010

Alaska Suit for Psychiatry Drug Fraud

http://psychrights.org/pr/100325Motion4PreliminaryInjunctionNR.pdf

NEWS RELEASE

FOR IMMEDIATE RELEASE CONTACT

March 25, 2010 Jim Gottstein

907-274-7686

jim.gottstein@psychrights.org

PsychRights Files for Order Prohibiting State of Alaska from Continuing to Perpetrate Medicaid Fraud

Late yesterday the Law Project for Psychiatric Rights (PsychRights^®) asked the United States District Court in Alaska to prohibit William Hogan, Alaska's Commissioner of Health and Social Services, and William Streur, its Director of Health Care Services, from continuing to defraud the federal government by submitting claims for off-label psychotropic drugs forced on children and youth that have been banned by Congress.

"Commissioner Hogan and Director Streur were informed these practices were illegal and constituted Medicaid Fraud in September of 2008, yet they have continued to flout the law and perpetuate this fraud on the federal government," said Jim Gottstein, the attorney handling the case for PsychRights, "Children and youth continue to be grievously harmed by this practice and this is the first chance we have had to try and get a court to stop the practice."

PsychRights Motion for Preliminary Injunction Against Defendants Hogan and Streur was filed in United States ex rel Law Project for Psychiatric Rights v. Matsutani et.al, USDC Alaska Case No. 3:09-cv-80-TMB, which seeks $5,500 in minimum penalties for each of thousands to millions of offending prescriptions from 32 defendants, including psychiatrists, their employers, and pharmacies.

It is Medicaid fraud to cause or submit prescriptions to Medicaid for reimbursement if they are not for a medically accepted indication. PsychRights has developed a Medically Accepted Indications Chart showing what is allowable for common psychiatric drugs. Every other use of these drugs in children and youth and submitted to Medicaid is fraudulent. The fraud is rampant, with PsychRights conservatively estimating at least half of psychotropic drug prescriptions to children and youth submitted to Medicaid are not for medically accepted indications and therefore fraudulent.

The Law Project for Psychiatric Rights is a public interest law firm devoted to the defense of people facing the horrors of forced psychiatric drugging and electroshock. PsychRights is further dedicated to exposing the truth about psychiatric interventions and the courts being misled into ordering people subjected to these brain and body damaging drugs and electroshock against their will. Extensive information about the tragic damage caused psychiatric drugs and electroshock is available on the PsychRights web site: http://psychrights.org/.

James B. (Jim) Gottstein, Esq.

President/CEO

Law Project for Psychiatric Rights
406 G Street, Suite 206
Anchorage, Alaska 99501
USA
Phone: (907) 274-7686) Fax: (907) 274-9493
jim.gottstein[[at]]psychrights.org
http://psychrights.org/

See also:

http://www.nypost.com/p/news/local/fraud_docs_foot_rubs_rLATNW7CHWIZmsX0R2yg8M

'Fraud' docs' 500G foot rubs

By JANON FISHER

New York Post

Last Updated: 7:28 AM, March 25, 2010

Posted: 3:26 AM, March 25, 2010

Obama and Insurance Premiums

[From article]
"In 301 AD, the Roman emperor Diocletian imposed price controls on most commodities and professions in the empire. The penalty for raising prices was death. Yet the controls failed utterly, leading to shortages, more inflation and the near collapse of the imperial economy.[. . .]
Medicare already reimburses at roughly 80 cents on every dollar of actual costs. Medicaid pays even less. As a result, more than a third of physicians have closed their practices to Medicaid patients; 12 percent no longer accept Medicare patients.
[. . .]
more than 750,000 Britons are waiting for admission to hospitals. Every year, British physicians cancel almost 50,000 surgeries because patients on the waiting list become too sick for the operations to proceed.

In Canada, almost 800,000 people are on the waiting list for care. And, according to the Canadian Supreme Court, many are in chronic pain and some will die while waiting for treatment."

http://www.nypost.com/p/news/opinion/opedcolumnists/price_controls_by_any_other_name_U1itPDcdkkV9creOxoysFK

Price controls by any other name
By MICHAEL TANNER
New York Post
Last Updated: 4:02 PM, February 23, 2010
Posted: 12:21 AM, February 23, 2010

Mayo Clinic Drops Obama Model Medicare Patients


http://www.bloomberg.com/apps/news?pid=20601087&sid=aHoYSI84VdL0

Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
By David Olmos
Bloomberg.com
December 30, 2009

Public Option Alternative


The Medicare Payment Advisory Commission says only 69.5 percent of doctors are willing to accept new Medicaid patients.

http://www.nypost.com/p/news/opinion/opedcolumnists/public_option_rotten_replacements_VKbjcLcg1hpL3dHmwPkI2H

Public option's rotten replacements
By MICHAEL TANNER
New York Post
Last Updated: 8:35 AM, December 10, 2009
Posted: 1:48 AM, December 10, 2009

Mammograms, and the Health care Bill


"Sen. Barbara Mikulski (D-Md.) introduced an amendment to [that] did nothing to change page 17 of the Senate health bill -- which focuses on guidelines that insurance, starting with Medicare, will be compelled to cover: 'Items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventative Services Task Force.'"

"That is, insurers wouldn't have to cover tests graded C or D -- and the Senate bill, with its taxes and other penalties for "overly generous" policies -- slams many insurance plans that go beyond government recommendations."
[. . .]
"That not only means that some important things won't be covered but also that wasteful spending that has support from the bureaucrats or the politicians will be part of every policy."

http://www.nypost.com/p/news/opinion/opedcolumnists/the_don_check_list_L6sve6A9ClAq4fQ6Q5qOBM

The don't-check list
Doctor's ObamaCare worry
By MARC K. SIEGEL
New York Post
Last Updated: 6:55 AM, December 7, 2009
Posted: 2:02 AM, December 7, 2009