Politico (5/9/12) reports that health insurance companies cited by the US Department of Health and Human Services (HHS) “for ‘unreasonable’ premium hikes are refusing to back down in the first year of HHS’s new rate review authority.” While “the health reform law gave HHS the power to scrutinize ‘unreasonable’ rate hikes in states that didn’t have robust review programs,” such “’scrutiny’ doesn’t give the department power to actually block the rates from going into effect.” In four cases, HHS has used “its bully pulpit to publicly shame insurers whose rates don’t pass its sniff test,” but when “faced with the choice of dealing with some negative press on the national stage or upending their business plan, the four insurers that have been dinged by HHS have all chosen to stick with the business plan.”

The National Journal (5/9/12) reports, “Congress may have just renewed the payroll-tax holiday in February, but the AARP is already trying to ensure it doesn’t happen again.” The organization “sent a press release on Monday sure to act as a GOP dog whistle, rekindling previous tensions over how reductions to the payroll tax would affect the Social Security Trust Fund.” The Journal says “the early warning from AARP is a clear hint that not everyone in Washington believes lawmakers’ claims that the payroll tax holiday was always meant to be temporary.” Another National Journal (5/9/12) news roundup includes the same story.

The Huffington Post (5/9/12) reports, “When someone is diagnosed with cancer, they are so deluged with information about their health and how to treat the disease so that managing their Medicare or Medicaid coverage gets overlooked.” The American Cancer Society offers volunteers to help patients deal with the paperwork. Patients diagnosed with cancer are urged to “connect with their hospital’s social worker for help in navigating their Medicare and Medicaid coverage.”

USA Today (5/7/12) reports, “Health care costs are a top retirement fear, and that’s even though many older workers vastly underestimate how much they’ll have to pay.” According to a Harris Poll released by Nationwide Financial, “nearly half of affluent Americans, who have at least $250,000 in household assets, say they are scared that rising health care costs will deplete their retirement savings,” while “43% of the affluent older workers don’t know how much they will spend for health care in retirement.” John Carter, president of Nationwide Financial Distributors, noted that “pre-retirees often wrongly assume that Medicare covers the cost of long-term care,” which “is a wake-up call that Americans need good financial advice to prepare for their future health care costs.”

USA Today /Kaiser Health News (5/7/12) reports on NowClinic online care, a subsidiary of UnitedHealth Group, which “is part of the explosion of Web- and telephone-based medical services that experts say are transforming the delivery of primary health care, giving consumers access to inexpensive, round-the-clock care for routine problems – often without having to leave home or work.” While proponents “see it as an answer to a worsening doctor shortage,” several “physician and consumer groups worry about the trend.” Glen Stream, president of the American Academy of Family Physicians, remarked, “Getting medical advice over a computer or telephone is appropriate only when patients already know their doctors. Even for a minor illness, I think people are going to be shortchanged.”

The AP (5/3/12) reports, “Dozens of women on Thursday filed a lawsuit against Attorney General Rob McKenna, alleging that his participation in legal action seeking to overturn the new federal health care law threatens access to comprehensive coverage for women.” This “politically charged lawsuit is seeking a ruling that McKenna violated his ethical duties by asking the Supreme Court to invalidate protections for women’s health care.” The lawsuit seeks “to force McKenna to ask the US Supreme Court to maintain women’s health care requirements, no matter how justices rule on the individual mandate.”

The Hill (5/4/12) reports in its “Healthwatch” blog, “House Republicans attacked the 2010 healthcare law Wednesday for expanding a preventive care grant program that, they said, has funded pet spaying and neutering in Tennessee,” as well as “urban farming initiatives and the improvement of city bike lanes.” GOP spokeswoman Debbee Keller argued that “these projects are ‘examples of what we consider excessive, wasteful government spending,’…’and the healthcare law will funnel money to others like them.’” The piece notes, “A spokesman for the Department of Health and Human Services (HHS) responded to the allegations with a statement, saying that ‘HHS and its agencies take the responsibility as stewards of taxpayer dollars very seriously.’ ‘HHS is committed to ensuring the proper use of appropriated funds, and to ensuring awardees’ compliance with all applicable regulations and statutes related to lobbying activities,’ the statement added.”

Politico (5/3/12) reports, “The United States spends more on health care than 12 other industrialized countries, a new Commonwealth Fund study finds – but that doesn’t mean this country’s care is any better.” At a per capita cost of “nearly $8,000″ the report found that “health care spending in the US dwarfs,” the others’ spending with “Norway and Switzerland…a distant second and third…at a little more than $5,000.” Meanwhile the US “ranked at the bottom for the number of doctor consultations … had shorter hospital stays,” and “a smaller number of hospital beds.” The report attributes spending to “high prices for medication and medical services, as well as a good deal of use of expensive technology,” and a high rate of obesity. It also found that “quality in the US health care system is variable and not notably superior,” to compared countries which are “Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.”

Healthcare IT News (5/3/12) reports, “Higher prices and greater use of technology appear to be the main factors driving the high rates of US spending on healthcare, rather than greater use of physician and hospital services.” The US also has “among the highest rates of potentially preventable deaths from asthma and amputations due to diabetes, and rates that are no better than average for in-hospital deaths from heart attack and stroke.”

The Washington Post (5/3/12) reports in its “Wonkblog” that “in the health reform debate, there’s a lot of crystal-ball gazing about what employers will do when, in 2014, tens of millions of Americans become eligible for publicly-subsidized health insurance. … A new report, out Tuesday from Republicans on the House Ways and Means Committee, estimates that America’s 100 largest companies could save a collective $422 billion over a decade.” The piece notes that it is “worth understanding why employers offer insurance now, and how that might change under the Affordable Care Act.”

Holder, Sebelius Announce Charges In Massive Medicare Crackdown.
The announcement by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius that federal prosecutors have charged 107 doctors and others in a massive Medicare fraud crackdown generated heavy media coverage last night and this morning, including coverage on two network newscasts.

ABC World News (5/2/12) reported on “the largest nationwide bust in Medicare history. Seven cities, from Chicago to Miami, Houston to Baton Rouge showing us how gigantic this problem is, 107 doctors, nurses and social workers were charged and the FBI said they had scrammed taxpayers out of nearly half a billion dollars.”

The CBS Evening News (5/2/12) reported, “Federal agents have executed a massive roundup of suspects for Medicare fraud, breathtaking in its scope. There were raids yesterday in seven cities. One hundred and seven people are accused tonight in scams to steal $452 million from the program. They include doctors, nurses, and owners of mental health centers who allegedly billed taxpayers for treatments that patients never received.”

The AP (5/3/12) calls it “the latest in a string of major arrests in the past two years as authorities have targeted fraud that’s believed to cost the government between $60 billion and $90 billion each year. On Wednesday, hundreds of federal agents fanned out around the country, raiding businesses, seizing documents and charging 107 suspects in Miami, Los Angeles, Houston, Detroit, Chicago, Tampa, Fla., and Baton Rouge, La. The government suspended payment to 52 providers as part of the investigations.”

The Detroit Free Press (5/3/12) reports that 19 people were arrested in the Detroit area “in what authorities say is a health care fraud scheme that bilked the government out of $58 million, the Free Press has learned. Sources tell the Free Press the FBI has raided 10 facilities across metro Detroit as part of a nationwide crackdown on health care fraud. Agents across the country are conducting more take-downs today as part of an ongoing effort to tackle what has become a pervasive problem in the country: medical facilities and health care providers billing the government for bogus services.”

The Wall Street Journal (5/3/12) reports that Holder and Sebelius announced that individuals had been charged in seven cities nationwide, and notes that at least 83 defendants were in custody as of Wednesday morning.