Archive for May, 2007

Authorities arrest 12 in HIV billing probe

Thursday, May 31st, 2007

The owners of a Belle Glade clinic and 11 of their employees were arrested today on charges they fraudulently billed medicaid and medicare more than $5 million for HIV treatments that were never delivered to patients.

Read more here…

Belle Glade woman among nine arrested in $5 million health fraud scheme

Thursday, May 31st, 2007

Nine people, including a Palm Beach County woman, were arrested Thursday for their alleged roles in a $5 million criminal operation that billed Medicare and medicaid for fake HIV treatments, prosecutors said.

Read more here…

Storan Technologies Releases New Version of Medicare Risk Adjustment Software

Thursday, May 31st, 2007

Storan Technologies Inc. is announcing the immediate availability of Merlin Risk Adjustment 5.0, a Web-based solution that helps health plans and medical groups efficiently and accurately document an individual patient’s diagnoses to ensure full Medicare reimbursement.

Read more here…

Medicare To Deny Coverage Of Artificial Spinal Disks

Thursday, May 31st, 2007

Federal regulators on Friday announced that Medicare planned to deny coverage of artificial disks implanted in the lower spines of beneficiaries older than age 60, the New York Times reports. Artificial disks “were seen as a potential alternative” for up to a quarter of the 220,000 spinal fusion surgeries performed annually, according to the Times. [click link for full article]

Read more here…

Bravo by Elder Health Names Gil Miller Its Executive Vice President of Sales

Thursday, May 31st, 2007

Bravo by Elder Health, a locally based Medicare Advantage health plan, announced today that Gil Miller has been appointed executive vice president of sales. In this new position, Miller will be responsible for sales and broker development in all markets Bravo serves, including Delaware; Maryland; Pennsylvania; Texas; and Washington, D.C.

Read more here…

JEN Associates, Inc.: Data Suggests Fewer Deaths But More Complications and Higher Costs for Medicare’s HIV Caseload

Thursday, May 31st, 2007

According to a new study published by the American Journal of Public Health, improved HIV treatments continue to lower the death rate among Medicare patients with HIV, while total Medicare expenditures for this population are rising sharply. In addition, Medicare’s HIV patients, particularly African Americans, face growing non-HIV illnesses such as diabetes, heart failure and kidney and liver …

Read more here…

Insurers Launch Comprehensive Initiative To Strengthen Protections For Medicare Beneficiaries, USA

Thursday, May 31st, 2007

The Board of Directors of America’s health insurance plans (AHIP) today announced a new initiative to protect beneficiaries as they consider enrolling in the Medicare Advantage and Part D programs and ensure that brokers, agents and plan marketing staff meet new qualifications and requirements. [click link for full article]

Read more here…

Debate over Reducing Medicare Advantage Plan Payments Continues

Wednesday, May 30th, 2007

May 30, 2007 - Lawmakers continue to debate whether to reduce federal payments to private insurers that administer the fastest-growing type of Medicare advantage plans — private fee-for-service plans, the AP/Atlanta Journal-Constitution reports (Freking, AP/Atlanta Journal-Constitution, 5/30).

Read more here…