Tag Archives: reading

South Shore Hospital Overcharged Medicare

  By jellybellyhoo | March 28, 2011 - 7:43 pm |
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Auditors have reported that South Shore Hospital overcharged Medicare by around $341,000. The money will be reimbursed by the hospital.

WEYMOUTH —

South Shore Hospital is reimbursing the federal Medicare program for about $341,000 after federal auditors discovered nearly 250 billing or coding errors that created overpayments to the hospital.

The inspector general’s office at the U.S. Department of Health and Human Services sent a final report on the agency’s audit to the hospital earlier this month. The errors were discovered when auditors from the agency visited the Weymouth hospital last August and September to comb through records of claims from 2008 and 2009 that would be particularly susceptible to Medicare billing errors.

The auditors focused on a sample of 389 claims that could be susceptible to errors, and found 249 claims in that group with mistakes. The errors led to overpayments to the hospital totaling about $341,000 over the two years, the agency said.

South Shore Hospital spokeswoman Sarah Darcy said the hospital made internal improvements to prevent similar errors and… continue reading

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Critz Tries to Protect Social Security

  By jellybellyhoo | March 27, 2011 - 7:42 pm |
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U.S. Rep. Mark Critz has offered an amendment that will help protect Medicare and Social Security. The amendment was made during Tuesday’s House debate.

U.S. Rep. Mark Critz, D – Johnstown, offered an amendment to protect Social Security and Medicare during Tuesday’s House debate on a stopgap measure to extend federal funding of government agencies through April 8.

The continuing resolution will expire March 18. Continuing resolutions keeps the federal government funded until a budget can be passed.

Critz’s motion failed by a vote of 190 to 239. His motion would have prohibited funds in the legislation from being used to implement a system that cuts Medicare benefits or privatizes Social Security.

“The folks I live with and live around come to rely on Social Security,” Critz told House members.

Critz is concerned that as more cuts are made to the federal budget, some may target Medicare or Social Security. He said that Social Security has $2.6 trillion in reserves and has not contributed to the federal deficit.

“Don’t buy into this crisis legislation,” he said.

Critz also used his time encourage… continue reading

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Man Guilty of Social Security Fraud

  By jellybellyhoo | March 26, 2011 - 7:41 pm |
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A Ceres man has pleaded guilty to Social Security fraud. The man was collecting and cashing checks of a deceased woman.

Charles Francis Sheppard, 56, of Ceres, pleaded guilty Monday to theft of government property, according to U.S. Attorney Benjamin Wagner.

According to the plea agreement, from 1988 to 2009, Mr. Sheppard received the Social Security retirement benefits of a legitimate recipient who had died in 1988.

Mr. Sheppard was on the deceased’s death certificate as the person to be notified. As such, he identified the deceased and provided her personal information to the county recorder who issued the certificate of death.

The Social Security Administration was not informed of the death and its checks kept on coming – and Mr. Sheppard kept on cashing them, prosecutors say.

The government says he could have gotten as much as $400,000 this way.

Mr. Sheppard is scheduled to be sentenced on Aug. 1, when he could face a maximum penalty for theft of… continue reading

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Medicare Lawsuit for Alleged Underpayment

  By jellybellyhoo | March 24, 2011 - 6:18 am |
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Several California counties and three doctors have brought a lawsuit against the Department of Health and Human Services. The lawsuit states that Medicare has underpaid its physicians and is seeking $3.2 billion in compensation.

Seven California counties and three physicians have sued the Dept. of Health and Human Services for $3.2 billion, accusing the agency of Medicare underpayments to physicians.

The lawsuit claims that Medicare knowingly has used an outdated geographic rate system to pay physicians for more than 10 years. The formula has led to severe underpayments to doctors in some parts of the state while providing overpayments to physicians in other areas, according to the suit, filed Feb. 19 in the U.S. District Court for the Northern District of California.

This is the second time the lawsuit has been filed. The court battle started in 2007, when seven California counties, including Santa Cruz, San Diego and Monterey, sued HHS. A federal trial court dismissed that case in 2009, saying the counties did not have standing to sue on behalf of doctors.

But a Sept. 29, 2010, ruling by… continue reading

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Woman Charged With Fraud

  By jellybellyhoo | March 24, 2011 - 6:14 am |
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A woman has been sent to federal prison for 21 months for Social Security fraud. The 55-year-old woman was charged with conspiracy to produce and sell fraudulent Social Security and immigration documents.

A 55-year-old Strathmore woman was sentenced Friday to 21 months in federal prison for conspiracy to possess, transfer, produce and sell fraudulent U.S. immigration and Social Security identification documents.

Maria Ines Rangel-Lemus had pleaded guilty in November. According to court documents, prospective purchasers would meet Rangel-Lemus and ask that Social Security cards and permanent-resident cards be made with their pictures and biographical information. A co-defendant would then acquire the picture and biographical information, return to his residence to produce the documents, and then provide Rangel-Lemus with the… continue reading

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Looking After Aging Parents

  By jellybellyhoo | March 23, 2011 - 6:10 am |
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More children these days have to confront the issue of looking after aging parents. It is better to address the situation early on in order to come to an agreement regarding their future.

They struck a deal. Graybeal, 75, still lives alone in her own home in Mountain City, Tenn., despite having treatments for oral cancer in 2007 and a total hip replacement two years ago. With the aid of services Greene found through the area Council on Aging, her meals are delivered, and a caregiver helps several hours a week with household tasks.

In return, Graybeal gave her daughter durable power of attorney, a binding agreement allowing her to make legal and financial decisions for her. They talk daily and Greene visits weekly.

“I took it upon myself to say, ‘Things are going to be different now,’” Greene says. “I told her in anticipation of things down the road, we’re going to have to get things in order. I knew I was going to have to be… continue reading

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New Mexico Does Not Want to End Immigrant Licenses

  By jellybellyhoo | March 22, 2011 - 6:06 am |
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New Mexico has rejected a Republican-backed plan that would prohibit illegal aliens from getting driving licenses. The proposal would have made it illegal to get a license without a Social Security number.

SANTA FE, N.M. — The Senate has rejected a Republican-backed proposal to stop New Mexico from issuing driver’s licenses to illegal immigrants.

The Senate voted 24-17 Wednesday night against a proposal that would have ended the practice of granting licenses to foreign nationals without a Social Security number.

Sen. John Ryan, R-Albuquerque, said it’s a public safety risk to issue licenses to those living in this country illegally. But Democrats said the move was politically motivated and targeted Mexican immigrants.

Under a 2003 law, more than 80,000 driver’s licenses have gone to foreign nationals. The state says it doesn’t know how many of those went to illegal immigrants because it doesn’t ask the immigration status of… continue reading

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Social Security Employee Threatened by NY Man

  By jellybellyhoo | March 18, 2011 - 6:01 am |
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A man in Long Island threatened to kill a Social Security employee and has been arrested by the Nassau County police. The man was unhappy about the service he had received, and made the threat over the phone.

MINEOLA, N.Y. — A Long Island man has been arrested for allegedly threatening to kill a Social Security employee.

Nassau County police say Patrick Finnegan of Port Washington made the threat over the phone on Wednesday.

They say he told the worker he was unhappy with the service he had received and if his complaint was not resolved he would blow her or someone’s brains out.

Police charged Finnegan with making a terrorist threat and aggravated harassment. He’s to be arraigned on Thursday in Hempstead.

It was not immediately known if he had obtained a lawyer.

The employee worked in office in… continue reading

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Government Focuses on Prevention to Curb Medicare Fraud

  By jellybellyhoo | March 17, 2011 - 8:11 pm |
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Right now, Medicare fraud costs the government and taxpayers billions of dollars. In order to reduce the occurrence of fraud, the government is stressing prevention practices.

(Reuters) – Healthcare programs are moving away from “pay and chase” and concentrating more on prevention in the battle against fraud that costs the government billions of dollars, U.S. officials told Congress on Wednesday.

Overseers of Medicare and Medicaid are concentrating on preventing “bad actors” from enrolling as service providers in the massive federal programs that provide healthcare to the elderly and poor, Peter Budetti of the Centers for Medicare and Medicaid Services told the Senate Finance Committee.

“Our goal is to keep those individuals and companies that intend to defraud Medicare, Medicaid and (Children’s Health Insurance Program) out of these programs in the first place, not to pay fraudulent claims when they are submitted, and to remove such individuals and companies from our programs if they do get in,” Budetti said in testimony.

Historically the programs would pay claims and… continue reading

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More and More Texas Doctors Leaving Medicare

  By jellybellyhoo | March 16, 2011 - 8:09 pm |
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In 2010, the number of doctors who left Medicare reached an all time high. Doctors have become fed up with the declining reimbursements from the federal program.

Texas doctors fed up with Medicare’s declining reimbursements dropped out of the government-funded program for the elderly in record numbers in 2010, according to new data.

One hundred and seventy-two doctors formally ended involvement with Medicare last year, the most yet in a surge of “opt-outs” that has claimed more than 450 Texas doctors since 2008. Before 2007, the number averaged a handful a year.

“Those numbers show the growth in opt-outs is definitely a trend and that the system is dysfunctional,” said Dr. Susan Rudd Bailey, president of the Texas Medical Association, the state’s largest organization of doctors. “It’s a real concern that more doctors are being forced out of the system every year.”

Since 2001, Medicare reimbursement has been cut about 20 percent in inflation-adjusted dollars. TMA officials contend those cuts are forcing doctors out of the system.

The 172 opt-outs follow totals of 135 in 2009 and 151 in 2008, according to data compiled by the… continue reading

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