Medicare

Medicare scams come in varied sizes, but William Hlushmanuk's was one of the more industrious. The Northeast Philadelphia man had little training when he launched an ambulance service and went to dialysis centers to recruit passengers, sometimes right in the waiting rooms. Most weren't medically eligible for a ride - they were able to walk or drive - but no one really checked. Three times a week, Hlushmanuk's staff would shuttle patients for treatment, then bill the government. In five years, he soaked Medicare for $5.4 million, spending it on motorcycles, drugs, a house, a souped-up Hummer, and trips to Las Vegas and Florida.

WASHINGTON - President Obama's plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president's budget. As released two days earlier, the budget included only a vague description of a controversial proposal that has grown more ambitious since Obama last floated it. "Means testing" has been part of Medicare since the George W. Bush administration, but ramping it up is bound to stir controversy.

President Bush yesterday signed into law the most sweeping changes to Medicare since its creation nearly four decades ago, including a new prescription-drug benefit for older Americans. The landmark law also will inject competition into the government health-care program for the first time, by letting private companies compete with traditional Medicare. Bush said the changes would bring Medicare into the 21st century. Critics predicted they would destroy the health-care safety net that serves 40 million older Americans.

Rich Welsh (Guest Opinion, July 30) appears to have been taken in by the Republican congressional leadership's disinformation to distract citizens from Rep. John Fox's votes for the Newt Gingrich budget that made deep cuts in Medicare. In reality, it is the Republican leaders and their right-wing allies who are "playing dirty on Medicare" in an attempt to undermine the AFL-CIO's efforts to educate the American public. They have even stooped to threatening libel suits against TV and radio stations that run AFL-CIO ads documenting votes for drastic cuts in Medicare by members of Congress, including Jon Fox. Welsh parrots the GOP's line that House Speaker Newt Gingrich wasn't referring to Medicare when he said, "We think it's going to wither on the vine.

More and more seniors are opting to remain in the workforce nowadays, even after their Social Security kicks in, leaving questions about Medicare benefits for another day. When another day arrives, chances are a retiree needs help in deciding where to go for supplemental health coverage, whether to sign up with an HMO or any one of the more than 40 insurance providers registered in Pennsylvania. Where does one find this kind of free help? In Delaware County it's an agency called Horizons Unlimited, which administers a state-funded Medicare health insurance counseling program known as APPRISE.

Edward Howard thought he was prepared for old age. The former government worker had managed to save $130,000 for retirement. He owned his ranch house in a suburb of Washington. And he had monthly income of nearly $2,300 from a pension and Social Security. Because he was 65, Howard automatically qualified for Medicare, the federal health-insurance program for the elderly. But just to be on the safe side, he bought four health-insurance policies. "I thought I had all the bases covered," Howard, a 72-year-old amputee, said in a recent interview.

Republicans greeted President Clinton's proposal to expand Medicare to include the "near elderly" with all the grace Socks showed Buddy. Fangs bared and back arched. California Republican Bill Thomas, chairman of the House Ways and Means subcommittee on health, said, "If the era of big government is over, why is the president proposing all these government expansions?" Texas Republican Sen. Phil Gramm called the plan "99 percent politics and 1 percent public policy. " And Ohio Republican John R. Kasich, head of the House Budget Committee, said there was no way Congress would approve.

LAST WEEK, I had to pay cash for my prescription because either Blue Cross' or our government's computers weren't updated to the changes in Medicare. Added to that aggravation is the unabashed greed the pharmaceutical industry expects us to support. My prescription plan has an annual cap. Because of that, I know the retail cost was $173 last year. This time, I had to pay $200. That increase, I suspect, is due solely to the federal government's paying either the whole freight or the difference in private coverage.

MEDICARE is not the panacea many make it out to be. Its costs are exploding and fraud is rampant - just another poorly administered federal program. Moreover, the projections in 1961 were completely wrong such that its present-day cost is hundreds of billions in excess of the estimates. Ronald Reagan was right in 1961 to object to government involvement - and if he were alive today, it's clear that he would be against Obamacare. John Belli, Philadelphia

WARREN, Ohio - Republican vice presidential contender Paul Ryan says he never would have included a $700 billion Medicare cut in his budget if President Obama hadn't done it first. "He put those cuts there," Ryan said Thursday, responding to a reporter's question. "We would never have done it in the first place. " Medicare, the health-care program for tens of millions of seniors, has become a key issue in the race for the White House. The Wisconsin congressman is perhaps best known for authoring a controversial budget plan that would transform Medicare into a voucher-like system.

Medicare scams come in varied sizes, but William Hlushmanuk's was one of the more industrious. The Northeast Philadelphia man had little training when he launched an ambulance service and went to dialysis centers to recruit passengers, sometimes right in the waiting rooms. Most weren't medically eligible for a ride - they were able to walk or drive - but no one really checked. Three times a week, Hlushmanuk's staff would shuttle patients for treatment, then bill the government. In five years, he soaked Medicare for $5.4 million, spending it on motorcycles, drugs, a house, a souped-up Hummer, and trips to Las Vegas and Florida.

Bills for knee replacements in the Philadelphia region in 2011 ranged from $30,386 at Chester County Hospital to $202,777 at Our Lady of Lourdes Medical Center in Camden, federal data released Wednesday showed. But Medicare paid both hospitals just a fraction of those billed charges. When a patient receives his statement, it usually indicates the inflated billed charges as well as the lower figure actually paid by the insurer. Medicare paid Lourdes an average of $15,681 for 31 knee replacements in 2011.

Chemed Corp., the largest for-profit provider of hospice care in the United States, was accused by the U.S. government Friday of false billing for Medicare services. Based in Cincinnati, Chemed is a holding company that also owns Roto-Rooter plumbing services. The U.S. filed a lawsuit in federal court in Missouri, claiming Chemed's Vitas Hospice units knowingly billed the government's Medicare program for crisis-care services that were not necessary, were not provided, or were not performed as required, the Justice Department said.

A former head of operations for Vanguard, Vincent McCormack is a brusque New York native who values results. So when asked to evaluate his 2011 treatment for heart failure at Lankenau Medical Center, he zeroed in on the most fundamental kind of outcome. The fact that he lived to tell the tale. "I haven't felt this good in 20 years," said McCormack, 75, whose case was so severe he had a heart pump implanted in his stomach. The government began publicly reporting death rates in 2007 for heart failure and heart attacks, and Lankenau, a member of the Main Line Health system, has been a perennial standout.

EVEN ON our better days, we have a hard time figuring out how Gov. Corbett's brain works - although not for lack of trying. We get that one of his big ideas is that bigger government is bad, and that free markets are better. That probably explains his resistance to allowing more federal dollars to flow into the state under an expansion of the Medicaid program. But Corbett is the governor of an entire state, not just a single party, so when economic benefits outweigh ideological beliefs, it's his job to make the decision that will help as many residents as possible.

WASHINGTON - President Obama's plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president's budget. As released two days earlier, the budget included only a vague description of a controversial proposal that has grown more ambitious since Obama last floated it. "Means testing" has been part of Medicare since the George W. Bush administration, but ramping it up is bound to stir controversy.

Federal prosecutors in Philadelphia on Wednesday accused the owner of an ambulance company that operated in Philadelphia Huntingdon Valley, and Camp Hill, Pa., of submitting $3.6 million in fraudulent bills to Medicare for the ambulance transport of dialysis patients who didn't need it. The loss to the government was $1.5 million, the indictment said. In addition to the owner, Anna Mudrova, the indictment also named the company, Penn Choice Ambulance Inc., and six operators. Individuals who answered the phone in Huntingdon Valley and Camp Hill said the company had no comment.

WASHINGTON - Washington frets endlessly over the problems that Social Security and Medicare, both of which are projected to exhaust their trust funds in the coming decades, might cause the budget. But two reports underscore the serious problems they might solve for the country. Take Social Security. For years, pension experts have spoken of the "three-legged stool" of retirement savings: Social Security, employer pensions, and private savings. In recent years, however, that stool has begun to wobble, and today, Social Security is basically the only leg holding it up. In 1980, about 40 percent of private-sector workers had a guaranteed pension.

D EAR HARRY : I have a friend who is very conservative in his political and social views. As a result, I have always had to take his "fact" statements with a couple of grains of salt. He told me that the new Obamacare will replace the "death panels" (which never were a consideration) with age limits on care. He was very specific, indicating that he heard that starting in 2014, Medicare would no longer cover cancer and diabetes after recipients hit 80. I called my congressman and I got the response that there is no such provision in the law. What's going on here?