August 21, 2013 |
Health Partners of Philadelphia Inc., a hospital-owned health-insurance plan that manages Medicaid benefits for 166,300 people in Southeastern Pennsylvania, is applying to reenter the Medicare Advantage market. The nonprofit also will announce Tuesday that it has changed its corporate name to Health Partners Plans to accommodate a broader array of products beyond its current offerings of Medicaid and KidzPartners - for children whose families do not qualify for Medicaid. The move back into Medicare comes six years after Health Partners sold a Medicare business called Senior Partners.
August 18, 2013 |
David Carolina, 76, was rushed to the emergency room and admitted five times in the first 10 months of last year - four times in a two-month span - with heart and respiratory failure and flare-ups of gout. He is morbidly obese and has diabetes, sleep apnea, and chronic obstructive pulmonary disease. Carolina is a very sick man. But he's happy. Since October, his poor health has qualified him for a new government experiment involving an old idea: His doctors make house calls. In the last 10 months, an ER visit led to a hospital admission only once.
July 16, 2013 |
Medicare has two more years to live than previously thought. The program's trustees recently estimated that the "depletion date for the trust fund is 2026, two years later than was shown in last year's report. " But that conclusion is less a vote of confidence than a two-year stay of execution. Absent substantial reform, Medicare will eat up more and more of our nation's resources even as it provides less and less to beneficiaries. The report notes that Medicare expenditures will increase faster than earnings or the economy.
June 20, 2013 |
WASHINGTON - Medicare begins a major change next month that could save older diabetics money and time when they buy crucial supplies to test their blood sugar - but it also may cause some confusion as patients figure out the new system. On July 1, Medicare opens a national mail-order program that will dramatically drop the prices the government pays for those products, but patients will have to use designated suppliers. The goal is to save taxpayers money, but seniors should see their co-pays drop, too. Don't care about the convenience of mail delivery?
June 20, 2013
In the Region Iroko seeks to raise $145M in IPO Iroko Pharmaceuticals Inc. , a small developer of pain drugs based at the Navy Yard, will try to raise $145 million through an initial public offering, according to a registration statement filed with the Securities and Exchange Commission. Iroko, begun by several former GlaxoSmithKline executives in 2007, generated 2012 sales of $6.7 million from two medicines, Aldomet and Indocin. The company filed a new-drug application with the Food and Drug Administration seeking approval for Zorvolex to treat acute pain in February.
June 11, 2013 |
In politics, we often skip the simple questions. This is why inquiries about the fundamentals can catch everyone short. The independent-minded scholar Michael Lind posed one such question last week about libertarianism. I'll get to it in a moment. It's important because many in the new generation of conservative politicians declare libertarianism as their core political philosophy. Libertarians have the virtue, in principle at least, of a very clear creed: They believe in the smallest government possible, or what the philosopher Robert Nozick called the "night-watchman state.
June 5, 2013
A Philadelphia doctor was convicted Monday of taking more than $260,000 in illegal Medicare or Medicaid kickbacks, federal prosecutors said. After a two-week trial, a jury convicted Eugene Goldman, 55, of conspiracy and violations of the federal antikickback statute, according to the office of U.S. Attorney Zane David Memeger. Goldman took the money between 2000 and 2011 for referring Medicare and Medicaid patients to Home Care Hospice Inc., a for-profit hospice provider in Northeast Philadelphia, even if they were not eligible or appropriate candidates for hospice.
May 27, 2013 |
The patient was on a ventilator at Cooper University Hospital, and his head was positioned so that saliva dribbled down one side of his neck - a common result of having a breathing tube in your mouth. But intensive-care nurse Karen Fluehr-Heinkel noticed a problem: the saliva was landing right where a catheter had been inserted into the man's jugular vein. So she did something that once would have been unheard of: she immediately got a doctor to fix it. "We've been empowered to speak up," said the nurse, a 25-year veteran of the Camden hospital.
May 15, 2013 |
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.
May 10, 2013 |
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.