June 28, 2014 |
The U.S. Attorney in Philadelphia charged the owners and manager of Life Support Corp., a Bucks County ambulance company, in a $1.9 million Medicare fraud. Those charged Thursday in the 12-count indictment were brothers Nazariy Kmet, 35, of Jamison, and Bogdan Kmet, 30, of Warminster, who owned Life Support. Their cousin, a company manager, Rostislav Kmet, 26, of Philadelphia, was also charged. The defendants were arrested Thursday morning and made initial court appearances in the afternoon.
June 26, 2014
SUMMER has arrived, but hunger doesn't take a vacation. For too many students, the lunch they receive at school is their only meal. And during the summer, many of these young people lose access to regular meals. To address summer food insecurity, the city of Philadelphia provides free, healthy meals to eligible Philadelphians through the summer meals program, funded by the United States Department of Agriculture, the Pennsylvania Department of Education and local partners. Beginning this week, more than 700 summer-meal locations will open citywide, serving delicious and healthy breakfast, lunch and snacks to young Philadelphians.
June 23, 2014 |
A VETERAN federal prosecutor passionately told a judge yesterday that Alex Pugman, a leading defendant in a Medicare fraud case, "was without a doubt the most exceptional cooperator I have worked with. " Pugman, who was the director and co-owner of the now-defunct Home Care Hospice in Northeast Philly, helped explain the roles of other participants in the scheme, pointed out the fraud in the agency's records, and testified at two grand juries and at three trials, Assistant U.S. Attorney Suzanne Ercole said.
May 18, 2014 |
When Frank ONeill's heart was failing, what saved his life was a heart transplant. But what improved his quality of life and the strength of his peripheral muscles before his transplant was an individually tailored exercise program that he paid for out of pocket - $300 for six sessions - at Lankenau Heart Institute, part of Main Line Health. Now, for the first time, Medicare will cover cardiac rehabilitation programs for patients suffering from "stable, chronic heart failure," according to a February decision memo from the Centers for Medicare and Medicaid Services.
May 16, 2014 |
Martha Little says her patients are among the sickest of the sick. She is a psychiatrist in name, but at her Cheltenham practice she coordinates care for a wide range of conditions in her older patients, many of whom have dementia and cannot reliably describe what ails them. As a result, she almost always bills Medicare for the most complex level of office visit on a five-point scale - one of several hundred Pennsylvania and New Jersey physicians who do so. "Any move I make is complex," Little said.
May 12, 2014 |
If you're facing retirement with financial anxiety - and who isn't? - chances are you worry about the adequacy of your savings and investments, and perhaps about the reliability of a pension. Both those pillars of American retirement look disturbingly wobbly nowadays. By all rights, you should be much less concerned about the third pillar, Social Security. Surprisingly, that's not what the evidence suggests. Ask a sampling of millennials whether they expect to get Social Security when they retire, and 9 of 10 will say either no or with reduced benefits, according to a recent Pew study of those who came of age in the shadow of 9/11 and the Great Recession.
April 17, 2014
Smoke and glamor If we really wanted smoking cessation, or at least a dramatic reduction, we could achieve it ("Pa. to get back $120M in tobacco ruling," April 11). Jurisdictions that enjoy the revenue from smokers, however, are not about to turn off the spigot. That's why so many well-touted efforts are no more than smoke screens (pun intended). I was a three-pack-a-day smoker. If we are serious about the health effects of smoking, there is only one way: Cut out blatant promotion of smoking in movies and on TV. The all-time classic movie smoking scene remains Sharon Stone in that short white dress, lighting her cigarette and taunting police.
April 17, 2014 |
The Einstein Healthcare Network joined in two civil lawsuits against Medicare administrators alleging that a new rule on what qualifies as an inpatient hospital admission is arbitrary and should be dropped and that a related 0.2 percent cut in Medicare payments to hospitals should be revoked. The rule, adopted in August by the Centers for Medicare and Medicaid Services, says that a patient has to be in the hospital at midnight on two consecutive days for the hospital to receive an inpatient payment rate.
April 11, 2014 |
Among the weapons to treat the "wet" form of macular degeneration in 2012 were two potent drugs that are injected into the eye. Studies have found the two to be equally effective, yet Medicare pays doctors less than $50 to administer one and about $320 to inject the other. Which do you think doctors used more often? The costlier one, by far. Local ophthalmologists say that money isn't a factor in their decisions and that there are medical reasons to use the more expensive Lucentis for some patients.
April 11, 2014 |
It doesn't take many customers to build an ambulance business, according to Medicare payment data released Wednesday by federal regulators. For example, Red Cross Ambulance, which is based in Huntingdon Valley and operates two ambulances, state data show, collected $395,601 from Medicare for a dozen patients in 2012. That amounted to an annual average of nearly $33,000 per patient. It's not clear how many trips Red Cross made or whether it provided service to those patients for the full year.