Category Archives: Medicare

AAJ President Praises New Guidance on Medicare Secondary Payer Program

Written On January 10, 2012 By Bob Kraft

Everyone involved with personal injury claims knows that dealing with Medicare has become a nightmare over the past several years. Without going into detail, following the convoluted process required by Medicare in order to get a verified amount owed (or a statement that nothing is owed) takes months after a settlement is made with the [...]

Posted in Medicare

Medicare Penalties for Readmissions May Impact Hospitals Serving Low-Income Patients

Written On January 3, 2012 By Bob Kraft

The Washington Post /Kaiser Health News reported, “Medicare is preparing to penalize hospitals with frequent potentially avoidable readmissions,” with the aim of prodding them “to make sure patients get the care they need after discharge. But this new policy is likely to disproportionately affect hospitals that treat the most low-income patients, according to a Kaiser Health [...]

Posted in Medicare

Plaintiff and Defense Lawyers Agree — Medicare Claims Procedures Need Improvement

Written On September 20, 2011 By Bob Kraft

In continuing coverage, Business Insurance reported insurers groups and “trial attorneys represented by the American Assn. for Justice” are supporting the Strengthening Medicare and Repaying Taxpayers Act, which “would require Medicare to respond within 65 days of a party’s request for information on Medicare’s final payment demand.” The Medicare Secondary Payer System requires parties to “notify [...]

Posted in Medicare

Odd Allies in Medicare Fight — Plaintiff Lawyers and U.S. Chamber of Commerce

Written On August 24, 2011 By Bob Kraft

New federal rules regarding Medicare have made life miserable for personal injury claimants and the lawyers who represent them. The crux of the matter is that money must be withheld from the settlement or verdict amount in order to repay Medicare any money it may have paid for the plaintiff’s medical expenses. But getting a [...]

Posted in Medicare

Hospital Cost Shifting Adds to Auto Injury Claim Costs

Written On June 13, 2011 By Bob Kraft

According to a recent study from the Insurance Research Council, low reimbursements from public health insurance programs, such as Medicare and Medicaid, have prompted hospitals to shift costs to automobile insurance companies—raising auto injury claim costs and forcing auto insurers to more closely scrutinize and negotiate hospital bills prior to payment. The IRC estimates that for [...]

Posted in Health Insurance, Insurance Information, Medicaid, Medicare

Medicaid Will No Longer Pay Hospitals for Preventable Illnesses or Injuries

Written On June 8, 2011 By Bob Kraft

The National Journal reports, “Medicaid will no longer pay hospitals or doctors for certain preventable illnesses and injuries, such as operating on the wrong body part, the Health and Human Services Department said Wednesday.” In a statement, Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said, “These steps will encourage health professionals [...]

Posted in Medicaid, Medical Malpractice, Medicare

Medicare Offers Financial Incentives to Hospitals for Improved Care, Error Reduction

Written On May 13, 2011 By Bob Kraft

The Los Angeles Times reported that the “Obama administration issued a final regulation to reward hospitals that provide high-quality care, the first in a series of steps that are designed to fundamentally transform the way that the federal government pays for healthcare.” Indeed, the practice is “commonplace in many industries,” but “setting quality benchmarks and [...]

Posted in Medical Malpractice, Medicare

Who Represents Me in Washington and in Austin?

Written On May 12, 2011 By Bob Kraft

We are in the midst of some very bad legislative proposals, both in Washington and in Austin. Whether you’re concerned about the loss of Medicare (Washington) or passage of a corporate immunity bill (Austin), you should contact your representatives and make your concerns known.
There is a handy site for Texas who want to know who [...]

Posted in Government, Medicaid, Medicare, Political and/or Judicial, Tort Reform

Medicare Data Reveal Top Safety Issues at Texas Hospitals

Written On April 27, 2011 By Bob Kraft

The Houston Chronicle reports, “Allowing the public to see information about mishaps and errors that occur during a patient’s hospital stay has been a contentious issue for hospital personnel, who believe the public could misread it.” Two reports released this month by the Centers for Medicare and Medicaid Services are the “first to look strictly [...]

Posted in Medical Malpractice, Medicare

HHS Initiative Aims to Reduce Medical Errors and Cut Costs

Written On April 18, 2011 By Bob Kraft

Print media sources widely covered an announcement last week that the Obama Administration was partnering with hospitals, insurers and other groups in order to reduce medical errors. Most sources considered the move a positive for the Administration.
The Los Angeles Times reports, “The Obama administration announced a broad new initiative Tuesday to reduce medical errors, partnering [...]

Posted in Government, Health Insurance, Medicaid, Medical Malpractice, Medicare

Medicare Rise Could Mean No Social Security COLA

Written On March 31, 2011 By Bob Kraft

For the past two years Social Security retirees and Social Security disability recipients have had no cost of living allowance increases because the COLA is tied to inflation and inflation has been very low.
This coming year inflation might be high enough to justify a COLA adjustment, but now there’s another problem — the cost of [...]

Posted in Medicare, Social Security, Social Security Disability

Ten Costly Mistakes to Avoid When Applying for Medicare

Written On December 21, 2010 By Bob Kraft

The annual enrollment period for Medicare runs through the month of December. For those who have not yet made a decision, here is a list of ten mistakes to avoid, provided by PlanPrescriber, a subsidiary of eHealth, Inc.
10 Costly Mistakes That Seniors May Make During Medicare Annual Enrollment Period
(1) Missing the Fine Print: Don’t ignore [...]

Posted in Health Insurance, Medicare

Patient Care Compromised by Drug Makers’ Price Inflation Scheme

Written On December 9, 2010 By Bob Kraft

The AP (12/7, Caldwell) reported Abbot Laboratories Inc., B. Braun Medical Inc., and Roxane Laboratories Inc. “agreed to pay more than $421 million to settle allegations that the companies reported inflated prices for numerous products,” according to the Justice Department. Assistant Attorney General Tony West said the companies “inflated the average wholesale price for dozens [...]

Posted in Medicaid, Medicare, Prescription Drug Claims, Product Liability or Medical Devices

About 15% of Medicare Patients Receive Harmful Hospital Care

Written On November 19, 2010 By Bob Kraft

The U.S. Health & Human Services’ inspector general has issued a report stating that 1 in 7 Medicare patients received harmful medical care while in a hospital. This inadequate or negligent care increased the duration of the hospital stays and caused or contributed to the deaths of some patients. And of course this all increased [...]

Posted in Medical Malpractice, Medicare

Two Doctors and a Medical Clinic Owner Charged in Patient Recruiting Scam

Written On November 5, 2010 By Bob Kraft

How can anyone, especially well-educated doctors, engage in such shameful conduct as alleged in this case? It just baffles me that some people are so driven by greed that they will cross any legal or moral boundary. I know this is true in the legal profession also, sadly. Apparently not everyone has the morality gene. [...]

Posted in Medical Malpractice, Medicare

Senator Says Government Should Investigate High-Prescribing Doctors

Written On October 27, 2010 By Bob Kraft

Medicare fraud is a huge problem in the United States, as I’ve written about several times before. The good news is that Congress finally seems to be figuring this out — probably because of the federal budget situation. Whatever the reason, any exposure of this situation is good, and Iowa Senator Charles Grassley is calling [...]

Posted in Government, Medicare

Featured Link – Senior Medicare Patrol

Written On October 19, 2010 By Bob Kraft

I had occasion last week to listen to an excellent presentation by volunteer Gary Travers, a member of the SMP, or Senior Medicare Patrol program. I have to admit I was not familiar with this group’s work, but their goal is to “…teach Medicare beneficiaries how to protect their personal identity, identify and report errors [...]

Posted in Featured Link, Medicare

Medicare’s Private Eyes Let Fraud Cases Get Cold

Written On August 10, 2010 By Bob Kraft

The government is doing a poor job of policing the Medicare system for fraud. According to an article in the Houston Chronicle, Medicare investigators routinely take months before referring fraud cases to law enforcement, and in that length of time the cases can go cold — with records destroyed, witnesses lost, etc. Taxpayers are getting [...]

Posted in Government, Medicare, Uncategorized

94 Arrested in Medicare Scams Totaling $251 Million

Written On July 20, 2010 By Bob Kraft

Almost 100 people were arrested last week for defrauding Medicare. I’m sure this is just a drop in the bucket of Medicare scams across the country. Everyone knows that Medicare poses perhaps the greatest risk to our country’s fiscal survival, and if we could root out more of these crooks it would certainly help our [...]

Posted in Government, Medicare

Texas Doctors Opting Out of Medicare at Alarming Rate

Written On May 24, 2010 By Bob Kraft

“Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.” That’s the lead of an article in the Houston Chronicle a few days ago. This is a real problem not only for Texas senior citizens, but also for younger people on [...]

Posted in Medicare