Medicare

President Obama, struggling to discredit bogus charges that his healthcare overhaul would create "death panels," soon could face another emotionally charged obstacle -- a plan to trim the federal subsidy for a program used by nearly a quarter of Medicare beneficiaries. The program, known as Medicare Advantage, pays insurance companies a hefty premium to enroll senior citizens and provide their medical services through managed-care networks. But whether the higher payments are worth it is a matter of dispute.

The Mayo Clinic is no longer accepting some Medicare and Medicaid patients, raising new questions about whether it is too selective to serve as a model for healthcare reform. The White House has repeatedly praised Mayo and other medical centers, many of which are in the Upper Midwest, that perform well in Dartmouth College rankings showing wide disparities in how much hospitals spend on Medicare patients. The centers have capitalized on their status to insert into healthcare legislation provisions that would result in higher Medicare payments for hospitals that do well on the rankings, while punishing those elsewhere -- mostly in big cities and the South -- that spend the most per Medicare patient.

Federal officials have charged 20 people with fraudulent Medicare billing in seven cases that total $26 million in unneeded or undelivered medical equipment, the U.S. attorney's office in Los Angeles said Wednesday. The charges came out of a joint investigation by the FBI, U.S. Department of Health and Human Services and California attorney general's office. A 30-year-old Long Beach man was arrested for allegedly recruiting relatives and members of the Brook Street Gang, based in Santa Ana, to act as owners for fake medical supply companies, which billed Medicare $11.2 million for unneeded wheelchairs and equipment.

Federal officials are expected to announce in Los Angeles today a nationwide effort to combat fraudulent Medicare billing by medical equipment suppliers in 70 urban areas. Such fraud in the federal healthcare program for the elderly has increased in recent years, particularly in the sprawling urban areas of Southern California and south Florida where many of the most vulnerable Medicare recipients live.

Pharmacists say a government report released Thursday validates their concerns that payments under the Medicare drug benefit are driving some of them out of business. The report from the Health and Human Services inspector general showed that pharmacies are able to charge insurers about 18% more than what they pay for medicine. Also, the pharmacists get a dispensing fee of about $2.27 per prescription. But the Assn.

Many large employers are struggling with the obligation to cover the rising medical costs of retirees, but last year officials in Michigan found a way to save at least $40 million on care for retired teachers and other public-school workers: Send the bills to Washington.

After a series of surprise inspections in Los Angeles County, Medicare fraud investigators found persistent corruption among medical equipment suppliers who set up phony offices that billed the government $21 million over one year, prompting officials to call for stronger enforcement efforts, according a report to be released today. Investigators checked 905 suppliers. Their offices should have been filled with wheelchairs, crutches, bedpans and other medical equipment.

With the presidential campaign going full tilt, a new government report on a big national problem is usually followed by volleys of rhetoric from the candidates. But on Tuesday, when the annual report on the precarious state of Medicare and Social Security came out, the reaction was not exactly deafening.

Medicare proposed new rules Thursday to curb marketing abuses that have cropped up as the role of private insurance plans has grown in the giant healthcare program for the elderly and disabled. Critics called the rules an improvement, but questioned whether the federal government could adequately enforce them.

As if escalating prices for food and gas weren't enough of a worry, most seniors in Medicare's prescription-drug program are paying considerably higher monthly premiums for coverage this year, according to a study to be released today. Those in the 10 largest plans -- which account for nearly three-fourths of seniors signed up for drug coverage -- are paying an average of $26.