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BUSINESS
November 10, 2000 | SHARON BERNSTEIN, TIMES STAFF WRITER
Secure Horizons, the nation's largest Medicare HMO, said Thursday it will freeze membership next year in 41 counties nationwide, most of them in California. The announcement that new members will not be accepted in 24 California counties, among them Riverside, San Bernardino, Santa Barbara, Kern, Alameda and Contra Costa, came as Secure Horizons' parent company reported disappointing results for the third quarter, though they beat estimates. Santa Ana-based PacifiCare Health Systems Inc.
ARTICLES BY DATE
OPINION
April 13, 2014
Re "How Medicare pays MDs," Editorial, April 10 It's wrong to blame physicians for Medicare's fiscal woes. Doing away with fee-for-service as a way to "reward quality and efficiency" is unworkable. The federal government could never figure that out. The small, shriveled carrot it would offer as the "reward" would be an insult to the medical profession. Medicare's problems, as evidenced by the testimony of physicians fingered in the recent revelations, have to do with outrageous drug, laboratory and facility charges.
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BUSINESS
January 19, 2006 | Michael Hiltzik
One recent afternoon in Los Alamitos, I watched Marcy Zwelling-Aamot, M.D., pick her way through a government website designed to help elderly patients select the right Medicare drug plan, based on their prescription needs and hometown. The website, created for the launch of Medicare's new prescription drug benefit, identified 48 individual plans available for Southern California residents.
OPINION
April 11, 2014
Re "Medicare lifts the veil on payments," April 9 Wednesday's news that Medicare is making public Part B payments to doctors received mixed reviews. That's to be expected when healthcare's economic black box is pried open. Sadly, one doctor's full scope of competent and caring services may result in unusually high reimbursement compared to his or her peers. And just as easily, one doctor's modest billings to Medicare could contain a disproportionate share of fraud. Publishing the numbers doctor by doctor doesn't tell the complete story; it's not holistic because it focuses on only one area of medicine, Medicare Part B. But it's a start.
BUSINESS
August 23, 2013 | By Lisa Zamosky
After an outpatient procedure last summer, Sidney Fallender was expecting to go straight home. But when two nurses tried to get the 93-year-old Sherman Oaks resident on his feet, they discovered he was unable to walk on his own. "The doctor told her assistant to call the paramedics," Fallender recalled. He was taken to Cedars-Sinai Medical Center by ambulance, less than a mile from his doctor's office, for possible emergency surgery. "A couple of weeks later I got a bill for the ambulance service in the amount of almost $1,000," he says.
CALIFORNIA | LOCAL
October 26, 1995
Medicare is like Humpty Dumpty. If the Republicans push it, we will never be able to put it together again! BOB MORGAN Van Nuys
OPINION
August 24, 2012
Re "Ryan plan may hurt disabled the most," Column, Aug. 21 Without Medicare, those of us who have pre-existing conditions will have difficulty getting health insurance. After we lost coverage because of a layoff, Blue Shield, which was at the time one of the three companies in California's program for high-risk patients, would not insure my husband because he has acid reflux and takes medication for it. I was turned down because I was a six-year cancer survivor. Apparently, Blue Shield forgot it was part of the high-risk program.
NEWS
November 30, 2011 | By Melissa Healy, Los Angeles Times/For the Booster Shots blog
Medicare, the nation's medical safety net for seniors, on Wednesday announced it would extend its coverage for obesity screening and "intensive behavioral therapy," ensuring that roughly 30% of the 42 million people insured by the program can undertake a weight-loss program supervised by their doctor. The decision by the federal government to cover face-to-face doctor visits as an aid to weight loss is likely to prod private insurers, many of whom have been reluctant to cover medically supervised obesity treatments, to follow suit.
OPINION
August 30, 2012
Re "It's Medicare vs. the economy," Opinion, Aug. 26 Doyle McManus says that neither the GOP nor the Democrats wants to focus on saving money from Medicare, and that for candidates it's a choice of either talking about Medicare or the economy. With Mitt Romney's choice of Paul Ryan as his running mate, the GOP ticket has boldly opened up a national discussion on Medicare and entitlement reform. Democrats can try to frighten and demonize Romney's and Ryan's ideas, but at least they are taking a leadership position that is totally lacking from the president and the Senate.
NEWS
August 11, 2012 | By Lisa Mascaro
WASHINGTON -- One of the most contested ideas from Rep. Paul D. Ryan 's budget blueprint is  revamping Medicare, the nation's healthcare program for seniors. Ryan's approach would not end or change Medicare immediately. Rather, for the next generation of seniors, those now 55 or younger, the system would change from one in which everyone gets the same set of benefits, for which the government pays, to one in which the government would give each senior citizen a fixed amount of money.
OPINION
April 10, 2014 | By The Times editorial board
The news that a small percentage of the country's physicians collected billions of dollars from Medicare in a single year may or may not be a testament to individual greed; some of the top recipients are under investigation for allegedly bilking the system, while others work long hours delivering costly care. But it is a powerful reminder that the program needs to stop rewarding doctors for the quantity of care they deliver rather than the quality. Happily, there's a bipartisan plan to do just that; unhappily, lawmakers haven't been able to agree on how to cover its cost.
BUSINESS
April 9, 2014 | By Chad Terhune and Doug Smith
Newport Beach oncologist Minh Nguyen woke up Wednesday wearing a dubious distinction: Medicare's highest-paid doctor in California and one of the top physicians nationwide. Some of his patients and fellow physicians immediately called him wanting an explanation of why newly released federal data show he got paid $11.3 million for treating Medicare patients in 2012. Like dozens of other doctors across the country, Nguyen was unwittingly thrust into the spotlight as federal officials listed for the first time what the government pays individual doctors to treat elderly Americans.
OPINION
April 2, 2014
Re "Bickering over Medicare ," Editorial, March 27 Your assertion that the Medicare sustainable growth rate, or SGR, represents only "paper savings" is not supported by the actual history of the SGR and "doc fixes" enacted by Congress. Though it is true that most SGR cuts have not gone into effect as scheduled, the SGR has actually done a great deal to control healthcare costs by keeping physician payment updates modest and pushing policymakers to offset the cost of avoiding cuts.
NEWS
April 1, 2014 | By Lisa Mascaro
WASHINGTON -- House Republicans will revive Rep. Paul Ryan's lightning-rod proposals to slash the federal safety net, beef up military spending and reduce taxes for the wealthy in a budget unveiled Tuesday -- an election-year calling card that Democrats are poised to use against the GOP. The blueprint from Ryan, the party's former vice presidential nominee, is expected to be met with stiff opposition not only from Democrats, but also from hard-line...
OPINION
March 27, 2014 | By The Times editorial board
Maybe it was too good to be true. A rare bipartisan healthcare reform proposal backed by leaders of three major House and Senate committees is foundering because Republicans and Democrats can't agree on how to pay for it. The irony is that the measure, which would change the way Medicare reimburses doctors, would slow the growth of healthcare spending and taxpayers' costs. Lawmakers should stop the partisan bickering and start working in good faith to find a way to enact the long-overdue and much-needed reform.
BUSINESS
March 20, 2014 | By Soumya Karlamangla
Federal investigators say one of Medicare's most wanted fugitives , who was convicted in a $20-million fraud case, may be hiding out in the Los Angeles area. Authorities say Nuritsa Grigoryan fled last month after being found guilty for her role at a Glendale clinic where she was accused of posing as a doctor and writing prescriptions for pricey anti-psychotic medications. Investigators with the U.S. Department of Health and Human Services say the clinic often recruited homeless patients, used their information to bill Medicare and Medi-Cal for the drugs, and then resold the medications, such as Abilify, to rake in even more money.
OPINION
August 16, 2012
Re "A budget to reshape the nation," Aug. 14 Does anyone remember why Medicare was created? In the "good old days" before Medicare, older people could not buy health insurance after they retired. Insurance companies would not sell to them, as most people have a preexisting condition by the time they reach 65. The elderly are bad for profits. A voucher system will not change this fact. Medicare is the most effective and efficient insurance we have. Let's not mess with success.
BUSINESS
February 6, 2014 | By Noam N. Levey
WASHINGTON - In a rare bipartisan agreement, congressional leaders have settled on a plan to fix Medicare's system for paying physicians, potentially ending years of uncertainty that often held up fees for doctors who care for the nation's senior citizens. The proposed fix still must be paid for, requiring lawmakers to come up with as much as $150 billion in savings from elsewhere in the budget. But there is optimism on Capitol Hill that the federal government will finally replace a dysfunctional 17-year-old system designed to control Medicare spending by limiting annual increases in physicians' reimbursements.
CALIFORNIA | LOCAL
December 29, 2013 | By Times staff and wire services
Andrew Jacobs Jr., a former longtime Indiana congressman known for turning down pay raises and PAC donations as well as for being an early opponent of the Vietnam War, died Saturday at his Indianapolis home. He was 81. He had been in declining health for some time, said Gary Taylor, a family friend and former campaign manager. A Democrat, Jacobs served in the U.S. House of Represenatives from 1965 until a reelection defeat in 1973. He succeeded in another House election and served again from 1975 until his retirement in 1997.
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