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Showing posts from December, 2011

Stopping the Over Charging in the U.S. Health Care System

How Profit-taking Distorts Health Care Delivery in America Recently, a Public Broadcasting Station (Channel 9) featured a story on a for-profit hospital group which was using obscure diagnostic codes to achieve higher Medicare payments. The level of unethical and fraudulent activity was so egregious that more than one of their billing coders quit their jobs and testified against their former employer. The Wall Street Journal has also reported on fraudulent Medicare billing, including requisitioning public records from CMS(Medicare) and identifying abusive billing practices by multiple clinicians. For example, the New York City osteopath who billed Medicare 2 million for family medicine, when this was not the nature of her medical practice. WSJ staffers examined the Medicare database and uncovered 25 billing codes for an array of expensive medical tests which were regularly performed by 20 other clinicians in the country. Of that group, 33% have already been convicted of fraud, have u...

Why Diabetes Prevention and Management and the U.S. Health Care System Are At Odds

Diabetes Current-State and Changes to Come Unless you are Cro-Magnon-man and just emerged from a glacial field you are probably aware of some of the 2010 health care reforms. This article reviews how the United States got to be in such poor shape, health-wise and how some provisions of the 2010 reforms will create incremental changes. Since I am nearly finished with my second book, the Russell Guide for Diabetes: Type I or Type II This Could Happen To You , let me share some mind boggling information about this scourge. The American statistics on this disease have a huge impact on government funded health plans, including Medicare and these metrics from the CDC explain why : � The proportion of diagnosed diabetics in the United States has increased by more than 50% since 2007; 17.7 million in 2007 and 25.5 million in 2010 � Fully one third of the U.S. population is expected to be diabetic by 2025; 115 million � In 2010 18.7% of the 25,564,000 U.S. residents diagnosed as diabetic were ...