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Medicare Advantage Money Grab Fraud and billing mistakes cost Medicare — and taxpayers — tens of billions last year

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Congressional auditor said federal health officials need to crack down on billing errors by insurers

By Fred Schulte

 Updated:

Federal health officials made more than $16 billion in improper payments to private Medicare Advantage health plans last year and need to crack down on billing errors by the insurers, a top congressional auditor testified Wednesday.

James Cosgrove, who directs health care reviews for the Government Accountability Office, told the House Ways and Means oversight subcommittee that the Medicare Advantage improper payment rate was 10 percent in 2016, which comes to $16.2 billion.

Adding in the overpayments for standard Medicare programs, the tally for last year approaches $60 billion — which is almost twice as much as the National Institutes of Health spends on medical research each year.

“Fundamental changes are necessary” to improve how the federal Centers for Medicare and Medicaid Services ferrets out billing mistakes and recoups overpayments from health insurers, he said.

Medicare serves about 56 million people, both those 65 and older and disabled people of any age. About 19 million have chosen to enroll in Medicare Advantage plans as an alternative to standard Medicare.

Federal officials predict the Medicare Advantage option will grow further as massive numbers of baby boomers retire in coming years.

Standard Medicare has a similar problem making accurate payments to doctors, hospitals and other health care providers, according to statistics presented at the hearing. Standard Medicare’s payment error rate was cited at 11 percent, or $41 billion for 2016.

Last week, Attorney General Jeff Sessions announced the arrest of 412 people, some 100 doctors among them, in a scattershot of health care fraud schemes that allegedly ripped off the government for about $1.3 billion, mostly from Medicare.

CMS official Jonathan Morse said that the “largest contributors” to billing mistakes in standard Medicare were claims from home health care and inpatient rehabilitation facilities.

Some lawmakers appeared frustrated that CMS cannot say for sure how much of the “improper payments” in both Medicare options are caused by fraud. The agency uses the term broadly to cover billing fraud, waste and abuse, as well as simply overcharges and underpayments.

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Breaking NEWS: Vaccine rights attorney attacked by State Bar agency in classic ‘witch hunt’

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1. Please sign one of these petitions:

(a) Petition for Attorneys:
https://www.change.org/p/investigate-the-nc-bar

(b) Petition for Non-Attorneys:
https://www.change.org/p/no-attorney-is-above-the-law

NaturalHealth365) The North Carolina State Bar clearly is on a ‘witch hunt’ by initiating a lawsuit against the nation’s leading vaccine rights attorney, Alan Phillips. What’s their intent? Mr. Phillips is required to hand over years of (confidential) client files or risk being jailed for civil contempt. Every lawyer (and civil rights advocate) should be outraged by this action.

Alan has been the only attorney in the United States focused solely on issues surrounding vaccine exemptions and vaccine legislative activism. He has been an advocate for parental rights and medical freedom. But, as you’ll soon see, this ability to freely choose which medical treatments to accept or deny is quickly being destroyed by all those supporting the pharmaceutical industry and its overbearing policies.

Vaccine Rights Action ALERT: Help Alan Phillips, J.D.

The following statement was issued by Alan Phillips as a way to describe what’s happening to him and gives all of us an opportunity to help. Feel free to share this article far and wide.

The North Carolina State Bar, the agency that licenses NC attorneys, has taken the unprecedented step of filing a lawsuit against the nation’s leading vaccine rights attorney, Alan Phillips, J.D., to force Phillips to hand over years of his clients’ files or risk being jailed for civil contempt…

Attorney Phillips is the nation’s leading Vaccine Rights attorney, the only attorney whose practice is focused solely on vaccine exemptions and vaccine legislative activism, and who works with clients, attorneys, legislators and activists nationally in virtually every possible U.S. exemption setting.[1] North Carolina is known as “Vaccine Central” for its award-winning vaccine companies.[2] So, it’s not surprising that the NC State Bar is going after Phillips, with what Phillips claims are invented facts and law in a series of steps that appear to have been designed from the start to disbar Phillips, for helping people legally avoid vaccines.

This is not just a personal attack against Phillips, it’s an attack on the entire vaccine awareness movement, given Phillips’ unique role in helping clients nationally with exemptions and legislative activism!

So, please 1) share this story far and wide, 2) sign the petition linked below, 3) donate to support Phillips’ legal defense fund, and 4) stay tuned for updates to this story! (links below)

BASELESS ATTACK

The NC Bar’s lawsuit and underlying investigation are both unlawful for several reasons, according to Phillips. First, the Bar lacks the legally-required “allegation of misconduct.”

That’s right, they are not even claiming Phillips actually did anything wrong, in which case (or should we say, “witch case”?) there is no legal basis for the investigation or lawsuit!

There is also a blatant conflict of interest, Phillips points out, as he filed a good-faith complaint against State Bar attorneys for their fabrication of facts and law in a February 2017 “Letter of Warning” to Phillips. NC Bar attorneys can’t lawfully investigate Phillips while Phillips has an unresolved complaint open against Bar attorneys; both matters must be addressed by outside, independent people to avoid the obvious conflicts of interest.

But the NC Bar is ignoring that conflict; it is suppressing Phillips’ complaint against Bar attorneys, and aggressively pursuing Phillips. More

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