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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

This breastfeeding mom who was told to ‘cover up’ at a restaurant had a hilarious response

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              Posted by | Aug 8, 2018

Last week, a Facebook user named Carol Lockwood shared a photo and story of Melanie Dudley nursing her 4-month-old baby in a hotel restaurant, with a blanket totally covering her head. Why on earth would she cover her head up? Because in 2018 people (in this case a man) are still asking women to cover up when they nurse their babies and yet not the least bit upset about lingerie shows on prime-time TV or half naked pictures of women in the mall.

This breastfeeding mom who was told to ‘cover up’ at a restaurant had a hilarious response

 

SCOTUS, the Constitution, Freedom and Your Health

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by Elizabeth Lee Vliet, M.D.

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We stand at the crossroads of liberty or despotism. Each day the news brings examples of assaults on life and liberty. These include:

The multifaceted assault on individual freedom is by design, as outlined in the teachings of Karl Marx, Saul Alinsky, and other radical leftists whose goal is to tear down the principles and institutions that made America the quantum leap in the history of humankind, based on the exceptional idea that Life and Liberty are natural rights that come from our Creator, not from government. More

Government Aims to Dictate Your Vitamin Dosages

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Draconian limits on vitamin dosage amounts could be coming if the feds get their way. Action alert!

That bottle of 1000mg vitamin D capsules in your medicine cabinet could soon be contraband. Important entities are meeting to discuss how to restrict the kinds of supplements you can take under the guise of “harmonization” of supplement standards. If they’re allowed to move forward, it’s possible that the federal government could adopt restrictions on vitamin doses that can be legally sold, as Europe has already done.

At the request of the Bill & Melinda Gates Foundation, the National Academy of Sciences (NAS) recently convened a workshop to “assess methodological approaches that could be applied uniformly across countries in setting nutrient intake recommendations,” with particular attention on how standards could be set for population subgroups such as young children and women of reproductive age. “Nutrient intake recommendations” include upper levels of intake, which are used to restrict the vitamin dose that a supplement can contain.

This workshop is another in a series of meetings NAS is involved in with other entities, including the World Health Organization (WHO) and the United Nations, who are both sponsors of Codex, to discuss limits on vitamin doses. As we reported previously, Codex is an intergovernmental body whose goal is to establish international standards regarding food safety and food ingredients, with the goal of promoting “fair trade practices” and consumer protections. Codex standards on supplements, however, are widely expected to follow Europe’s draconian restrictions, where selenium, for example, is limited in supplement form to that found in one-third of a Brazil nut.

It is extremely concerning that NAS is working to establish upper limits for supplements on multiple fronts. To be clear, NAS cannot create standards—they merely make recommendations. But government bodies listen closely to NAS, and as we discussed in our previous article, it isn’t clear whether the FDA can ban therapeutic supplements doses on its own, without public involvement. If the agency decides, following recommendations from NAS, that vitamin D, for example, over a certain amount “presents a significant or unreasonable risk of illness or injury”—the legal definition of an adulterated supplement—the FDA may be able to ban it. The agency recently placed restrictions on certain bulk caffeine products along similar lines, so the path seems open for similar actions against other products.

Of additional concern is that NAS has proven that it does not understand the science of supplements. Recall that their “experts” recommended that adults ingest 600 IU of vitamin D each day, and they established an upper level (the level above which supposedly poses a danger to adults) of 4,000 IU. Any real experts will tell you this is nonsense; the Vitamin D Council recommends 5,000 IU of vitamin D for adults, and it’s not uncommon for an integrative physician to recommend higher levels when needed. For this reason, we don’t want NAS anywhere near a discussion that could lead to supplement restrictions.

What the NAS, Codex, and European authorities don’t seem to understand is that, to gain the beneficial effects of certain vitamins, they must at times be taken in therapeutic doses. Consider vitamin C. Research has indicated that therapeutic doses of vitamin C impart many benefits. Students who supplemented with hourly doses of 1000mg vitamin C for six hours and then three times daily afterwards exhibited an 85% decrease in cold and flu symptoms compared to those who took decongestants. Therapeutic vitamin C regimens also have heart protective benefits, including reducing damage caused by heart attacks and lowering coronary heart disease risk. For comparison, the “safe” upper limit set by the NAS for vitamin C is 2,000mg. (Note that the upper levels currently set by the NAS are meant to serve merely as a guide, that is, they are non-binding.)

In the past, NAS has studied and published upper limits for a handful of vitamins and minerals, mostly for educational purposes. Our concern is that now, NAS is increasingly meeting and consulting with governmental bodies from other countries who have been responsible for setting upper limits and then banning supplements above those limits, as the European Union has done. Will the US head down the same road? It’s unclear as of yet, but these recent developments are not encouraging.

Compared to other parts of the world, the US enjoys relative freedom in our choices regarding therapeutic doses of supplements. We must act now, in the initial stages of the multiple processes underway at NAS, to make sure it stays that way.

Action Alert! Write to Congress and the FDA, the agency that would be responsible for any future bans on supplements, and tell them not to limit therapeutic doses of supplements in the US. Please send your message immediately.

Source: Government Aims to Dictate Your Vitamin Dosages

An Attempt to Enlighten Concerned Patients and Parents Regarding Essentia Health Duluth’s Recent Vaccine Controversy

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By Gary G. Kohls, MD – July 24, 2018

 

On July 23, 2018, my local Duluth, Minnesota TV news teams reported the following short bit of information that they had received from Essentia Health’s media relations folks. Essentia admitted that their clinic’s varicella (live chickenpox virus) vaccines and ProQuad inoculations (= MMR [live measles, mumps, rubella viruses plus varicella]) had been injected into a number of pediatric patients over an unspecified period of time. Essentia had discovered that the inocula had been stored at an “improper temperature”. The parents of the patients had been urged by a separate letter to return for a repeat shot of the live virus vaccine.

I checked Essentia’s website and found no clarification of the brief bit of information that had been reported on TV, so I decided, in the interest of providing the information that patients are supposed to be given before giving their consent to being injected with a potentially hazardous group of substances, I went online to get it for them through this column. After doing my research, I obtained the following information, some of which I will comment upon below.

1)             Essentia Health Duluth Says Certain Vaccines Were Improperly Stored at Duluth Clinic

The Hospital is Unaware how Many Children are Affected

From www.kqdsfox21.com – July 24, 2018

DULUTH, Minn. – Pediatric patients who received two types of vaccines at the Essentia Health-Duluth Clinic may need to return for a second round due to improperly stored doses.

According to a letter sent out to parents, the vaccines at the clinic were not stored at the manufacturer’s recommended temperature.

Essentia is recommending that patients who received a dose of Varicella or Proquad return to the clinic to receive a second dose so they can ensure the children are fully protected against illnesses.

Essentia says they are unaware how many children, if any, received a dose of the less-than-optimal vaccines.

Proquad vaccinations protect children against measles, mumps and rubella while Varicella is a vaccine that protects against chickenpox.

The hospital says they have put measures in place so this type of incident does not occur again and that no children have experience any ill effects from the earlier vaccine.

[Ed note: the ingredients in the chickenpox virus portion of each vaccine need to be stored at freezing temperatures until immediately before the inoculation or else it must be discarded as useless. Merck has provided no information as to why or if administering a thawed vaccine is either useless of dangerous. See immediately below for information on the (surprising) ingredients in the two shots (2), the (potentially serious and frequent) adverse effects of the shots (3) the (unaffordable) costs of the two shots (4)] and the recent sudden deaths of two infants in Samoa who died within minutes of being inoculated with their routine MMR shots (which are widely advertised as being “safe and generally well-tolerated” (5). More

Jon Rappoport: The secret behind fake bipolar disease in children

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Jon Rappoport’s Blog

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“This isn’t a sophisticated situation. This is basic brain disruption.

Here’s another drug sequence with the same outcome: ADHD diagnosed, Adderall prescribed; child goes into a big funk and this is diagnosed as depression; doctor prescribes Zoloft, which causes a few high-flying “manic episodes.” New diagnosis: bipolar.

Or a young toddler is fed formula that is largely synthetic, and chemicals cause a severe series of reactions, which are labeled “bipolar.”

Or a child is given a series of vaccine shots containing aluminum (a known neurotoxin), formaldehyde, and other injurious chemicals, and as a result develops severe symptoms labeled “bipolar.”

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ABC News, 5/11/12: “…Columbia University researchers found a 40-fold rise in office visits among youth diagnosed with bipolar disorder between 1994-95 and 2002-3.”

In 1995, a new wind began blowing across the psychiatric landscape. The public wasn’t aware of it. But among professionals, it was big, very big:

Children, including the very young, could, for the first time, legitimately be diagnosed with bipolar disease (aka manic depression).

The impetus for this “revelation” was a 1995 report, “Is Your Child Bipolar?” written by two doctors at Massachusetts General Hospital, Janet Wozniak and Joseph Biederman.

Biederman would go on to become the target of internal investigations at Harvard and Mass General—did the pharmaceutical money he took influence his judgment in deciding bipolar was a real disorder among children? The charges against him were ultimately reduced to a few light slaps on the wrist; he retained his prestigious position.

But back in 1995, he and Wozniak, as the NY Times Magazine recounts (9/12/08, “The Bipolar Puzzle”), arrived at an earthshaking conclusion about children coming through their hospital clinic: a number of them fit the description of “bipolar irritable manic.”

It was a huge wow for the psychiatric profession. No one had seriously insisted, with “convincing evidence,” that very young kids could develop bipolar.

But now, psychiatrists were going to pick up that ball and run with it. Drug companies were going to develop and promote drugs (very serious and toxic drugs, like Risperdal) to treat childhood bipolar.

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