Hands to Help Seniors

The Wall Street Journal released the results of another of its in-depth investigations, announcing  that literally thousands of medical providers signed up to bill Medicare using questionable addresses, and dozens of doctors enrolled despite disciplinary actions by state medical boards, according to a congressional probe.  Medicare records listed doctors and other providers as practicing at invalid addresses, such as commercial mailbox stores, construction sites and, in one case, a fast-food restaurant, according to a report by the Government Accountability Office that examined data through March 2013.  The GAO posted its report online after The Wall Street Journal reported the findings.  It isn’t clear how much Medicare has paid out to providers whose addresses have been shown to be invalid. The agency estimates that overall, it made $44.2 billion in improper overpayments to medical providers in the fiscal year ended Sept. 30, 2014—a figure that includes payments to ineligible providers, for services that aren’t covered and duplicate payments, among other things.

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The Food & Drug Administration (FDA) is close to approving a new drug called Praluent, the first of a new class of powerful cholesterol-lowering drugs. Many in the medical community are excited about prospects for the drug, although health care companies are worried about the potentially high cost of treating all of the people who may need an extra boost to lower their lipids. The drug, made by Sanofi and Regeneron Pharmaceuticals is expected to be priced at $7,000 to $12,000 a year. 

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The Food and Drug Administration approved a promising new heart-failure drug from Novartis which cardiologists around the country day could save millions of lives.  Called Entresto, the drug was studied in a clinical trial of more than 8,000 adults and—in a rare development—reduced the rate of cardiovascular death and hospitalization compared to a standard generic therapy, enalapril.  This is great news for those with this terrible affliction.

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As waiting times getting increasingly long to get in to see a physician and ER visits getting extremely expensive, more and more Americans are turning to services that use Skype to hook up a patient with a doctor for a quick diagnosis and a prescription.  Telemedicine services like Carena are multiplying like crazy.  Medicare, however, is fighting this trend, strictly limiting the reimbursement rates for electronic doctor visits.  The fear is that it's easy to misdiagnose if there is not an in-person visit.  Private insurance companies differ in their policies.  UnitedHealthcare has said it will cover telemedicine visits for 16 million members by year-end, and 20 million by the end of next year.  Clearly this is a rapidly evolving field and with the shortage of doctors this field of medicine is likely to grow.  

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