If this doesn't work, heads should roll at CMS...and other random musing on healthcare

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10/21/2009

Sybil movie download Here are some random thoughts on the state of healthcare in this country today.

1. They new surety bond and accreditation requirements for DME that took effect earlier this month are intended to help reduce fraud and abuse. That means a year from now DME fraud and abuse should be much lower than it is today. If it is not, heads should roll at CMS, the NSC and other contractors charged with protecting the Medicare trust fund.

2. You’ll never hear me complain about Social Security and Medicare. They are great programs, but to be sustainable well into the future, they need to be modernized. That means raising the ages at which people become eligible to receive these benefits. Instead of 65, maybe eligibility begins at 70. And when it comes to Medicare, maybe the co-pay jumps from 20% to 30%. We’d have to implement these changes gradually to allow people time to plan, but other than raising taxes, I don't see any other solution.

3. Let me get this straight: There are actually lawmakers in Washington who believe in their hearts that doctors deserve an extra $247 billion over 10 years? That is the so-called Medicare doc fix, and what a joke it is. Lawmakers propose reimbursement cuts for HMEs and other provider groups as part of healthcare reform, but the docs get a big fat raise. Whatever happens with reform, physicians must share the pain just like everyone else. The AMA is not AIG, after all. Let’s get something straight: Doctors are not underpaid. Check out this physician salary survey

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4. We’ve got two not-for-profit hospitals in our Portland, Maine community. One is always adding new additions and the other has just competed a big new fancy hospital facility. When it comes to non-profit hospitals, I must be missing something. How do some of them make so much money? Whatever, it seems like a lot of fun: Make a lot of money; spend a lot of money; pay no taxes. What’s not to like? Check out this salary survey: Top hospital executives make pretty good money

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5. If I were a CMS official, I’d be very interested in talking to crooks convicted of defrauding Medicare. Specifically, I’d want to know how they got hold of a provider number? What can be done to reduce fraud and abuse—how can CMS keep the crooks out?

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Maybe CMS and government law enforcement agencies have done this, Z.P.G. but with Medicare fraud and abuse now practically an industry unto itself, you’d never know it. Great job, guys.

— Mike Moran