News briefs: Chicago lags other cities in health care, study says

(Crain's) — Also, Fresenius Medical Care wants to open a 12-station dialysis center in Schaumburg, and a federal jury convicts a Schaumburg doctor of defrauding insurers including Medicare and Blue Cross.

Webbmason Client, Highmark, Earns Gartner And 1 To 1 Media Crm Excellence Award

Blue Cross Blue Shield Plan Sees Significant Increase in Health Partner Program ParticipationHunt Valley, MD (PRWEB) March 14, 2012 WebbMason, (http://www.webbmason.com), an on-demand marketing solutions and services company headquartered in suburban Baltimore, today announced its client Highmark Inc., an independent licensee of the Blue Cross and Blue Shield Association based in Pittsburgh …

5 Ways to Become an Informed Medicare Consumer

By Marilyn Tavenner, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS)

Each day, you make decisions about your finances, health, privacy, and more. It’s important to protect yourself and make the best choices for you, especially when it comes to your Medicare.

During National Consumer Protection Week (NCPW), non-profit organizations and government agencies give people like you information on how to take advantage of your rights and make better-informed choices. At Medicare, we’re here to help you become an informed Medicare consumer. Here are 5 things you can do:

1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law says you can get.
2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes. Keep the following personal information safe:

• Your name
• Your Social Security number
• Your Medicare number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan)
• Your credit card and bank account numbers

Get more information on how to protect yourself from identity theft.

1. Help fight Medicare fraud. Medicare fraud diverts money from the Medicare program each year, which means higher health care costs for you. Learn how to spot and report fraud.
2. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.
3. Make informed Medicare choices. Each year during the fall Open Enrollment Period (October 15-December 7), review your plan to make sure it’s going to meet your needs for the following year. If you’re not satisfied with your current plan, you can switch during the Open Enrollment Period.

Visit NCPW to learn more about the campaign, see which agencies and organizations are able to help you, and to find out if there are any NCPW activities happening in your area.

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Get Regular Screenings for Colorectal Cancer

Did you know colorectal cancer is the second leading cause of cancer-related deaths in the United States among cancers that affect both men and women?? If everyone 50 or older got screened regularly, as many as 60% of deaths from this cancer could be avoided.

 In most cases, colorectal cancer develops from precancerous polyps (abnormal growths) in the colon or rectum. Fortunately, screening tests can find these polyps, so you can get them removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best.

 It’s National Colorectal Cancer Awareness Month – do what you can to reduce your risk for colorectal cancer. If you’re 50 or older, or have a personal or family history of colorectal issues, make sure you get screened for colorectal cancer regularly. Don’t worry about the cost—Medicare covers a variety of colorectal cancer screenings, and you pay nothing for most tests.

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Fighting Improper Payments And Fraud – Protecting Taxpayer Dollars

By Marilyn Tavenner, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS)

Fighting fraud and waste in the health care system is a top priority for the Obama Administration.  We are committed to using all resources at our disposal in these efforts – and they are paying off.

Just last week, the Departments of Justice and Health and Human Services (HHS) released an updated annual report showing that in FY 2011 anti-fraud efforts have recovered more than $4.1 billion in fraudulent Medicare payments – the second year in a row recovery efforts reached this unprecedented level.  Compare this to just $2.14 billion recovered in FY 2008.  Prosecutions are way up too:  the number of individuals charged with fraud increased from 821 in fiscal year 2008 to 1,430 in fiscal year 2011 – nearly a 75 percent increase.

But we know we need keep doing more to end the “pay and chase” model of fighting fraud.  We need to stop fraud and waste from happening in the first place.  Today we’re taking an important step to protect taxpayer dollars by reducing improper payments to Medicare Advantage plans, an action that is estimated to save $370 million in the first audit year alone.  By improving the way we audit Medicare Advantage contracts, we will reduce the payment error rate for the Medicare Advantage program  and that saves money for Medicare.

We are also using new, advanced techniques to fight fraud.  Starting last year, we have been using “predictive modeling” technology – similar to technology used by credit card companies to identify and fight fraud nationwide.  This effort is just getting started but it’s already making a difference. Since the predictive modeling system was activated, CMS has stopped, prevented or identified $20 million in payments through November 2011 that should not have been made.

In addition, predictive modeling has identified 2,500 leads for further investigation, 600 preliminary law enforcement cases under review and resulted in 400 direct interviews with providers who would not have otherwise been contacted.

Predictive modeling won’t reach its full potential in overnight, but it’s already making an incredible difference and will do even more in the weeks, months and years ahead.

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