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The Spokesman-Review Newspaper The Spokesman-Review

Spokane, Washington  Est. May 19, 1883
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McMorris Rodgers proposes bill to help ALS patients

Thousands of Americans diagnosed with Lou Gehrig’s disease face the possibility of losing access to their communication technology when making frequent visits to the hospital. Rep. Cathy McMorris Rodgers said the rule, which affects ALS patients covered by Medicare, is “bureaucratic nonsense” and has proposed the Steve Gleason Act in Congress to solve the problem. The bill is named after Washington State University and NFL player Gleason, who revealed in 2011 he was diagnosed with the neurodegenerative disorder that affects roughly 30,000 Americans.

Guidance through the health coverage maze

Before stumbling upon the free Medicare workshop last week, Toni Mastronarde spent three years feeling ashamed and beaten down because she couldn’t figure out her Medicare coverage and didn’t have enough money from Social Security to pay for medications and basic needs like food and heat. She carried so much stress in her muscles, her neck could hardly turn. The 69-year-old diabetic said she had mostly gone without insulin for months, canceled appointments with specialists and only eaten beans and split pea soup – never fresh fruits or vegetables. Her apartment is always cold because she fears the cost of heat.

Lakeland Village gets reprieve

Federal officials have backed away from a threat to cut funding from Lakeland Village as a result of improvements responding to numerous violations. The Washington state Department of Social and Health Services on Thursday said that the federal government will maintain Medicaid funding for 83 residents under long-term care at Lakeland Village Nursing Facility in Medical Lake.

Lakeland Village Nursing Facility residents to lose Medicaid funding

The federal government plans to cut off Medicaid funding for 83 residents under long-term care at Lakeland Village Nursing Facility as of next Thursday. State officials said on Wednesday that they have been working for several years to recover from recession-caused staff cuts, which led to negative findings on subsequent federal inspections to the Medical Lake facility.

Medicare Advantage enrollment deadline looms

Millions of Medicare Advantage customers are fast approaching a deadline for a task they’d rather avoid: researching and then settling on coverage plans for 2015. The annual enrollment window for the privately run versions of the government’s Medicare program for elderly and disabled people closes on Sunday. This is the main opportunity most customers have each year to adjust their health coverage, and it may be worth paying extra attention to the details.

Smart Bombs: Chase away the political blues

In August, when the jobless rate was 6.1 percent, the polling outfit Ipsos-MORI asked, “Out of every 100 people of working age, how many do you think are unemployed and looking for work?” The average response was 32. What in the name of Tom Joad were people thinking? I know times are tough, but at the depths of the Great Depression the jobless rate was 25 percent. Five years ago, at the bottom of the Great Recession, it was 10 percent. Today, it’s 5.8 percent.

Patient injuries, infections lead to Medicare sanctions

During a hernia operation, Dorothea Handron’s surgeon unknowingly pierced her bowel. It took five days for doctors to determine she had an infection. By the time they operated on her again, she was so weakened that she was placed in a medically induced coma at Vidant Medical Center in Greenville, North Carolina. Because of complications like Handron’s, Vidant, an academic medical center in eastern North Carolina, is likely to have its Medicare payments docked this fall through the government’s toughest effort yet to crack down on infections and other patient injuries, federal records show.

Medicare coverage ban on sex-change surgery lifted

SAN FRANCISCO - Transgender people receiving Medicare may no longer be automatically denied coverage for sex reassignment surgeries, a U.S. Department of Health and Services review board ruled Friday in a groundbreaking decision that recognizes the procedures as a medically necessary and effective treatment for individuals who do not identify with their biological sex.

Editorial: Knowledge is power for health care cost control

The Obama administration on Wednesday released 880,000 reasons why compensation for medical care in the United States should be shifted away from a fee-for-service model that encourages some doctors to bill, and bill, and bill. The breakdown of Medicare payments to the nation’s doctors – an action the American Medical Association has fought since 1979 – helps explain a hemorrhaging of health care money that consumes one of every seven dollars expended in the U.S. economy. A Florida ophthalmologist, billed the program $20.8 million; the top 2 percent of all doctors pocketed $15 billion – almost 24 percent of the $77 billion included in the newly released information.

Medicare database reveals top-paid doctors

WASHINGTON — Medicare paid a tiny group of doctors $3 million or more apiece in 2012. One got nearly $21 million. Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.

Rural, small hospitals may get break from federal rule

Rural and small hospitals across the Inland Northwest may soon see relief from a federal rule that critics argue could stretch physicians too thin and could lead to fewer medical services being available. The rule requires that a doctor be present in a department during routine procedures, such as blood transfusions and some immunizations. While it passed in 2009, it wasn’t enforced at small hospitals until this year.

Lakeland cuts to specialized services are improper, feds say

Lakeland Village, the state-run nursing facility for the developmentally disabled, is under fire from federal regulators for what’s described as improper cuts in specialized services to nearly 30 residents. The U.S. Department of Health and Human Services has suspended distribution of matching dollars for the state-provided care and wants as much as $16 million in previous payments returned. In a Nov. 7 letter to state officials, regulators also advised they are recommending a civil rights investigation be initiated.

Medicare Advantage plans require scrutiny

Ominous warnings about Medicare Advantage plans have sounded for more than a year now. Health insurers say federal funding cuts to these privately run versions of Medicare will force them to whack plan benefits, hike premiums or leave some geographic markets entirely as they continue to fight rising health care costs. The government is paring back the money it provides for this coverage as part of its effort to fund the health care overhaul, which aims to cover millions of uninsured people.

BBB Tip of the Week: Health care scams

Provisions of the Affordable Care Act, also known as Obamacare, are in effect and scammers are pouncing on the confusion related to these healthcare changes. Here are several scams that have cropped up:

As boomers ease into Medicare, battle rages over health-care costs

The first baby boomers came of age in a political whirlwind: African Americans marched for equal rights, and Southerners attacked them. Anti-war protesters squared off against tear gas, nightsticks and bullets. Feminists pounded on the nation’s boardroom doors, demanding opportunities for women. Environmentalists demanded cleaner air and water. Federal government responded, with historic reforms: Voting rights. Civil rights. Environmental protection laws. Withdrawal from Vietnam. The resignation of a president.

Hospitals need surgery on pricing

How much of our current predicament regarding health care can be packed, symbolically, into one surgical procedure? A whole lot, if we’re talking about joint replacements. All the promise and the problems of modern medical care seem focused in the rapid rise of our ability to replace our hips, knees and shoulders – from the demographic challenges of an aging population to the long-term effects of obesity to the life-altering benefits of technology to preposterous pricing schemes.

Cheney family caught in Medicare quirk after kidney transplant

WASHINGTON – Like many high school graduates, Katelynn Janes, of Cheney, made big plans last June: move out of the house, study psychology and eventually counsel young people who have chronic physical ailments. Kidney failure didn’t make the list. But in December, after months of being lethargic and unable to eat, tests showed her blood was filling with toxins. She needed dialysis right away.

Murray: Senate will pass budget

WASHINGTON – Count Washington Sen. Patty Murray among those confident the U.S. Senate will pass a budget this spring. The new Budget Committee chairwoman said Wednesday it’s time for her colleagues “to get to work,” acknowledging that the upper chamber has failed to approve a spending plan since 2009, but chastising Republican members of the GOP-controlled House for what she considers years of disruptive tactics.

State eyes system to streamline health care

OLYMPIA – State officials think they can save $14 million over the next five years and provide better health care to a group of patients who are among the most expensive to treat. Washington received a waiver Thursday from the federal government to start a new program for people who qualify for both Medicare and Medicaid. The state hopes to put about 30,000 so-called dual-eligibles into a single program that provides someone to coordinate their care, reducing costs that arise from conflict between the programs.