Doctors Successfully Repel Aetnas Unwarranted Intrusion Into How They Perform Colonoscopies

After coming under attack from doctors, Aetna has withdrawn its intention, announced late last year, that in New Jersey, effective April 1, 2008, it would drop its coverage of propofol, the anesthesia typically used during colonoscopies, calling the same medically unnecessary. In reality, it is not the propofol that Aetna minds paying for; what Aetna wants to cut-out is the … Read the rest

Medical Device Manufacturer’s Settlement of Kickback Charges Shows That Even Criminal Fines Can Be “Privatized”

The U.S. Attorney for New Jersey directed that a no-bid 18-month contract worth $28 million to $52 million contract be awarded to The Ashcroft Group, the consulting firm of former Attorney General John Ashcroft, to monitor a large settlement of criminal accusations against medical device manufacturer Zimmer Holdings and four smaller companies accused of paying kickbacks to doctors who recommended Read the rest

Report on Medicare/Medicaid Overbilling and Fraud in 2007 Focuses on Nursing Homes/Rehab Centers, Pharmaceuticals and Boutique Hospitals

Americas Watchdog and its Corporate Whistleblower Center have just released the results of its third annual study focused on Medicare & Medicaid fraud. The report continues to show widespread Medicare/Medicaid billing abuse and fraud involving all aspects of health care.

The Corporate Whistle Blower Center has just reported its 2007 year end findings on the state of Medicare/Medicaid over billing/fraud … Read the rest

Health Insurers’ Physician Ranking Programs Spark Concerns About Consumer Deception: Investigation by New York Attorney General Leads to Agreement

New York Attorney General Andrew M. Cuomo has been conducting an industry-wide investigation of doctor ranking programs, concerned that the insurers use their ranking system to steer their insureds to doctors who cost the insurers less but are not as well qualified to treat the insured as physicians who are more expensive for the insurer to pay. This investigation has … Read the rest