Medicare Lifts Ban on Sex-Change Surgery

By Lisa Leff of The Associated Press SAN FRANCISCO – Medicare can no longer automatically deny coverage requests for sex-reassignment surgeries, a federal board ruled Friday in a groundbreaking decision that recognizes the procedures are medically necessary for people who don’t identify with their biological sex. Ruling in favor of a 74-year-old transgender Army veteran whose request to have Medicare pay for her genital reconstruction was denied two years ago, the agency’s Departmental Appeals Board said there was no justification …

Medicare Overpays $6.7 Billion for Patient Evaluation Services

Medicare spent $6.7 billion too much in 2010 by “inappropriately” paying claims from physicians who had submitted the wrong billing codes or no documentation at all for certain services, according to a new report from the inspector general of the U.S. Department of Health and Human Services (HHS). Although that amount was a small fraction of Medicare’s total spending of more than $525 billion in 2010, it still added up to 21 percent of what Medicare paid for all “evaluation …

11 Things We Didn’t Know Last Week

News, discoveries and … fun 1. The bones of a seven-story-tall dinosaur, called the largest creature ever to walk the earth, were discovered in Argentina. (Learn more at NPR) 2. The outgoing Indian prime minister had 1.24 million Twitter followers before he reset the government account, making the new PM start over. (Learn more at Quartz) Honorable Outgoing PM Dr Manmohan Singh farewell speech to the nation Full Speech: http://t.co/Z7NrGabt1R pic.twitter.com/An6GyIlBRI – Yuva Desh (@yuvadesh) May 17, 2014 3. The residents of Paraguay are …

Low-Value Health Services Cost Medicare Billions

Medical services that provide little or no health benefit to older Americans cost Medicare at least $1.9 billion a year, according to a landmark new study. Researchers at Harvard University’s department of health care policy found that at least 25 percent of the more than 1.3 million Medicare beneficiaries had one or more of 26 tests and procedures that have been shown to provide scant medical value. The study is thought to be the first to measure wasteful spending by …

Who Really Pays for Health Care? It’s Not Who You Think

By Jay Hancock, Staff Writer, Kaiser Health News Eight million Americans have signed up for private health insurance – much of it government subsidized – under the Affordable Care Act. Millions more obtained new coverage through Medicaid, the government-sponsored insurance program for low-income people. The full implementation of the law – along with its wider coverage, new taxes and shifting subsidies - has brought renewed discussions and debates over the winners and the losers in the new health care landscape. Here are …

Groundhog Day for Medicare ‘Doc Fix’

Another year, another last-minute “doc fix” by Congress. Am I the only one starting to feel a little like Bill Murray in the 1993 comedy Groundhog Day? On March 31, just one day before Medicare payments to doctors would have been slashed by 24 percent, Congress approved a short-term patch to delay the payment cuts for another year. This is the 17th time in 11 years that Congress has had to delay the Medicare reimbursement cuts created by SGR (the …