The "Doc Fix"

A recent editorial at The Chicago Tribune looks at the the Medicare situation many doctors refer to as the "Doc Fix." Many doctors have left Medicare as a result of the diminishing pay from the government. If doctors reach the maximum payment they can receive, a fee cut kicks in and they are paid less for their work. This is even after the standard rate for Medicare per visit is lower than private insurers and those who visit uninsured. Congress has suspended these pay cuts many times over the past few years, but The Chicago Tribune suggests that with the current changes in Medicare, Congress finally fixes this problem. The government should find a balanced answer and pay rate that can promote quality and efficient care. They also look to Dr. Donald Berwick, new head of Centers for Medicare and Medicaid Services, to solve this problem. Read the full editorial here.

Medicaid, Medicare Make Easy Marks for Fraud

Greg Burns of the Chicago Tribune writes that in a troubled economy, cheating Medicare and Medicaid just might be the easiest money anywhere. Recent reports about violent criminals and organized-crime figures putting aside their drug-running enterprises to pose as health care providers only scratch the surface.

Burns continues, some health care fraud is sophisticated and subtle. Some results in bloody crime scenes as hardened criminals enter the racket.

"If you're going to defraud somebody, the government is a reliable payer," said John Blum, a law professor at Loyola University Chicago who specializes in health matters. "Eventually, people like me catch up to you."

Read more about Burns' thoughts on Medicaid and Medicare fraud on his original post here.