In Case You Missed It — Healthcare Daily Digest for Friday, 21 December

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Kwashiorkor. Say it loud and there’s music playing, say it soft and it sounds like that super healthy cereal in the Hippie aisle of my grocery store that appears to be made from twigs and earnestness. What it actually is: a nutritional disorder usually seen among children during famines in developing countries, and something a Redding, Calif.-based healthcare services system billed Medicare for on a regular basis. “At its height,” according to a story on television station KQED’s website, “[Prime Healthcare Services'] billing for the malady surged to nearly 70 times the state average.

And then it stopped.

On one hand, you have the KQED blog suggesting that the billing stopped “soon after California Watch published a story about aggressive billing practices at the hospital” and that “the chain’s founder…urged doctors and medical coders to pad computerized bills submitted to Medicare for reimbursement with conditions that qualify for premium payouts.” On the other hand, you have Prime itself, insisting “its billings are accurate [and] a reflection of its concern for patient care.”

It certainly seems more the former than the latter — especially in light of the recent spate of articles about Medicare/Medicaid abuses. But sure, it could also be that Norther California is rife with Kwashiorkor that went away with a quickness because of Lemurians.

Other headlines you might have missed:

Accountable Care Organizations: Early Results: “So now, nearly two years later, what have we learned about ACOs – and how have they fared at reducing costs and improving outcomes?” This review will answer that question, plus several more.

VIDEO: How Raising Medicare Age is a Virtual Death Sentence: Democratic Senator Jeff Merkley of Oregon spoke to HuffPost Live’s Abby Huntsmen about the devastation that change would bring.

Like Sharing Your Paycheck with Your Co-Workers: Here’s your opportunity to who got bonused and who got dinged. Medicare just disclosed bonuses and penalties for nearly 3,000 hospitals.

Here’s a Chilling and Sobering Question: In a Forbes.com blog post, Howard Gleckman shares that “four-in-ten have clients who ask about giving away their assets so they can become eligible for Medicaid long-term care.

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Posted in Medical Receivables, Patient Financial Services .

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