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BusinessWeek January 6, 2011 Justin Blum	Why Medicare Can't Catch the Fraudsters One provider's claims were paid despite unusual billing patterns
Fast Company November 22, 2011 Tristram Korten	How To Commit Medicare Fraud In Six Easy Steps How hard is medicare fraud? A thief can do it in six easy steps.
Insurance & Technology August 26, 2004 Babcock & McGee	Filter Out the Frauds Health insurers fight back against fake claims with fraud-detection software.
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Managed Care February 2006 Martin Sipkoff	Don't Bet That Problems With Part D Are Over Medicare Part D enrollment snags could be just the start of political and regulatory headaches facing health plans and pharmacy benefit managers.
Financial Planning April 1, 2007 Joan Warner	What's Next for Medicare Is America's retirement healthcare plan really in trouble? Here's some good news -- and some hard decisions for your financial advisory clients.
BusinessWeek November 12, 2009 Catherine Arnst	10 Ways to Cut Health-Care Costs Right Now Employers and hospitals don't have to wait for Congress to address inefficiencies and waste.
Reason December 2008 Jacob Sullum	Auditing the Auditors A report from the Department of Health and Human Services' inspector general casts doubt on recent claims by Medicare officials that they are finally cracking down on fraud.
Searcher October 2011 Stephanie C. Ardito	The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act).
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
Pharmaceutical Executive November 1, 2005 Rubinstein & Galardi	Bustin' a CAP: The Competative Acquisition Program The new Competitive Acquisition Program for Medicare Part B drugs aims to align market forces with the distribution of drugs and biologics that doctors administer in their offices, but increasing bureaucracy is a major downside.
Pharmaceutical Executive May 1, 2005 Robert Ullmann	Back Page: Unhealthy Justice More than any other healthcare law, the Medicare/Medicaid exclusion statute has distorted our criminal justice system with government fraud investigations. This well-intentioned but misguided law should be repealed.
Financial Planning November 1, 2007 Donald Jay Korn	Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility?
Managed Care March 2006 Taylor & Eck	It's Time for CMS to Release Physician Medicare Claim Information The Center for Medicare & Medicaid Services is a rich source of price and quality data. Isn't it about time it shared that data?
Managed Care April 2001 Gregory J. Borca	Technology Curtails Health Care Fraud The amount of fraud in the health care system is staggering, but computer analysis can help reduce the level. Here is one company's strategy...
BusinessWeek July 14, 2003 Howard Gleckman	This Medicare Reform Is No Cure The theory: The shift will improve treatment and save taxpayers money, helping to rein in ballooning Medicare costs while offsetting the expense of the drug benefit. Those are laudable goals. Unfortunately, Congress isn't likely to achieve them.
Financial Planning April 1, 2010 Donald Jay Korn	Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
Managed Care July 2002	Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1.
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.
Managed Care April 2002 Frank Diamond	Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems?
Managed Care May 2002 Patrick Mullen	Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care October 2007 John Carroll	Medicare Coverage Rules Are Not Always Last Word Yes, commercial health insurers often take a cue from the government, but that doesn't mean that they follow blindly.
CFO June 1, 2005 Russ Banham	Prescription for Malaise? Health-insurance providers are rushing to participate in Medicare's new drug-benefit program. Companies are proceeding with caution.
BusinessWeek July 14, 2003 Robert J. Barro	Medicare: Forget the Drug Benefit, and Face Up to Real Reforms Washington seems poised to make a major error on Medicare. The program's costs are out of control, and the situation will deteriorate further as the population ages. We should be considering basic changes to the structure of the health-care market.
Managed Care July 2006	Public Payers Foot Greater Pharmacy Costs Through 2005, private health insurance had covered most of the cost of prescription drugs. That picture is changing as public payments, mostly under Part D, are projected to exceed private health insurance and out-of-pocket payments.
Managed Care May 2005	Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.
The Motley Fool January 22, 2007 Dan Caplinger	Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it.
Managed Care May 2007 Frank Diamond	Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on?
Managed Care May 2006 Martin Sipkoff	Part D Means Health Plans Will Have To Pay Pharmacists Medication therapy management helps people to stay on their prescribed regimens. Part D plans can expect to start making payments for the service in 2007.
Managed Care June 2004 John Carroll	Some Plans Take Advantage of Managed Medicare Redux There's more federal money for Medicare plans, but is it enough to reverse the grim five-year drought of managed care offerings? In Florida, it seems so.
U.S. Banker September 2004 Karen Krebsbach	Security: The Inside Job Your employees wouldn't rip you off, right? Think again. Their theft will cost banks $2.4 billion this year.
Managed Care June 2007 Martin Sipkoff	Rebates for Anti-Anemia Drugs Draw Response From FDA, CMS Overusing erythropoiesis-stimulating agents to collect rebates can be really bad for the patient. Ripping off taxpayers and private payers is another concern.
BusinessWeek October 1, 2009 Sasseen & Arnst	Why Business Fears the Public Option Executives contend that it will lead health-care providers to charge patients in private plans higher rates.
Registered Rep. October 13, 2011 Mark Miller	Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season.
BusinessWeek October 10, 2005 Howard Gleckman	Medicare's Big Experiment The coming changes to Medicare aim to cut costs while improving care. Sound familiar?
Managed Care March 2006 John Carroll	New Tools to Detect Fraud Rely on Discovering Patterns The ability of the computer to find unexpected - and often unwelcome - patterns of utilization for health insurance is at the heart of today's fraud detection methods.
Managed Care August 2007 Martin Sipkoff	Soaring Price of Cancer Drugs Leads Plans To New Approaches Insurers are trying different methods, from pay for performance to promoting preventive care, to hold down cost of chemotherapy drugs.
Financial Planning February 1, 2006 Janet Aschkenasy	Drug Deals Here is how to help your financial advisory clients make sense of Medicare Part D.
Bank Systems & Technology August 27, 2009 Maria Bruno-Britz	Evolving Fraud Schemes Keep Pressure on Evolving Payments Instruments While some of the latest schemes borrow from scams past, today's fraud schemes are as sophisticated as banks' most advanced payments systems. And stopping them is still a challenge.
Managed Care February 2008 Martin Sipkoff	Why Is It So Tough to Deliver On E-Prescribing's Promise? The push to mandate this electronic tool is increasing in intensity, but dealing with costs and coming up with standards remain obstacles
Pharmaceutical Executive February 1, 2012 Jill Wechsler	Costs and Benefits of Health Reform Will expanded markets and accountable care organizations offset higher rebates, added fees, and closer scrutiny of marketing and prices?
Managed Care January 2001 David Ricks & Joe Suminski	Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too...
Bank Systems & Technology May 5, 2007 Maria Bruno-Britz	Fraud Techniques Evolve in Parallel with Bank Products and Defenses As fraudsters' techniques evolve alongside the products and services offered by financial institutions, new steps must be introduced to stop them.
Managed Care January 2002 Michael Levin-Epstein	HHS Seems To Soften Hard Line on Kickbacks Do two recent advisory opinions from the Health and Human Services Office of the Inspector General signal some moderation in federal policy on what constitutes a kickback? Maybe. Or then again, maybe not...
Pharmaceutical Executive February 1, 2006 Jill Wechsler	Washington Report: Cross-Agency Collaboration for Part D Medicare Part D gives CMS more clout over coverage, pricing, and even drug development.
Insurance & Technology June 1, 2006 Maria Woehr	Uncovering Crooked Claims Finding fraudulent claims can be challenging. But with the use of rules-based analysis, data mining and predictive modeling, insurers are waging a war on scam artists.
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.