For the second time in two years, Medicare officials are proceeding with a controversial demonstration plan to purchase medical equipment in Western Pennsylvania under a bidding system they contend will save billions.

The go-ahead, announced late last week, could impact thousands of Medicare recipients using everything from wheelchairs to mail-order diabetic supplies.

Federal officials cite potential savings of up to $17 billion over 10 years for the government and Medicare recipients, who typically pay 20 percent of fees directly or through private insurance. But critics warn any savings would be short-term, and suppliers of the goods say dozens of small businesses and hundreds of their employees could be out of work.

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The new healthcare legislation seeks to amend this problem by first issuing $250 checks to affected seniors. Starting next year, seniors will receive a 50% discount on medicine, and by 2020, this discount will reach 75%.

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Bucks County congressman Patrick Murphy (R-Pa.) is touting an add-on to the health care reform law that actually passed with bipartisan support.

The new law, known by the acronym “IMPROVE” (Improving Medicare and Medicaid Policy for Reimbursement through Oversight and Efficiency), requires health care providers getting government money receive it electronically through bank accounts. 

Congressman Murphy (above right):

“The reason why the Improve Act is important is that every single year there is $60 billion wasted in the Medicare program and we need to cut the fraud, waste, and abuse that occurs.”

…often when a shady provider would submit a fraudulent bill and use a check-cashing agency untraceably.  Murphy says a scheme like that in Miami hit $100 million before being stopped. 

Ray Landis of AARP (above left) is impressed:

“This stops the fraudulent distribution of Medicare funds through post office boxes.”

IMPROVE takes effect later this year.

Seniors aren’t breaking out the champagne for President Barack Obama’s health care law, and for good reason.

While Democrats hail the overhaul as their greatest health care achievement since Medicare, seniors fear it’s a raid on that same giant health care program-a bedrock of retirement security-in order to pay for covering younger, uninsured workers and their families.

There’s no doubt that broad cuts in projected Medicare payments to insurance plans, hospitals, nursing homes and other service providers will sting. What hasn’t sunk in yet is that the new law also improves the lot of many Medicare beneficiaries. Obama is hoping that most will eventually conclude the plusses outweigh the minuses.

Keenly aware that this is a congressional election year, Democrats structured the law so virtually all the cuts start next year and take effect only gradually. For this year, the law provides a sweetener. More than 3 million seniors who have been falling into a Medicare prescription coverage gap will get a $250 rebate, a down payment on closing the “doughnut hole.”

Nonetheless, seniors are anxious.

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U.S. Rep. Paul E. Kanjorski delivered a message about the health care reform bill Tuesday, one senior citizen to a roomful of them.

His message: Despite attempts to scare seniors into thinking the bill threatens Medicare, it does not.

“Medicare will not in any way be injured,” said Mr. Kanjorski, who will turn 73 this week. “Take it to the bank.”

Nine days after voting for the reform bill, Mr. Kanjorski, D-11, Nanticoke, tried to reassure a skeptical audience of about 30 seniors at the South Side Senior Center.

“I was worried more or less about Medicare, that something would happen to that, that we would lose Medicare,” Irene Prazych, 84, of Scranton, said. “I’m hoping that what he says will come to fruition, that they don’t cut back or take away from us on Medicare.”

At times, the meeting grew testy, especially when Joe Gasdik, 74, an Old Forge Republican, questioned why the state no longer ran hospitals where the poor could get medical care.

“Why couldn’t you people just fix what we had?” Mr. Gasdik asked.

“Who paid for that?” Mr. Kanjorski asked, referring to the taxpayer-paid state hospitals.

“This Obamacare is no good,” Mr. Gasdik shot back.

Republicans have criticized the $940 billion legislation for diverting $132 billion over 10 years from private Medicare Advantage plans to help pay for it. The private plans often offer extra benefits that seniors in traditional Medicare do not receive. Critics of Medicare Advantage say it amounts to a subsidy for private health insurers. More than a fifth of Medicare’s 45 million beneficiaries are in the plans, and the fear is private insurers will drop the plans or cut extra benefits without subsidies.

“Nothing in this bill takes anything away from anyone who is on Medicare,” Mr. Kanjorski said. “There just isn’t any change to Medicare. … What we are doing is not allowing the insurance companies to get money for Medicare Advantage that was being paid to them.”

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The Improper Payments Elimination and Recovery Act would reduce waste, fraud and abuse resulting from lack of oversight on the part of federal agencies.

Making closing arguments for his health care overhaul Wednesday, President Barack Obama gave a shout out of sorts to Congressman Patrick Murphy.

Promising to crack down on the waste, fraud and abuse in health care that costs taxpayers $100 billion each year, the president praised a bill Murphy co-sponsored with California Republican Brian Bilbray.

The Improper Payments Elimination and Recovery Act would reduce waste, fraud and abuse resulting from lack of oversight on the part of federal agencies.

“I’m thrilled the president has highlighted our bill,” Murphy said in a news conference. “Our proposal is a commonsense measure. This is a huge step in our efforts.”

Murphy, a two-term Democrat in the 8th District, said, “At a time when Pennsylvania families are watching our expenses, Americans expect government to do the same. There is simply no excuse to lose billions of taxpayer dollars to improper payments every year. The savings from this bipartisan bill should be redirected to middle class tax cuts.”

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The head of the Geisinger Health System is denying rumors that he will leave Geisinger to become head of the federal agency that administers Medicare and Medicaid.

“The rumors are not true,” Dr. Glenn D. Steele Jr. wrote in an e-mail to The Times-Tribune.

He did not comment further in the e-mail, and a Geisinger spokeswoman refused to arrange an interview with Dr. Steele, who is the system’s president and chief executive officer.

“Sorry, Dr. Steele doesn’t have anything else to say about the rumor, except that it was a rumor,” system spokeswoman Patricia Urosevich said.

Speculation circulated throughout Washington, D.C., last week that President Barack Obama would nominate Dr. Steele to run the Centers for Medicare and Medicaid Services, which has been without a permanent administrator since October 2006.

Two Web sites, including one that focuses on the pharmaceutical industry, reported Dr. Steele’s nomination to the post as fact without attributing it to any source.

“Not true,” Medicare spokesman Peter Ashkenaz said at the time.

Dr. Steele has led Geisinger since March 2001.

The speculation has been fueled by Mr. Obama’s mention of Geisinger’s efforts to link compensation for doctors and other health care providers to whether a patient is properly cared for.

 Legislation to temporarily extend higher Medicare reimbursement rates for area hospitals is pending, but the major health care reform under way on Capitol Hill could provide a permanent fix to the problem.

At Mercy Hospital, members of the Northeastern Pennsylvania’s federal legislative delegation Monday briefed health care officials on the progress.

“It’s an ongoing fight,” said Sen. Arlen Specter, D- Philadelphia.

Legislation in the House of Representatives would extend payments under the Medicare Wage Index Reclassification for two years, while the Senate’s extension would be for a year, he said.

Specter and others have succeeded in getting more than $200 million for hospitals during the past 10 years to ensure payments for services are in line with those paid to hospitals in larger metropolitan areas.

The more than $5 million provided to Mercy under the last extension that ended on Sept. 30, 2009, was the difference between the hospital operating in the black as opposed to the red, Specter said.

The money enables hospitals to pay competitive wages, added Sen. Bob Casey, D-Scranton.

“It’s critically important because we have a right to expect quality health care in Northeastern Pennsylvania,” Casey said.

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