medicare

The shutdown of the federal government is here. Now what?

We'll keep tabs on the people, programs, and places being affected by the shutdown on this post. Drop us a note below if you're affected by the shutdown or if you know of a program that we haven't mentioned.

If you've sat this story out, and need some "Shutdown 101," the Washington Post's WonkBlog has "Absolutely everything you need to know about how the government shutdown will work." That should about cover it.

*We will update this post as we learn more information

The shutdown shakes things out into two silos.

  1. "Essential" services/personnel, and
  2. "Non-essential" services/personnel.

 The federal budget cuts known as the sequester are hitting home across Metro Detroit.

That’s the message Congressman Sander Levin took on the road in his district Friday.

Levin met with seniors, defense industry employees, and hospital staff in Macomb County. All have been affected to some degree by the sequester.

At St. John’s Macomb hospital, a 2% cut to Medicare payments has taken a $4.5 million bite out of the budget. About 70% of the hospital’s patients are covered by Medicare.

Lindsey Smith / Michigan Radio

Governor Snyder is scheduled to sign a law tomorrow that will transform Blue Cross Blue Shield of Michigan into a customer-owned non-profit insurance company.

Supporters say the change will make Michigan’s health insurance market more competitive.

But the AARP and other opponents complain the change will eventually cost nearly 200 thousand Michigan senior citizens the Medi-gap coverage they need.

Local governments and businesses are waiting to see how they will be affected by automatic federal budget cuts that take effect today.   

In Grand Rapids, the city’s plans for a new rapid bus service may end up being delayed by the sequester cuts.

Peter Varga is the CEO of The Rapid.   He says 80 percent of the funding for the nearly $40 million project is slated to come from the federal government.

Varga says if the federal funding is held up, the project will be delayed beyond its 2014 completion date. He says a delay will add to the cost of the project.

Michigan hospitals could be among those hardest hit by automatic federal budget cuts this week.

Under the sequestration, Medicare reimbursements to doctors and hospitals would be cut by two percent.

Laura Appel is the vice president for federal policy and advocacy with the Michigan Health and Hospital Association.  She says sequestration would add up to tens of millions of dollars a year in loss reimbursements to Michigan hospitals. 

Mark Brush / Michigan Radio

Former state Attorney General Mike Cox says Blue Cross Blue Shield of Michigan illegally denies seniors access to certain plans.

Cox filed a class action lawsuit Wednesday against the state’s largest health insurer.

It claims Blue Cross denies access to its most popular Medigap plan to anyone with a retiree health savings account. Medigap is a program that covers healthcare costs that Medicare does not.

Cox said the policy unfairly forces some customers to buy more expensive plans.

Premshree Pillai / Flickr

A Michigan congressman in a tight re-election campaign will stand in the spotlight today at the Republican National Convention.

Republican Dan Benishek defeated Democrat Gary McDowell two years ago to win the congressional seat formerly held by Bart Stupak.   The two will face off again in a rematch in November.

U.S Department of Education

Hundreds of thousands of Michigan residents already have benefited from the health care law passed in 2009, according to the federal government. Some examples:

  •  More than 23,000 Michigan seniors and people with disabilities have saved $17.6 million this calendar year on prescription drugs because of the law, an average of $757 per person. The money goes to help residents with medical costs after they hit the Medicare Part D prescription drug coverage gap, the so-called "doughnut hole."
  • More than a half-million Michigan seniors have received a free preventive health care service so far this year.
  • Around 1.8 million residents now receive preventative services with no co-pay.
  • Around 57,000 more young adults in Michigan under the age of 26 are on their parents' health insurance plans.
  • Around 7,000 small businesses get federal tax credits for offering health insurance to their employees.
  • Six Michigan health centers have been awarded $3.7 million from the federal government to help expand access to care for 59,431 additional patients.
  • Around 114,000 Michigan residents will get $13.9 million in rebates from insurance companies this summer because of a rule that requires insurance companies give rebates if they don't spend at least 80 percent of consumers' premiums on medical care and quality improvement. The rebates will average $214 for 65,000 Michigan families.
Lindsey Smith / Michigan Radio

Opponents of proposals for major changes to Medicare spent today making the rounds of retirement communities in Michigan.

They denounced the budget plan passed by the U.S. House of Representatives.  Under the Republican budget plan, future retirees would get a stipend to buy health insurance.   Its an approach Republicans say would hold down costs and begin to rein in the deficit.

Max Richtman  is the president of the National Committee to Preserve Social Security and Medicare.   He says House Republicans want to do away with what’s left of the ‘New Deal’.

DETROIT (AP) - A Detroit man charged with ripping off Medicare and selling powerful painkillers has pleaded guilty to conspiracy and health care fraud.

George Williams admitted Thursday that people were paid $220 to get prescriptions filled and then return the drugs to him for sale, including Vicodin and Oxycontin.

The drugs were peddled in southeastern Michigan as well as in Kentucky and Alabama, from January 2007 through December 2008. A big break for investigators occurred in 2007 in Wood County, Ohio, when deputies discovered a doctor's name on 55 bottles of cough syrup with codeine.

People posing as patients were also taken to a Southfield hotel or a Detroit house for a phony exam. Williams admits his business billed Medicare and received $422,000.

Federal prosecutors in Detroit have charged another 28 people in three alleged Medicare fraud schemes.

The allegations outline typical Medicare fraud schemes totaling over 28-million dollars.

One scheme involved 14 people operating out of the Detroit suburb of Livonia, who allegedly submitted fraudulent claims for home health care services.

Rebecca Williams / Michigan Radio

Michigan Radio's West Michigan reporter Lindsey Smith went to Kalamazoo yesterday to report on a community forum with Congressman Fred Upton (R-St. Joseph).

Upton was invited by the Kalamazoo County Advocates for Senior Issues and he discussed the economy, health care, and social security with the group.

But as Smith reported the "crowd of 200 people also demanded he talk about what he’s doing to create jobs and improve the economy. Several interrupted and shouted at Upton. Those doing the interrupting asked him about the economy."

Here's some video of that forum. Upton attempts to talk about the information on his chart, but he's interrupted:

Corey Seeman / Flickr

Congressman Fred Upton (R-St. Joseph) discussed the U.S. economy, health care reform, and the future of Social Security at a forum in Kalamazoo Monday.

Upton is one of twelve lawmakers selected to serve on a special Congressional committee. That committee will try to determine a compromise on long-term spending to help reduce the federal deficit.

Upton says the federal debt is “unsustainable”. He says the way to fix it is to get the economy moving so more people can get a job.

U.S. Attorney General Eric Holder and U.S. Health and Human Services Secretary Kathleen Sebelius will talk about health care fraud prevention at a regional summit at Wayne State University in Detroit this morning.

Law enforcement officials, consumer experts and health care providers are also expected to participate in the discussions, the Associated Press reports.

This is the fifth in a series of summits announced last June by President Obama. The AP reports:

Waste and fraud cost the federal Medicare program and Medicaid, its state counterpart, an estimated $54 billion in 2009. Holder said at a December summit in Boston that the Obama administration's crackdown on health care fraud has recovered $4 billion in Massachusetts alone over two years.

Federal prosecutors have charged 21 people with Medicare fraud in metro Detroit.

The indictments include doctors, physical therapists and clinic managers. They’re charged with billing Medicare for $23 million in services that either weren’t needed, or were never performed.

Andrew Arena heads the FBI’s Detroit office. He says one of the most striking examples is a physician who did $8 million worth of home visits:

Four Detroit-area residents have been indicted by the federal government for Medicare fraud.

The Department of Justice says Medicare fraud schemes were operated out of Patient Choice Home Healthcare and All American Home Care.