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Healthcare Roundup: Fed Step Into McKesson Case, WellCare Implicated in Medicaid Fraud, and More

Feds intervene in McKesson whistleblower case -- The Justice Department has stepped into a private whistleblower lawsuit against medical-product supplier McKesson. The suit alleges that McKesson and nursing-home operator Golden Living defrauded Medicare through a sham supplier of durable medical equipment. [Source: Modern Healthcare]

WellCare employee pleads guilty in Medicaid fraud -- The Florida managed-care firm WellCare, recently notorious because the FBI raided its headquarters a year ago, now has another claim to fame. An employee, Gregory West, pleaded guilty last year to participation in an "elaborate scheme" to inflate Medicaid bills. According to the Department of Justice, which just unsealed the plea, West didn't act alone, suggesting that the FBI has been busy flipping smaller fry in order to get to the bigger fish in the case. [Source: Tampa Bay Business Journal]

Tennessee Blues revise doctor-rating system -- BlueCross BlueShield of Tennessee has issued a new system for rating the performance of physicians, following complaints about an earlier version that debuted in March. Doctors are still unhappy that the system is based on claims data, and don't think they should be responsible for correcting errors. [Source: American Medical News]

Minnesota health plan puts prices online -- Bloomington, Minn.-based HealthPartners, a nonprofit HMO with more than one million members, has posted what its various medical offices will charge for 83 common procedures, ranging from office visits and immunizations to lab services and medical scans. By December, the plan intends to cover 100 procedures that patients can check at three different facilities at a time. [Source: FierceHealthcare]

Colorado hospitals report $796M in free care -- Uncompensated care at Colorado medical facilities rose 19 percent in the first half of 2008, to $796 million from $671 million a year earlier, according to the Colorado Hospital Association. Bad debt, meanwhile, grew by only six percent, although you have to contrast that with the fact that patient admissions barely rose at all during the period. [Source: Denver Business Journal via FierceHealthcare]

Medicare aims at durable-equipment fraud in seven states -- The feds are cracking down on fraud among durable medical-equipment suppliers and home healthcare outfits. Acting Medicare director Kerry Weems said the agency, as part of the expansion of its recovery-audit team program, will concentrate on durable-equipment billings in California, Florida, Illinois, Michigan, New York, North Carolina and Texas -- not surprisingly, states with large elderly populations. [Source: Kaiser Health Daily]

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