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AARP Applauds Senate for Progress on Health Care Reform
November 18, 2009

Survey Finds AARP Members Back Critical Provisions of Health Care Reform Legislation

Source: AARP Press Center November 16, 2009

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AARP Media Relations, 202-434-2560, media@aarp.org

Survey Finds AARP Members Back Critical Provisions of Health Care Reform Legislation

WASHINGTON—A new poll of AARP members released today finds strong support across party and ideological lines for elements of health care reform included in the Affordable Health Care for America Act, which recently passed the House of Representatives. The bill, which strictly limits how much more insurance companies can charge based on age and closes the Medicare prescription drug doughnut hole, was endorsed by AARP.

Among AARP members, strong majorities reported that many of the bill’s key provisions were convincing reasons to support the legislation. These include strictly limiting insurers from charging much higher premiums because of age (68%), closing the gap in Medicare’s prescription drug coverage known as the doughnut hole (69%) and improving coverage for critical preventive services like cancer screenings (77%).

“This survey demonstrates what we’ve been hearing from our members for a long time,” said Nancy LeaMond, AARP Executive Vice President. “Despite an inflammatory debate on a very personal and important issue, our members—across party and ideological lines—support health care reform that protects Medicare, lowers the price of prescription drugs, increases their access to coverage and protects their choice of doctors.”

While a partisan divide was evident when respondents were asked about the current plan in Congress, AARP members supported the legislation by more than a 2-1 (63%-30%) margin. More than half of self-described independents indicated support for the plan.

Other reform elements with high levels of support among AARP members included ensuring Americans can see the doctor of their choice (76%), stopping insurance companies from denying coverage because of a person’s health history (75%) and ensuring Americans can keep their current coverage (78%). Majorities of self-identified Republicans supported most of the reform elements presented, including stopping discrimination because of pre-existing conditions (66%), covering routine preventive care (64%) and allowing Medicare to negotiate lower drug prices (64%).

LeaMond added: “The bill recently passed by the House incorporates the reforms that our members care most about. We’ll continue the fight for these critical elements as the Senate takes up its own legislation in the coming weeks. Our members, and all older Americans, are counting on lawmakers to reform the health care system this year.”

Starting on Tuesday, November 17th, AARP will launch a new national television ad on a mix of news, lifestyle, cable and sports channels. The ad, entitled “HELP,” demonstrates that people from all walks of life are feeling stranded by the current health care system. It calls attention to the need for the kind of health care reform AARP has been fighting for: reform that will put patients first, protect Medicare, bring down drug costs and ensure that no one can be denied affordable health care because of their age or health history.

AARP surveyed its members on key health care reform provisions supported by AARP, as well as other contentious issues being discussed in the debate. The telephone survey, fielded October 30 to November 8, 2009, was conducted with randomly selected members of AARP. The nationally representative sample of 803 AARP members has a margin of error of +/- 3.5%.

The complete survey is available at http://www.aarp.org/research/surveys/care/health/hcreform/articles/hrhcr.html .

AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world's largest-circulation magazine with over 35.5 million readers; AARP Bulletin, the go-to news source for AARP's nearly 40 million members and Americans 50+; AARP Segunda Juventud, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

Track Loved Ones With Alzheimer's

By LAURAN NEERGAARD

WASHINGTON, Nov. 17, 2009 (AP Online delivered by Newstex) -- Tom Dougherty jokes that he takes "get-lost walks." To his wife, Cleo, it's a constant fear: When will his Alzheimer's get bad enough that she has to end his 4-mile daily strolls?

The Irvine, Calif., woman is about to watch her husband's neighborhood meandering via computer while she works. The Alzheimer's Association is adapting technology developed for monitoring prisoners to let caregivers track where their loved ones drive or walk -- and alert them if they go beyond the virtual fences each family can set.

"You're trying to help them maintain their dignity and independence," says Cleo Dougherty, who pilot-tested the service with her 67-year-old husband last summer and is awaiting arrival of the official version, which began shipping transmitters last week.

More than 5 million Americans are estimated to be living with Alzheimer's, as many as half in the disease's early stages. Increasingly early diagnosis means many patients still have years of independent living ahead of them before they have to give up the car, and eventually give up going out alone at all.

At some point, nearly 60 percent of Alzheimer's patients will begin what's called wandering, requiring more intense supervision to keep them safe.

A growing number of states are adopting "Silver Alerts" programs that notify the public when an Alzheimer's patient or other cognitively impaired adult wanders off, modeled on the Amber Alerts for missing children. Other families opt for higher-tech options -- from simple radio-wave beacons to more sophisticated GPS technology -- developed for search-and-rescue that allow tracking a transmitter signal if the person carrying the device is missing.

"That works great when they're lost, but until they're lost it isn't really helping families manage location," says the Alzheimer's Association's Beth Kallmyer.

So the association's new Comfort Zone program goes a step further, with a Web-based mapping service that works with multiple brands of tracking transmitters. First out are a pocket-size transmitter and a car version, while a harder-to-remove wristwatch style and one secreted in shoes are being explored.

Families can check where Dad is at any given time, or in an emergency track his movements every 2 minutes while someone heads him off.

Or families might set day- and nighttime perimeters for Aunt Sue. Cross the zone and an e-mail or text message alerts the caregivers. That might mean a call to her cell phone to see if she needs directions -- or it might just be useful information in judging how well she gets around on her own.

How it works: The Alzheimer's Association hired Omnilink Services, best known for prisoner monitoring, to run the Web mapping with various types of technology. Different manufacturers' transmitters are certified as compatible. Families buy a transmitter for about $200, and then choose a monthly monitoring plan that can range from $43 to $80.

That's far cheaper, says Cleo Dougherty, than the Alzheimer's day program she'll have to enroll her husband in once he can't walk his neighborhood alone.

A few small companies attempted similar Alzheimer's tracking a few years ago before the technology could keep pace, says University of Rochester assisted-cognition specialist Henry Kautz, who isn't involved with the Alzheimer's Association.

The accuracy of GPS, for instance, depends on clear access to satellites powering the navigation tool, meaning a tunnel or tall buildings can block signals. Today's "network-assisted GPS" can pair GPS with nearby cell phone towers to improve reliability, Kautz said.

"This is going to be a big hit," Kautz said of Comfort Zone, largely because "a trusted nonprofit" will be an umbrella for multiple choices.

The technology is not a replacement for in-person supervision, cautioned Nina Silverstein, a gerontology professor at the University of Massachusetts, Boston.

But pilot-testing Comfort Zone gave Karen Zimmerman's husband peace of mind. The Alexandria, Va., woman was diagnosed with Alzheimer's at the unusually young age of 51, and nearly two years later still drives on her own every day for volunteer work and to shop.

Independence is "the most important thing to me right now, it really is. If I had to sit here at the house all day, I don't know what I would do," says Zimmerman.

She does get "very flustered" on the few occasions she's gotten turned around, says husband Keith Holdsworth, who wants a new Comfort Zone transmitter on her car before the couple's next trip to the out-of-state retirement home they're building, where even he finds the unfamiliar roads confusing.

"It'll get to the point where I'll need to rein her in," Holdsworth says. But the service "will afford her that independence for a longer period of time."

EDITOR's NOTE -- Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Little-Known Provisions in Health Care Reform Bills Would Offer Help With Long-Term Care

They indulge their wildest whims—a private helicopter, Lamborghini sports cars, thoroughbred horses, even a “Pirates of the Caribbean” water theme park. For the schemers and scammers, Medicare fraud is one crime that does pay—and pay and pay.

The Benitez brothers of Miami—Carlos, Luis and Jose—can vouch for that, federal prosecutors say. The brothers, who operated fake storefront clinics there, were indicted last year on fraud charges after allegedly collecting $84 million from Medicare for phony medical treatments. They spent their Medicare millions on the helicopter, the horses, a rental car agency and tourist hotels—all items the government is now trying to seize and reclaim for taxpayers.

Medicare frauds are often inelegant—but they’re outrageously lucrative and relatively low-risk. So lucrative, and so low-risk, the FBI reports , that a number of cocaine dealers in Florida and California have switched from illicit drugs to Medicare fraud.

Medicare loses billions of dollars to fraud each year. “Those billions of dollars,” said Eric Holder, U.S. attorney general, “represent health care dollars” that could be spent on medicine or care or hospital visits, “but instead are wasted on greed.”

Yet Congress has denied Medicare the money officials say it needs to truly police itself. Four years ago, as fraud began spinning out of control, lawmakers ignored Medicare’s request for $300 million to fight these crimes—even though the agency’s Office of Inspector General says that every dollar spent protecting the program returns $17.

Now, with Congress and the Obama administration hoping to help finance health care reform with $500 billion in savings wrung from Medicare over the next 10 years, cracking down on fraud is a fresh priority. And it shows. Just this year, anti-fraud efforts have seen a marked increase in money and agents.

Miami vice

The nation’s first federal Medicare fraud strike force hit the ground in Miami two years ago—with agents from the FBI and investigators from the Department of Health and Human Services’ Office of Inspector General, as well as federal prosecutors. Altogether, the strike force and the southern Florida U.S. Attorney’s Office indicted 197 suspects in 2007, almost doubling Medicare fraud prosecutions.

In one Miami case alone, the team charged 16 people with orchestrating a $101 million fraud involving phony bills for medical equipment that Medicare patients neither needed nor received. Now, strike forces are operating in Medicare fraud hot spots like Los Angeles, Detroit and Houston, and officials say more cities will be targeted later this year. The scams are many, varied and spreading.

The Houston strike force, for example, shut down clinics billing Medicare for $3,000 “arthritis kits” that were only heating pads and knee and shoulder braces. A $16 million bust last July netted 32 doctors and executives. Some of the clinics, prosecutors charge, also were billing for liquid food supplements for patients who were deceased.

Since 2007, the strike forces have indicted nearly 300 defendants who allegedly stole $680 million, according to the U.S. Department of Justice . Sentences range from two to 15 years, with one doctor receiving 30.

Half of those defendants were arrested in Miami—the Medicare fraud capital of the nation . Schemes hatched there are perfected, then exported to other parts of the country.

“We know the fraud is viral and spreading to other communities,” says Kirk Ogrosky, deputy chief of the Justice Department’s criminal fraud section, who coordinates the strike forces.

Take the case of the two Miami men who allegedly set up a chain of about 40 clinics—with names like Fast Cure Company—in Florida and then four other states. Prosecutors contend the two men ran a ring that bilked Medicare out of $100 million for therapies—never administered­—for cancer, HIV and other illnesses. Investigators found some of the “clinics” were empty storefronts with hand-lettered signs; others were post office boxes.

Scammers obtain Medicare numbers by buying or stealing them from doctors, clinics or patients. Ogrosky says that once a “professional” patient sells his Medicare number, it can be reused again and again—or sold to others cheating the system.

Just one Medicare number—in the wrong hands—tricked Medicare into paying more than $1.1 million for phantom treatments. Alexander McCray of Miami paid for his crack cocaine habit by helping dozens of clinic operators file false claims for phony HIV infusion treatments billed in his name.

Hardened criminals

Medicare is now a magnet for miscreants, including not only dishonest doctors and white-collar crooks, but hard cases like Guillermo Denis Gonzalez, a convicted murderer. He bought a Medicare-licensed medical equipment company and submitted more than $500,000 in phony claims—two years after walking out of prison.

He pleaded guilty to defrauding Medicare in August but still faces murder charges. Florida investigators say that after an argument, he killed and dismembered an acquaintance. The victim’s body parts were found in six black garbage bags in three different dumpsters around the Miami area.

Calculating an exact national figure on the costs of Medicare fraud—estimates of losses range from $11 billion by the Centers for Medicare & Medicaid Services to $60 billion by industry experts—is difficult.

Criminals intent on stealing as much as they can as fast as they can “have a relatively easy time breaking through all the industry’s defenses,” Malcolm Sparrow, a one-time fraud investigator and now a professor at Harvard’s Kennedy School of Government, told a Senate committee in May.

He said that if the crooks learn to submit their bills correctly, then for the most part their bogus claims “will be paid in full and on time, without a hiccup, by a computer, and with no human involvement at all.”

Why is Medicare so vulnerable to crooks? The entitlement program is based on an honor system that many experts say is broken.

And Medicare officials admit that with their skimpy anti-fraud budget they are hamstrung because the system’s goal is to pay for medically necessary services quickly—within 14 days—which leaves little time to verify the millions of claims handled each week.

Shady health care operators have repeatedly proved they can circumvent Medicare’s weak technological defenses by simply altering computer billing codes to get their claims approved or by changing their scams to stay one step ahead of the system.

But this year Congress stepped up, allocating an extra $200 million for Medicare’s anti-fraud budget. An additional $300 million is on tap for 2010. The money has enabled the agency to make more unannounced visits to providers, launch more audits of dubious claims and upgrade its computer software that flags suspicious bills. And Medicare crime fighting is becoming more resourceful to keep up with the crooks. Now, for example, the agency is trying to rein in billing for expensive home visits to Medicare patients that are not needed or never made.

Miami’s average cost for each Medicare home health care patient with diabetes and related illnesses runs $11,928 every two months, according to a new HHS report—32 times the national average of $378. “That’s how bad things have gotten in Miami,” says Cecilia Franco, who heads the Medicare office there. So her office is sending nurses and investigators door-to-door to see if beneficiaries that health care agencies claim as clients really need twice-daily visits by skilled nurses. To discourage this scam, in January federal officials will impose a 10 percent cap on payments while they investigate claims—a first in Medicare history.

In a Nov. 3 Politico opinion piece titled “Don't Price Older People out of Care,” Executive Vice President, Social Impact Nancy LeaMond writes, "The debate over how to fix what's wrong with our health care system has been interrupted by political gamesmanship as opponents and special interests attempt to stall or stop reform. As the largest association representing Americans age 50-plus, AARP has again found itself targeted by opponents of reform who are trying, through misdirection and sleight of hand, to influence the debate." But, "this comes as no surprise to AARP," Nancy says, because the group has encountered such opposition before. She explains that AARP is working to ensure that health reform improves Medicare, deals "with the high cost of prescription drugs by closing the Medicare Part D 'doughnut hole,'" and ensures that "health insurance coverage [is] available and affordable for older Americans." Therefore, eliminating age discrimination by insurers is crucial.

In a Nov. 3 Politico opinion piece titled “Don't Price Older People out of Care,” Executive Vice President, Social Impact Nancy LeaMond writes, "The debate over how to fix what's wrong with our health care system has been interrupted by political gamesmanship as opponents and special interests attempt to stall or stop reform. As the largest association representing Americans age 50-plus, AARP has again found itself targeted by opponents of reform who are trying, through misdirection and sleight of hand, to influence the debate." But, "this comes as no surprise to AARP," Nancy says, because the group has encountered such opposition before. She explains that AARP is working to ensure that health reform improves Medicare, deals "with the high cost of prescription drugs by closing the Medicare Part D 'doughnut hole,'" and ensures that "health insurance coverage [is] available and affordable for older Americans." Therefore, eliminating age discrimination by insurers is crucial.

Spring forward; fall back. Most of us can't wait for that extra hour of sleep this time of year. But with the additional zzzz's comes an extra hour of darkness which can be a challenge for some older drivers. To call attention to roadway safety, AARP deemed November as Driver Safety Month - what better way to celebrate the 30th anniversary of the AARP Driver Safety Program and its service to more than 12 million people nationwide.