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Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review May 12, 2006 / 14 Iyar, 5766

Medical charity illegal, government says

By Drs. Michael A. Glueck & Robert J. Cihak

The Medicine Men
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http://www.JewishWorldReview.com | "Thou shall not commit charity." So decrees the federal government, under the 1996 HIPAA and other laws and regulations.


In Western Civilization, ethical requirement for personal fulfillment once included charity and charitable action.


How did this ethic get turned on its head?


Once again, incompletely-considered intentions have gone awry. And this particular awryness goes back at least 40 years, when the federal government got into the business of paying for medical care big time, with the Medicare and Medicaid programs.


In addition to politicians garnering political points, votes and political campaign contributions, another intention was to help older Americans get medical and hospital coverage.


These government officials have been worried that doctors might inflate charges for patients covered by Medicare. So, the bureaucrats and Congress made rules limiting what doctors could charge for services rendered to Medicare recipients.


Government bureaucrats only allowed the small fries (such as doctors and hospitals) to collect their lowest price for goods and services.


From the beginning, doctors had trouble keeping up with government regulations and filling out the claim forms. This paperwork is like having to fill out an individual income tax return to the IRS for every patient.


The doctor is responsible for coming up with politically-correct patient information, code numbers, modifiers and other minutiae lest he be convicted of insurance fraud and sent to jail for five years.


Oh, I almost forgot to mention, the degree of fraud has to be significant, defined as at least $100, under the 1996 HIPAA Law.


In the late 1960s, Dr. James Baker of Aberdeen WA charged $8.00 for a standard office consultation. But when a patient on blood pressure medicine came in to have blood pressure checked, Dr. Baker couldn't justify charging the full $8.00 so he charged a more charitable $4.00 instead.


Because the government had to get the best price, the Medicare bureaucrats informed the doctor that as far as the Medicare program was concerned his fee for his standard office consultation was actually $4.00, not $8. So, the government would pay him or reimburse patients the usual 80 percent, or $3.20.


Oh, yes, and he better try really hard to collect that other 80 cents or the government would conclude that his usual fee was actually only $3.20, and the government would pay 80 percent of that, or $2.56; the formula spirals downward from there.


So, if a doctor charitably charged less to poor patients, the government paid the doctor no more than the fee paid by these charity patients.


Some doctors became charity cases themselves.


Of course, there could be exceptions, if you knew your way through the Magic Code Book and kept bureaucratic-style records meeting the bureaucratic requirements du jour.


If some doctor or hospital was rash enough to treat charity patients for free, the government would conclude that was the usual fee and pay nothing for services rendered to government patients.


Indeed, this seems to be the approach to several charity hospitals that had the gall to continue their charitable mission. They get into trouble when they only give charity to human beings and not to Medicare apparatchiks.


This is exactly happened to the 161 bed Deborah Hospital in New Jersey. The hospital never charges patients for medical services. But the hospital did collect from Medicare when patients had Medicare coverage.


As medical lawyer Madeline P. Cosman, Ph.D., writes "the U.S. Department of Health and Human Services prosecuted Deborah over the course of four years because Deborah accepts Medicare payments without requiring patient copayments and therefore violates a slew of civil and criminal laws.


"By following its own three-quarter-century-old mandate to never charge patients, Deborah Hospital was accused of granting incentives for referrals, submitting false claims to the government, unfairly competing with community and other specialty hospitals, and generally flouting White Coat Crime laws ... Medicare has no obligation to pay for hospital care that the patient gets as a free gift."


The "false claims" charge alone carries a $10,000 fine, per incident, plus triple damages. Each patient charge can be prosecuted as a separate false claim. "Deborah's refusal to violate its free care mandate that defies medical law nearly forced the generous doors and charity operating rooms to close shut. In 2003, Deborah Hospital finally got a reprieve, a waiver enabling them to continue their tradition of not charging copayments" writes Cosman.


Deborah Hospital was presumed guilty, until proven innocent or granted a waiver from the boss.


So, in order to keep government prosecutors at bay, doctors and hospitals who have contracts with Medicare or private insurance companies are essentially forced to charge their highest fees so that the government can't accuse them of cheating.


These fees are like the "rack rate" room charges posted in hotel rooms. In our experience, these posted hotel charges are always a lot higher than what you actually pay and are apparently posted because of some "consumer protection" regulation.


Just as individuals, travel agents and businesses negotiate lower rates for hotel rooms, insurance companies and individuals negotiate lower rates for hospital rooms, at least with some hospitals.


At least this bureaucratic inversion of charity is now coming to public attention.


The Robert Wood Johnson Foundation paid for a study of 6,600 physicians that found that 68 percent of doctors now say they deliver any free or discounted assistance to low-income patients. This is down from 76 percent a mere 10 years earlier according to Donald Devine, former director of the Federal Employees Health Benefits and Civil Service Retirement programs in an article published in the Washington Times two days after April Fools Day.


It took a study to find out what doctors have been experiencing for several decades.


Although Devine "had managed the largest employer health insurance plan in the nation and written often on health matters" this problem had escaped his notice, he writes. "When one reads about doctors being hauled off to jail for fraud, odds are this is the cause: Guilty not of fraud but of charity."

Editor's Note: Robert J. Cihak wrote this week's column

Every weekday JewishWorldReview.com publishes what many in in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here.

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