The National Health Care Anti-Fraud Association  estimates that over 10% of the nation’s annual health care outlay is lost to fraud and abuse.  Healthcare costs have been one of the fastest growing costs to organizations recently.

Who is the largest victim of healthcare fraud?

Indeed the answer to this question is Medicare.  The latest estimates from the Center for Medicaid and Medicare Services (CMS) indicate that the government’s expense is well over $100 billion annually, a cost that is passed on to all taxpayers.

The two most common types of health care fraud are:

Consumer Related:

• False Claims – deceiving insurance companies and state worker’s compensation programs by falsifying injuries
• Medical Identity Theft – using another’s medical benefits to obtain services personally
• Physician Shopping – moving between doctors to obtain multiple prescriptions

Provider Related:

• Kickbacks – accepting kickbacks for patient referrals
• Phantom Billing – billing for services that were never performed
• Pharmacy Fraud – dispensing less than the prescribed and charged amount of a prescription
• Providing Unnecessary Care
• Unbundling – charging separately for procedures that are actually part of a single procedure to increase the reimbursement
• Upcoding – charging for a more expensive service than what was actually performed

Here is what you can do to protect yourself or a loved one from Medicare fraud — and what to do if you think you might be a victim.

1. Guard Your Card. Protect your Medicare card as carefully as you would a credit card or Social Security card. Never give your number over the phone to a stranger — for instance, to someone who claims to be conducting a health care survey for the government. And never allow a friend or relative to use your card. Report a lost or stolen card immediately.
2. Beware of Free Services. Someone offering you a medical service for free does not need your insurance information. If you are asked for it in connection with such a service, walk away. This can be a scam to collect Medicare numbers to use for fraud.
3. Examine Your Statements. If you have traditional Medicare, you receive statements quarterly. Review them carefully, looking for doctor visits that never happened, unfamiliar medical provider names, and supplies and equipment you never received.
4. Avoid Enrollment Hazards. During the period in which Medicare recipients can sign up for or change plans is the most vulnerable for criminals to peddle bogus Medicare and Medicare D prescription drug plans. Many try to tempt seniors with offers of services and products that are not actually covered by Medicare.
5. Check Your Credit Report.  Review your credit reports periodically for unpaid medical bills that may be a result of fraud. In addition, it is a good idea to keep a journal of doctor visits and other medical services you receive to compare with any unexplained charges.
6. Make a Report. If you think you have encountered fraud and you have double-checked for errors with your medical provider, you can report the incident directly to the inspector general at 1-800-HHS-TIPS (1-800-447-8477), or via e-mail at HHSTips@hhs.gov.

In addition, California offers a Senior Medicare Patrol office as part of its State Health Insurance Counseling and Assistance Program. Workers at these offices will help you determine if you have been a victim of fraud and will forward your complaint to government investigators. To contact the office nearest you, call 1-855-613-7080.

Lastly, get informed!  For more information on preventing and reporting Medicare fraud, go to www.stopmedicarefraud.gov.

Before you spend unnecessary time or money, review these five exceptions to the law.

1. You needn’t provide healthcare benefits now. Most employers are not currently required to do so until 2014.
2. You may not ever have to provide such benefits. In 2014, most employers with 50 or more workers will be required to provide health insurance coverage for their employees or pay a penalty if they choose not to do so.  But if you employ fewer than 50 people, you do not have to provide coverage, and you will not be penalized.
3. You must apply for your tax credit. If you have fewer than 25 full-time employees or full-time equivalents (combining part-timers to find the number of people working full time), you may be eligible for the Small Business Healthcare Tax Credit. You will be if you pay at least 50 percent of the cost of your employees’ coverage, and they have average wages of less than $50,000 a year.  But you must claim your tax credit. To determine the amount you’re entitled to, consult your accountant and complete IRS form 8941.
4. You don’t have to report benefits on your W-2s.  Healthcare reform generally requires employers to report the cost of coverage under an employer-sponsored group health plan on employees’ W-2s.  But the requirement was optional for all employers in 2011. And it is still optional for companies that will file fewer than 250 W-2 forms for 2012. Reporting will remain optional for smaller employers until further guidance is issued.
5. You must provide proper COBRA notice. If you have 20 or more employees and you provide them with group healthcare coverage, they are entitled to continued coverage under COBRA if they retire or are terminated. You can require employees to pay the full cost of such coverage plus a 2 percent administrative charge. But you must notify your plan administrator within 30 days of any employee’s leaving the company so that the administrator can send the employee proper notification.

Of course, all of this information applies only if the U.S. Supreme Court does not invalidate one or more provisions of the healthcare reform law.  Until the justices issue their ruling, which they are expected to do in June, we won’t know how much of this will be in effect.

To read more about the Patient Protection and Affordable Care Act, click HERE.

Here are 10 common examples (and reasons!) to get travel insurance:

1. It’s 10 p.m. and you and your family arrive at the airport for a connecting flight, only to find that your flight has been cancelled. Who can assist you with finding new flights to get everyone home?
2. Your bag was lost with your insulin inside. You need help to locate your bag as soon as possible and have your emergency prescription filled. Who do you call?
3. Your first visit to Europe, and your passport and wallet are stolen. Where do you turn for emergency cash, and how will you get your passport replaced?
4. You’re involved in an accident and adequate medical treatment is not available. Who will help arrange and pay for a medical evacuation?
5. A family member becomes seriously ill and you must cancel your trip, what happens to your non-refundable deposits or pre-payments?
6. You arrive in Cancun and your luggage doesn’t. If it’s lost, who will help you find it? If it’s delayed, who will pay for your necessities? If it’s stolen, who will pay to replace it?
7. Your cruise line, airline or tour operator goes bankrupt. Who will pay for your non-refundable expenses?
8.  You’re walking down a street in Paris and twist your ankle. Who can help you find an English-speaking physician?
9. Three weeks before your scheduled arrival, a terrorist incident occurs in the city to which you are planning to visit. Who will pay if you want to cancel your trip?
10. You are at a beach resort in the Gulf Coast and you are forced to evacuate due to an approaching hurricane.  Who will help you evacuate and who will reimburse your lost vacation investment?

Convinced? These examples are real-life scenarios that can happen at any time! Don’t risk it – be prepared!  To review travel insurance company reviews and ratings, visit http://www.travelinsurancereview.net/reviews.

Question #1: Do only blue-eyed people have Alzheimer’s?

Absolutely not. In fact, the genes that influence eye color have not been linked to Alzheimer’s in any way.

Question #2: Does Alzheimer’s only affect the elderly?

This is untrue. While Alzheimer’s disease is certainly most common among the elderly, it can afflict people as early as in their 30s. When Alzheimer’s develops before age 65, as it does in up to 5 percent of cases, it’s considered “early onset”.

Question #3: Will a healthy diet and exercise help prevent Alzheimer’s disease?

Yes. Studies have shown that certain nutrients are linked to a lowered risk of Alzheimer’s disease. Omega 3 fatty acids, folate and vitamins E, C and B12 are all linked to a lower risk of Alzheimer’s disease.  Polyphenols, which are found in high quantities in red wine, may lower risk too.  Good cardiovascular health has also been connected to a decreased likelihood of developing Alzheimer’s.

Question #4: If I remember many things, can I still have Alzheimer’s?

Yes. Alzheimer’s disease first affects short-term memory, so someone with early to mid-stage Alzheimer’s disease may remember every detail about senior prom but not remember what she ate for breakfast. These remarkably vivid memories of events that occurred decades ago are actually characteristic of the illness. Only in the late stages does long-term memory fade.

Question #5: Are people with Alzheimer’s oblivious to their symptoms?

The answer is no. People with Alzheimer’s disease are often the first to know something is amiss. Just as someone with a normal memory may be perturbed by misplacing his keys, someone with early Alzheimer’s may be troubled by his own forgetting.  It’s not at all uncommon for people with Alzheimer’s to notice these episodes are becoming too frequent, and to proactively address the topic first with a physician. In later stages of the disease, insight and self-awareness are diminished, but moments of clarity may still occur.

Question #6: Do aluminum cans, silver dental fillings, aspartame and flu shots cause Alzheimer’s disease?

This is definitely untrue. A large body of evidence suggests there’s no correlation between exposure to any of these substances and Alzheimer’s disease. According to the Alzheimer’s Association, several mainstream studies link flu shots and other vaccinations to a reduced risk of Alzheimer’s disease.

For more information about Alzheimer’s disease, visit the Alzheimer’s Association, a very reputable online resource.

Homeopathy is a form of medicine that treats the whole person, not just a specific symptom. It is based on the theory that “like cures like” which means treatments are similar to the illness it is designed to cure.  Hippocrates, known as the father of modern medicine, was the first person to propose treating disease by using a remedy that will produce similar symptoms to what you are trying to cure.  In the late 1700′s and early 1800′s, Samuel Hahnemann developed a system of medicine that teaches that a substance and a disease, which cause similar symptoms, can cancel each other out. He called his system of medicine Homeopathy based on the Greek words homios and pathos that mean like and suffering.

Many of the sources of homeopathic remedies are themselves poisonous like bee stings or rattlesnake venom. The key to making them safe and useful as a homeopathic remedy is dilution. Homeopathy believes that each person has an energy or vital force. This vital force can be weakened by lack of exercise, poor dietary habits, pollutants in the environment, and even hereditary problems. Remedies are designed to let the body heal itself by stimulating a person’s vital force.

There are three principles that are used when prescribing homeopathic remedies. The principle of similars states a substance in large doses that causes symptoms similar to the disease being treated will negate or cure the disease when taken in minute doses. The minimal dose principal states that multiple dilutions allow a substance that causes similar symptoms to the disease being treated to be effective without having any side effects itself. The concept of prescribing for the individual means the whole person is treated not just a specific symptom so different remedies will be prescribed for different people that may have similar symptoms.

When you consult with a homeopath, he/she will ask many questions to determine your overall health and how best to treat your symptoms. After a remedy is prescribed, follow up visits will be required to determine the effectiveness of the treatment.

Homeopathic treatment facilities are becoming more common around the world so you should be able to find one close to where you live. The homeopathic remedies they prescribe can be highly effective at treating conditions that traditional medicine has been unable to cure.

For more information on homeopathic remedies, click HERE.

For example, brushing too hard can lead to enamel and gum erosion, damaging the teeth. The same is true of brushing immediately after a meal, especially a person eats or drinks something acidic, such as a soda. People should brush 30 minutes after a meal, to remove leftover food particles without eroding enamel.

Here are some brushing and flossing techniques that will help you ensure you are performing these daily tasks correctly:

Brushing technique

•  The head of your toothbrush should be placed beside the teeth, and the tips of the bristles placed at a 45-degree-angle to the gum line.
• Move the toothbrush back and forth, using short strokes and a scrubbing motion, several times in each spot.
• Keep the bristles angled against the gum line, while you brush both the inner and outer surfaces of each tooth.
• Brush the chewing surfaces straight on.
• Clean the inside surfaces of the front teeth by tilting the brush vertically and making several up-and-down strokes with the front of the brush.
• Finish by brushing your tongue, which helps remove bacteria from your mouth.

Flossing technique

• Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. This finger will take up the floss as it becomes used.
• Hold the floss tightly (without any slack) between your two hands, with about an inch of floss between them. Guide the floss between your teeth using a gentle sawing motion.
• When the floss reaches the gum line, curve it into a C-shape against the tooth. Gently slide it into the space between the gum and the tooth until you feel resistance.
• Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum.
• Repeat this technique on all of your teeth, including the teeth in back.

1. Heart disease. In women over 55, the symptoms of a heart attack can be quite different than with men. In a study, the most commonly reported symptoms were not chest pain or discomfort but fatigue, interrupted sleep, and shortness of breath.
2. Cancer. Older women must face the elevated chances of cervical, colon and breast cancer during this time.
3. Stroke. Every year in the U.S., 55,000 more women than men have strokes. 60% of total deaths by stroke occur in women.
4. Injuries caused by falling. Women were 58% more likely than men to suffer a nonfatal fall injury 
5. Failing vision. Vision tests and tests for glaucoma should be done every year.
6. Consequences of menopause like osteoporosis. The loss of hormones because of menopause can start to affect the bones around age 50. Senior women should continue to take Calcium with vitamin D to help prevent the onset of this degenerative bone disease
7. Disabilities. The rate of disabilities in women is higher than in men because women with disabilities tend to live longer than a man with similar afflictions.
8. Good nutrition is vital for good health.  Especially in the later years, a diet that has lots of vegetables and fruit and fewer fats and processed food are recommended.
9. Keep a healthy weight. This can be done by following a healthy diet and getting regular exercise. Weight bearing exercises like walking will also help keep osteoporosis at bay.
10. Lastly, regular testing for certain health issues is recommended.  Senior women should see a doctor on a regular basis and have standard screening tests such as:
    1. Pap tests to check for cervical cancer
    2.  Mammograms that look for unusual lumps are masses in the breasts. It is very important for women over 50 to have one once a year.
    3. Either a colonoscopy or sigmoidoscopy to look for polyps that may be responsible for colon cancer.
    4. Bone density screenings to test the strength of the bones.

Here are 10 easy ways to keep your mind fit forever and boost your brain health now:

1) Get moving.  Higher exercise levels can reduce dementia risk by 30 to 40 percent compared with low activity levels, and physically active people tend to maintain better cognition and memory than inactive people. Most recommend 150 minutes a week of moderate activity.

2) Pump some iron.  Older women who participated in a yearlong weight-training program at the University of British Columbia at Vancouver did 13 percent better on tests of cognitive function than a group of women who did balance and toning exercises.

3) Seek out new skills. Learning spurs the growth of new brain cells. When you challenge the brain, you increase the number of brain cells and the number of connections between those cells, but it’s not enough to do the things you routinely do — like the daily crossword. You have to learn new things, like sudoku or a new form of bridge.

4) Say “Ohm”.  Meditation — which involves focusing one’s attention on sensations, feelings and state of mind — has been shown to reduce harmful stress hormones. After eight weeks of meditation, researchers took MRI scans of participants’ brains that showed the density of gray matter in the hippocampus increased significantly as compared.

5) Eat like you’re Greek.   A heart-friendly Mediterranean diet — fish, vegetables, fruit, nuts and beans — reduced Alzheimer’s risk by 34 to 48 percent in studies conducted by Columbia University.  Omega-3 fatty acids in fish are very important for maintaining heart health and it is suspected these fats may be equally important for maintaining a healthy brain.

6) Spice it up. Your brain enjoys spices as much as your taste buds do. Herbs and spices such as black pepper, cinnamon, oregano, basil, parsley, ginger and vanilla are high in antioxidants, which may help build brainpower.

7) Find your purpose. Participants who approached life with clear intentions and goals at the start of the study were less likely to develop Alzheimer’s disease over the following seven years, researchers found.

8) Get a Social life. Having multiple social networks helps lower dementia risk, a 15-year study of older people from Sweden’s Karolinska Institute shows, providing emotional and mental stimulation, says Laura Fratiglioni, M.D., director of the institute’s Aging Research Center.

9) Reduce your risks. Chronic health conditions like diabetes, obesity and hypertension are often associated with dementia.  Diabetes, for example, roughly doubles the risk for Alzheimer’s and other forms of dementia. Controlling these risk factors can slow the tide.

10) Check vitamin deficiencies.  Older adults don’t always get all the nutrients they need from foods, because of declines in digestive acids or because their medications interfere with absorption. That vitamin deficit — particularly vitamin B12 — can also affect brain vitality, research from Rush University Medical Center shows. Older adults at risk of vitamin B12 deficiencies had smaller brains and scored lowest on tests measuring thinking, reasoning and memory, researchers found.

Solicitor General Donald Verrilli, representing the Obama administration, had argued virtually everyone needs healthcare — or eventually will. Verrilli pointed out by stating that “food isn’t a market in which a person’s participation is unpredictable or involuntary.”   He also added that law doesn’t force people to buy something they don’t want, but rather governs how they pay for something they inevitably will need.

Justice Anthony Kennedy — appointed by Reagan in 1988 and widely considered the court’s deciding vote — told Verrilli the government faced “a very heavy burden” on the mandate requirement.  “You are changing the relationship of the individual to the government,” Kennedy said.   The justices on Wednesday were to discuss the possibility the mandate could be overturned and, if so, which parts of the Affordable Care Act, if any, would remain.

On Tuesday, 3/27, the Justices considered whether Congress exceeded its constitutional authority to regulate interstate commerce in enacting the insurance mandate.   Justice Ruth Bader Ginsburg, appointed by President Bill Clinton in 1993, said she saw “something very odd” about that point.  She stated, “The government can take over the whole thing and we all say, ‘Oh, yes, that’s fine, but if the government wants to preserve private insurers, it can’t do that.”  Justice Elena Kagan, appointed by President Barack Obama in 2010, has also stated, “It seems as though you are just talking about a matter of timing that Congress can regulate the transaction, and the question is, when it makes best sense to regulate that transaction?”

During initial arguments Monday, 3/27, the justices indicated they believed they could rule on the healthcare overhaul now, rather than in two or three years, after it takes effect, removing a possible procedural hurdle. A decision by the court is expected by the end of June 2012.

Many people go to the emergency room when it isn’t necessary. Why? While some just simply may not know if their issue is serious or not, many others are choosing the emergency room because they have inadequate or no insurance coverage.  Unfortunately this is becoming a growing problem in the U.S – and a costly one at that.

Billions of dollars are spent each year for the care of uninsured people who visit the emergency room. Recently, a report from the California Institute for County Government at California State University, Sacramento indicated most emergency room abusers either lack insurance, are on Medicare or a state equivalent.  The tab is then usually picked up by the state – one factor that contributed to California’s financial crisis. Additionally, Medicare or Medicaid (Medi-Cal in the State of California) will also pay for emergency room visits even if it is not an emergency. Some patients may even misrepresent their condition or the condition of their child in order to receive Medicaid/Medi-Cal benefits in the emergency room.

Not only does this habit disrupt the normal operation of the emergency room and prevent people with legitimate emergencies from getting prompt care, it also disrupts finances. Treatment in the emergency room costs six times more than treatment in a doctor’s office.

Some states are now looking at programs to combat this growing problem. For example, Medicaid in the state of Washington is rapidly going broke. The state is faced with a $1.4 billion budget gap in the FY 2012-2013. As of April 1, 2012 the state has implemented new rules as it pertains to Medicaid coverage. Medicaid officials say the program will no longer pay for any medically unnecessary emergency-room visits, even when patients or parents have reason to believe they’re having an emergency. The new rules would block payment for emergency room visits for about 500 different conditions. It is unknown at this time if other states, including California, will be adopting a similar program.