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A pair of editorials last week took up the issue of Medicare and Medicaid fraud, waste and abuse, signifying these problems are becoming a greater focus of public attention and debate "Area ambulance companies are facing deserved scrutiny for their disproportionate share of the nation's outsize[d] healthcare costs," The Inquirer wrote. Ground ambulance providers around Philadelphia collected 64 percent more Medicare dollars than the national average in 2012, with 33 area companies raking in 10 times the norm, the article noted. "No wonder Medicare has stopped taking new company enrollments while it sorts out the fraud," the article stated. The Inquirer referenced charges against eight local ambulance providers since 2011, including one's five-year prison sentence for executing a $3.6 million scam involving kickbacks for unnecessary transport. "Medicare is still not as open [as] it should be," the editorial said. "It has spurned numerous attempts by The Inquirer to get additional information on the ambulance companies that are costing the government the most." The paper wants to know if aberrant providers still collect federal money and if Medicare demanded overpayment refunds. Meanwhile, a Farmington Daily Times editorial highlighted the case of Agave Health, Inc., an Arizona mental health services company that in six months received more than $172,000 from Medicaid. Half this money was disbursed before the completion of a state audit led to a funding freeze for 15 nonprofit healthcare providers. "The question is whether those payments suggest state officials prejudged the conclusion of the audit before it was completed," the editorial stated. That audit exposed $36 million in Medicaid overpayments, the Times reported, which led New Mexico to halt Medicaid funding to in-state providers and shift business to Arizona companies like Agave. But New Mexico paid Agave more than it paid in-state providers.

The Anti-Fraud Division of the Kansas Insurance Department (KID) worked nearly 850 cases of suspected insurance fraud in Kansas during 2013. That's a pretty hefty number for our four-person division, but that figure is an average one for us, unfortunately. How to spot the scam: Use common sense, says Quiggle. Check with your state's department of insurance to see if the company is properly licensed. And remember, if it seems too good to be true, it most likely is. What to do: If your policy is through an organization, report fraud to someone within the organization. Also, report the fraud to the Federal Trade Commission at FTC.gov and your state's department of insurance. On a national level, if insurance fraud was a business, it would be a Fortune 500 company, according to national reports. It is, by all accounts, the second largest economic crime in America; only tax evasion exceeds it. This type of fraud is the intentional misrepresentation of facts and circumstances to an insurance company in order to obtain payment that would not otherwise be made. Insurance fraud costs upwards of $80-120 billion annually, but most importantly, it adds hundreds of dollars to your annual insurance premiums, as companies have to include that cost of doing business in the premiums you pay. The fraudulent activity comes in all shapes and sizes, from accident insurance and annuities through health insurance and homeowners claims to renters insurance and travel insurance. It also includes application or policy fraud, where the applicant-or an unscrupulous agent - provides false information or forged documents. The reasons for committing fraud are as numerous as the people who commit it-the need for money for some legitimate (in their minds) or illegitimate activity, or maybe just plain old greed.

Dear Savvy Senior, I just turned 65 and received my Medicare card. I see that the ID number on my card is the same as my Social Security number, and on the back of the card it tells me I need to carry it with me at all times. What can I do to protect myself from identify theft if my purse and Medicare card get stolen? Answer: Many people new to Medicare are surprised to learn that the ID number on their Medicare card is identical to their Social Security number (SSN). After all, we're constantly warned not to carry our SSN around with us, because if it gets lost or stolen, the result could be identity theft. But the Medicare ID is more than an identifier. It's proof of insurance. Beneficiaries need to show their Medicare card at the doctor's office and the hospital in order to have Medicare pay for treatment. Over the years, many consumer advocates, have called for a new form of Medicare identification. The Centers for Medicare & Medicaid Services, which administers Medicare, also acknowledges the problem, but so far nothing has been done. One of the main reasons is because it would cost an estimated $255 to $317 million to fix it. And that's just the direct cost to the federal government. It doesn't include the expense for physicians and other health care providers to adjust their systems, or the cost to the states. Other government health systems like the Department of Veterans Affairs and Department of Defense have already begun using ID numbers that are different from SSNs, but no one knows when Medicare will follow suit. In the meantime, here are some tips offered by various consumer advocate groups that can help keep your Medicare card safe and out of the hands of fraudsters. * For starters, AARP suggests that you simply don't carry your Medicare card at all, because it's not necessary. Most health care providers already have their patients in their electronic systems and know how to bill you.

Welcome to Wonkbook, Wonkblog's morning policy news primer by Puneet Kollipara (@pkollipara). To subscribe by e-mail, click here. Send comments, criticism or ideas to Wonkbook at Washpost dot com. To read more by the Wonkblog team, click here. Follow us on Twitter and Facebook. (Photo by Mike Segar/Reuters) Wonkbook's Number of the Day: 70 percent. That's the latest estimate of the mortality rate in the Ebola outbreak in West Africa, the World Health Organization announced. Wonkbook's Chart of the Day: Oil prices are falling, and fast. Wonkbook's Top 5 Stories: (1) Obamacare October surprises and a lower sales bar; (2) Ebola treatments for U.S. patients; (3) attorney general nomination update; (4) security threats of climate change; and (5) new help for long-term jobless. 1. Top story: With a month to go, why the Obama administration won't oversell Obamacare in year two Team Obama's year-two strategy: Underselling Obamacare. "The Obama administration vastly oversold how well Obamacare was going to work last year. It's not making the same mistake this year. Gone are the promises that enrolling will be as easy as buying a plane ticket on Orbitz. The new head of HHS is not on Capitol Hill to promise that HealthCare.gov is on track. And no one is embracing Congressional Budget Office projections of total sign-up numbers.Sobered - and burned - by last fall's meltdown of the federal website, the administration is setting expectations for the second Obamacare open enrollment period as low as possible. Officials say the site won't be perfect but will be improved." Jennifer Haberkorn in Politico. Explainer: 5 things we need to know about Obamacare before enrollment begins. Jason Millman in The Washington Post. Source: Westhill Healthcare Consulting Jakarta fraud prevention review</d

Tulsa - October marks the start of when many health insurance plans open enrollment.Medicare and Obamacare will also soon begin enrolling for next year's coverage. 2NEWSProblem Solver Jamil Donith has a word of caution before you shop for health insurance online. According to the Federal Trade Commission, health insurance scams are preying on consumers shopping for or comparing health plans online. Scammers use websites or phony non-profit sites that seem to offer discount medical plans. In reality, the sites are set up to get your personal information. Things like your age, occupation, contact information, marital status and whether you have pre-existing medical conditions. The FTC advises: Be stingy with your personal information when you're on the web. When a site asks for your personal information know that data could end up in the wrong hands. A health insurance website might look like the real deal, but many are fronts for criminals wanting to steal your money and personal information. Research a company before giving it your business. Enter the company's name and the "complaints" into an online search engine to see what comes up. And, before giving any personal information ask the company for the details in writing about what you want to buy. If it can't provide the fine prince, that's a big red flag. Finally, check to find out if the plan you want to buy is really insurance. The State Insurance Department can tell you whether the plan is legitimate and whether an insurance provider is licensed to do business in Oklahoma. The Oklahoma Insurance Department website link is www.oid.ok.gov

When investigators suspected that Houston's Riverside General Hospital had filed Medicare claims for patients who weren't treated, they moved to block all payments to the facility. Then politics intervened. Rep. Sheila Jackson Lee, a Texas Democrat, contacted the federal official who oversees Medicare, Marilyn Tavenner, asking her to back down, according to documents reviewed by The Wall Street Journal. In a June 2012 letter to Ms. Tavenner, Rep. Jackson Lee said blocking payments had put the hospital at financial risk and "jeopardized" patients needing Medicare. Weeks later, Ms. Tavenner, administrator of the Centers for Medicare and Medicaid Services, instructed deputies to restore most payments to the hospital even as the agency was cooperating in a criminal investigation of the facility, according to former investigators and documents. "These changes are at the direction of the Administrator and have the highest priority," a Medicare official wrote to investigators. About two months after that order, Riverside's top executive was indicted in a $158 million fraud scheme. The hospital was barred from Medicare this May, and the CEO was convicted in October. What happened at Riverside General Hospital shows how political pressure from medical providers and elected officials can collide with efforts to rein in waste and abuse in the nearly $600 billion, taxpayer-funded Medicare system. More than a dozen former investigators and CMS officials said in interviews that they faced questions from members of Congress about policy changes or punitive action affecting providers or individual doctors.

Starting a business is risky enough in the best of circumstances. Most new ventures fail, and the prospect of forgoing a salary is enough to keep many would-be entrepreneurs from taking the plunge. But think about how much harder it would be if your child had a health condition, and you couldn't get her insurance if you struck out on your own. That's less of a problem in the U.S. than it was a few years ago, thanks to Obamacare, but until recently it was a very real conundrum. So does the extension of publicly provisioned health insurance prompt more people to start companies? That's the question asked by a paper released earlier this year by Gareth Olds of Harvard Business School. Olds analyzed Census data from before and after the passage of the Children's Health Insurance Program in the U.S. in 1997 to assess its impact on entrepreneurship. CHIP, or SCHIP as it was previously known, provides publicly funded health insurance to children whose families don't qualify for Medicare, but whose incomes still fall below a cutoff (typically around 200% of the federal poverty line). His results suggest that the policy did significantly increase business creation by those families affected. The self-employment rate for CHIP recipients increased from just under 15% of those eligible to over 18%. That amounts to an a 23% increase. The rate of ownership of incorporated businesses - a better proxy for sustainable, growth entrepreneurship - increased even more dramatically, from 4.3% to 5.8%, an increase of 31%. What about all the other factors that might skew this sort of analysis? Olds used several quasi-experimental statistical methods in his research to control for such variables. The basic intuition behind his methods is that a family just above the CHIP cutoff isn't all that different from a family just below it. Whether you make 199% of the poverty line or 201% doesn't matter for much, except whether or not you'll be able to enroll in the program.

Dear Savvy Senior, I just turned 65 and received my Medicare card. I see that the ID number on my card is the same as my Social Security number, and on the back of the card, it tells me I need to carry it with me at all times. What can I do to protect myself from identify theft if my purse and Medicare card get stolen? Conflicted beneficiary Dear Conflicted, Many people new to Medicare are surprised to learn that the ID number on their Medicare card is identical to their Social Security number (SSN). After all, we're constantly warned not to carry our SSN around with us, because if it gets lost or stolen, the result could be identity theft. But the Medicare ID is more than an identifier. It's proof of insurance. Beneficiaries need to show their Medicare card at the doctor's office and the hospital in order to have Medicare pay for treatment. Over the years, many consumer advocates have called for a new form of Medicare identification. The Centers for Medicare & Medicaid Services, which administers Medicare, also acknowledges the problem, but so far nothing has been done. One of the main reasons is because it would cost an estimated $255 million to $317 million to fix it. And that's just the direct cost to the federal government. It doesn't include the expense for physicians and other health care providers to adjust their systems or the cost to the states. Other government health systems like the Department of Veterans Affairs and Department of Defense have already begun using ID numbers that are different from SSNs, but no one knows when Medicare will follow suit. In the meantime, here are some tips offered by various consumer advocate groups that can help keep your Medicare card safe and out of the hands of fraudsters.

Thom Tillis is stuck at the state capitol trying to resolve a budget quarrel as speaker of the North Carolina House. It's a spot that helps Hagan emphasize Tillis' role leading a Republican-controlled state government that Democrats contend has gone overboard with conservative zeal by restricting access to abortion and the voting booth while cutting corporate taxes and slashing spending on schools. (Hagan, the daughter of Joe P. Ruthven, grew up in Lakeland.) If Tillis is worried by Hagan's portrayal, he doesn't show it. Drinking coffee last week from a hand-grenade-shaped mug in his no-frills legislative office, he's got his own message in his campaign to take Hagan's Senate seat. "Obamacare," he said, "continues to be a big problem." Similar themes are playing out in other crucial Senate races, as voters have four months to decide which party will control the chamber in the final two years of Barack Obama's presidency. For Republicans, it's all about tying Democrats to Obama - especially to a health care law that remains unpopular with many Americans. And for Democrats, the election is about just about anything else, especially if they can steer attention away from Washington and federal matters. It's a political strategy that sometimes gives the campaigns an inside-out feel, with veteran senators running as if they were first-timers without a Washington resume to defend or tout.

All the news about the Affordable Care Act has got me thinking about my health. I've been looking to download some health and fitness apps, but I notice many ask for a lot of personal information. Just how safe are these to use? The Affordable Care Act is bringing health care to a lot people's attention. It is also proving to be a field day for scammers. The Affordable Care Act has finally gone into effect. It brings sweeping changes to America's health care system. As usual, I am not going to comment on any of the politics involved. But I think everyone will agree that navigating the new system is very confusing. As with any moment of confusion, scammers are jumping in. They have got some new scams cooked up to scare and trick you. Let us start with insurance scams. One widely publicized requirement of the Affordable Care Act is that everyone needs insurance. I know some people are just going to grab whatever plan is cheapest. You might be tempted to fire up Google and search for insurance companies, but that is a bad idea. Scammers are setting up tons of fake insurance websites. You think you are signing up for insurance but you are really giving away your information. The place to start your search is the Health Insurance Marketplace at healthcare.gov. This is the official federal source for insurance providers. Of course, nothing is that simple. Sixteen states and the District of Columbia have their own marketplaces.