Health insurers that treat millions of seniors have overcharged Medicare by nearly $30 billion over the past three years alone, but federal officials say they are moving ahead with long-delayed plans to recoup at least part of the money.

Officials have known for years that some Medicare Advantage plans overbill the government by exaggerating how sick their patients are or by charging Medicare for treating serious medical conditions they cannot prove their patients have.

Getting refunds from the health plans has proved daunting, however. Officials with the Centers for Medicare & Medicaid Services repeatedly have postponed or backed off efforts to crack down on billing abuses and mistakes by the increasingly popular Medicare Advantage health plans offered by private health insurers under contract with Medicare. Today, such plans treat more than 22 million seniors — more than 1 in 3 people on Medicare.

Now CMS is trying again, proposing a series of enhanced audits tailored to claw back $1 billion in Medicare Advantage overpayments by 2020 — just a tenth of what it estimates the plans overcharge the government in a given year.

At the same time, the Department of Health and Human Services Inspector General’s Office has launched a separate nationwide round of Medicare Advantage audits.

As in past years, such scrutiny faces an onslaught of criticism from the insurance industry, which argues the CMS audits especially are technically unsound and unfair and could jeopardize medical services for seniors.

America’s Health Insurance Plans, an industry trade group, blasted the CMS audit design when details emerged last fall, calling it “fatally flawed.”

For the article from NPR, click here.

The reason women appear to be at greater risk of developing Alzheimer’s disease than men might be due to a number of genetic, anatomical and even social influences, researchers have suggested.

Recent figures show about 65% of those with living with dementia in the UK are women, with a similar statistic seen in the US for Alzheimer’s disease, while dementia is the leading cause of death for women in England. Alzheimer’s disease is only one of the types of dementia, but the most common form.

While one explanation is that dementia risk increases with age, and women have longer life expectancies than men, new research suggests there might be more to the matter, including that protein tangles found within neurons and linked to Alzheimer’s disease might spread differently in women’s brains than men’s.

The study, presented at the Alzheimer’s Association International Conference in Los Angeles by researchers from Vanderbilt University and which has not yet been peer-reviewed, used scans from a method called positron emission tomography. That allowed them to look at the way clumps of a protein called tau were spread in the brains of 123 men and 178 women without cognitive problems, as well as 101 men and 60 women with mild cognitive problems – although not yet diagnosed with Alzheimer’s disease. Cognitively normal older people often have small amounts of tau in certain areas of their brain.

From the data the team could build maps showing which areas of the brain show similar signals relating to tau in the scans, suggesting they are somehow connected. “Based on that we kind of try to reconstruct the pattern of spread,” Dr Sepideh Shokouhi, who is presenting the research, told the Guardian. “It is kind of like reconstructing a crime scene.”

For the article from The Guardian, click here.