Susie Fagan / Heartland Health Monitor

Lawrence Memorial Hospital is forcefully denying fraud allegations made in a whistleblower lawsuit filed by a former employee.

The lawsuit was originally filed under seal in May 2014 by former emergency room nurse Megen Duffy and unsealed this summer. It charged that the hospital defrauded the federal government by submitting falsified Medicare and Medicaid claims.

In its response last week, the hospital charged that Duffy’s lawsuit and her failure to disclose it violated the terms of a settlement it reached with her after she was fired.

Susie Fagan / Heartland Health Monitor

Editor's note: This story was updated on Sept. 1 to include the response of the CEO of Lawrence Memorial Hospital.

A former emergency room nurse at Lawrence Memorial Hospital has filed a federal “whistleblower” lawsuit alleging that the hospital falsified patient records to obtain higher Medicare and Medicaid payments.

The lawsuit filed in U.S. District Court in Kansas City, Kan. on behalf of Megen Duffy alleges that top hospital officials knew about the fraud, which began in 2007, and threatened to fire employees who objected.

iStock/Getty Images

A bill headed to President Barack Obama’s desk will require hospitals to notify Medicare patients if they were admitted or only kept under observation.

But advocates for hospitals and nursing homes say there’s more work to be done on Medicare regulations that tie patients’ hospitalization status to reimbursements for skilled nursing care afterward.

The bill that unanimously passed both houses of Congress mandates that hospitals must inform Medicare patients within 36 hours whether they were admitted or kept under observation.

Executive Office of the President of the United States

Advocates of government-sponsored health care gathered Thursday at the Harry S. Truman Library and Museum in Independence, Missouri, to mark the anniversary of legislation that’s both a local story and a milestone for medical care in the United States.

Fifty years ago, on the same stage where speakers sat, President Lyndon Johnson signed the law establishing Medicare and Medicaid, vastly expanding insurance protections for the elderly and for low-income Americans.

Courtesy photo / U.S. Department of Justice

Kansas Secretary of State Kris Kobach is urging members of Congress to ratify a controversial health compact that would give Kansas and eight other states control over Medicare and other federal health care programs within their borders.

University of Kansas Medical Center

Note: KCUR will run a series of stories Friday on end-of-life issues and the policy changes needed to give people more control over what happens to them in their final days. 

This week’s announcement that the federal government is proposing Medicare reimbursements for doctors who discuss end-of-life plans with their patients was one Christian Sinclair has been waiting for.

Bryan Thompson / Heartland Health Monitor

A lot of the hospitals in rural Kansas are called “Critical Access Hospitals.” It’s an important designation, because Critical Access Hospitals were created by the federal government to maintain access to health care in rural areas.

But Many Kansas Critical Access Hospitals are in financial trouble. Medicare requires them to offer 24-hour emergency services. But most don’t have enough ER patients to justify the cost of 24-7 service, says Melissa Hungerford, senior vice president for health care leadership at the Kansas Hospital Association.

A whistleblower lawsuit alleging a Kansas oncologist provided medically unnecessary services is the second suit to question his practices, according to The Wichita Eagle.

The newspaper reported on Sunday that Viran Roger Holden, the former chair of the Mercy Clinic oncology department in Springfield, Missouri, claims he was fired after raising questions about Greg Nanney, a cancer doctor who now works for Central Care Cancer Center in Newton and Great Bend, Kansas, and in Bolivar, Missouri.

This story was updated at 5:14 p.m. to include comments from a spokeswoman for Cox Medical Center.

Cox Medical Center in Branson, Missouri, is the latest hospital to come under scrutiny for billing Medicare for a rare form of malnutrition usually seen in third-world countries.

In a report released Wednesday, the Department of Health and Human Services’ Office of Inspector General (OIG) said not one of the hospital’s 59 claims for the treatment of Kwashiorkor that the OIG reviewed was legitimate.

Story updated at 12:26 p.m.

Saint Luke’s Hospital of Kansas City overbilled Medicare $581,000 over a two-year period, a federal report concludes.

The report by the Department of Health and Human Services’ Office of Inspector General (OIG) says the hospital failed to comply with Medicare requirements for 80 of 294 inpatient and outpatient claims reviewed by OIG.

AP Photo

The public should expect to see significant evolutions in Medicare and Medicaid in coming years, a national health care expert told a Kansas City audience Friday.

Genevieve M. Kenney of the Urban Institute said an inevitable component of Medicare’s need to save money will be talk about raising the eligibility age. The current age of eligibility is 65, but life expectancy has increased since enactment of the program 50 years ago.

Mark Hillary / Flickr -- Creative Commons

Hospitals and skilled nursing facilities in Kansas are part of an ongoing national conflict over “observational stays” that can leave the facilities and Medicare patients on the hook for uncovered rehabilitation costs after they leave the hospital.

The conflict revolves around Medicare’s “three-day rule,” which requires a person to be admitted to the hospital on an inpatient basis for at least three days in order to qualify for inpatient rehabilitation at a skilled nursing facility, covered by Medicare, after they’re discharged.

A once-obscure effort by a group of states to get out from under federal health care regulations has become an issue in the final days of the Kansas governor’s race.

Kaiser Health News


Twenty hospitals in the Kansas City area will be penalized by Medicare starting Oct. 1 for excessive readmissions, although eight of them will be hit with lower fines than in Medicare’s previous round of penalties.

Saint Luke’s East Hospital in Lee’s Summit will get hit with the biggest fine, 2.08 percent of its Medicare reimbursements, according to an analysis by Kaiser Health News of data released this week by the Centers for Medicare & Medicaid Services (CMS).

Andy Marso / KHI News

Legislators who passed a health care compact in Kansas said changes to Medicare were not the impetus, but a “Medicare coach” told a Johnson County crowd Tuesday night that the originator of the multi-state compact favors Medicare privatization.

A total of 23 Johnson County legislators — all Republicans — signed onto an op-ed in the October edition of The Best Times, a magazine for seniors in the county, that praises the health care compact bill.

The rebuttal comes after a weeks-long disagreement between legislators who supported the compact and members of the Johnson County Commission on Aging, who wrote an article that appears on the previous page criticizing the compact for its potential effects on Medicare.

A health care compact bill designed to get Kansas and other states out of federal health regulations is gaining attention locally for its possible Medicare implications, but a national expert on Medicare says the compact, which would need congressional approval, is not even being discussed in Washington, D.C.

Tension built Monday as legislators who supported a health care compact bill that would free Kansas from federal health care regulations made a last ditch-effort to pressure a Johnson County advisory board not to publish an article critical of the compact in a county newsletter.

File photo


A newsletter for Johnson County seniors has become a source of consternation to some legislators, who say an upcoming article critical of the health care compact passed this year unfairly portrays the legislation as a threat to Medicare.

Todd Feeback / Hale Center for Journalism at KCPT

Spritzing perfume is how Judy Johnson realized her eyesight had gone bad.

At one point, diabetes had worsened her vision so much that the 69-year-old Lansing, Kan., resident had to squirt out a puff of her favorite scent just to find the opening in the mister.

“I looked at it this morning,” Johnson said Wednesday, “and I could see the hole.”

Alex Smith / KCUR

The older you get, the more complicated and expensive health care becomes. A study from the National Institutes of Health shows that half the money that’s spent on Americans’ health is spent on care after age 65.

That’s why changes to the health system – like the Affordable Care Act and Medicare reform — can be especially concerning to older people.

Alex Smith / KCUR

Changes to insurance have been getting all the headlines, but the Affordable Care Act aims to change the way doctors operate as well.

The federal law offers incentives for health providers to work together to keep Medicare patients healthy in hopes of saving money. Whether this approach can actually create savings is still unclear, and many doctors remain skeptical. But in Kansas City, a few doctors are teaming up.

The open enrollment period for Medicare prescription drug plans and Medicare Advantage plans got underway Monday.  The Kansas Insurance Department says people need to be alert for potential scams.

The concern is heightened this year because the Medicare signup period coincides with the opening of the insurance exchanges under the Affordable Care Act or Obamacare.

The annual enrollment period for Medicare's prescription drug coverage and privatized Medicare Advantage plans is now open. It's the one time of year when people can make changes to their coverage without being penalized.

This year, many senior citizens have been confused. The enrollment period for the Affordable Care Act started just two weeks ago. Many people are under the mistaken impression that they need to sign up for coverage on the exchange, even though they have Medicare. 

A new study from a non-profit research group says predictions of huge premium increases when the Affordable Care Act goes into effect in January are unfounded. 

Kansas is one of 10 states the Rand Corporation studied in detail. The study predicts that by 2016, only 6.6 percent of Kansans too young for Medicare will be uninsured. Without the new law, that figure would be more than 14 percent. 

cogdogblog / Flickr--Creative Commons

Medicare patients who have diabetic testing supplies delivered to them experienced some changes this week.

It’s all part of an effort by the Medicare program to save money and cut down on fraud. But some people are worried about unintended consequences.

A public services announcement issued by Medicare attempts to lay out the changes for diabetic Medicare recipients:

The Medicare Summary Notice senior citizens receive every month has been redesigned. The changes are meant to make it easier to spot fraudulent claims.

As part of the Affordable Care Act, or Obamacare, the federal government has devoted new resources to rooting out fraud, waste, and abuse in the Medicare program. The notice beneficiaries receive each month to explain their claims is being upgraded to make it easier to spot claims for services they never received.

A competitive bidding program aimed at helping Medicare avoid overpaying for products like scooters, diabetic testing supplies, and oxygen tanks is being expanded to 91 communities nationwide, including Wichita. 

The program began a little more than two years ago as a demonstration project in nine communities, including Kansas City. 

Top Of The Morning News: December 24, 2012

Dec 24, 2012

Gun shows, Missouri Medicaid expansion & more: Your morning news from KCUR.

Kansas City will soon know more about the quality of primary care in the region.