Wednesday, April 28, 2021

Disclosing Medicare number can lead to fraud

Phone calls offering a free cancer screening are most likely to be a scam, AARP Bulletin details


That was the intriguing first word of a headline in a yellowed AARP Bulletin, a copy of which I just dug out of a manila folder that had literally fallen between the cracks of my Shelter-in-Place home-office desk.

The entire headline: "Beware of Offers for a Free Cancer Screening."

A subhead tells even more: "Crooks may be fishing for your data so they can commit Medicare fraud."

Rebecca Kinney
The story, by Katherine Skiba, tells of people tricking folks into giving up their 11-digit Medicare numbers so they can create fraudulent claims, "part of the estimated $60 billion that is lost to waste and fraud each year." 

Skiba's piece quotes Rebecca Kinney, acting director of the U.S. Department of Health and Human Services office that trains volunteers to recognize and report such fraud, as saying that they've "seen several cases where Medicare has been billed anywhere from $6,000 to — in one case — $30,000" for unnecessary DNA tests.

Kinney adds that the "tests are being marketed to them as free without the understanding that Medicare will be billed" — and that people realize they've been duped only when charges show up on their Medicare statements.

Beware, says the HHS' Office of Inspector General of the scams, which have been continuing.

More information about medical fraud can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Monday, April 19, 2021

New drug can melt tumors in 1 in 4 lung cancer patients before surgery, Associated Press reports

A new immune-boosting drug may help patients and doctors before lung cancer operations. 

According to last week's Associated Press story by Marilynn Marchione, physicians have reported that the drug, Opdivo, "gave dramatic results when used with chemotherapy before surgery in patients with operable lung tumors."

The article says a study of 350 patients showed 25% of them given the Bristol Myers Squibb drug and chemo "had no signs of cancer remaining" after their operations.

Marchione quotes Dr. Roy Herbst, a lung specialist at the Yale Cancer Center who had no role in the study, as saying, "They open the person up and the tumor's just melted away. It's incredible."

The study's results were reported at an American Association for Cancer Research conference.

Opdivo and similar drugs called checkpoint inhibitors, the AP story indicates, "work by removing a cloak that some cancer cells have that hides them from the immune system."

Dr. Antoni Ribas, a cancer special at the University of California, Los Angeles, and president of the group sponsoring the conference, declared that the drug "is a great new step" for furthering the immune system's ability to attack lung cancer.

More details about recent research can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Thursday, April 1, 2021

New U.S. guidelines urge doubling of people that should get annual lung-cancer cat-scans

New federal guidelines could almost double the number of people advised to get yearly lung-cancer screenings.

The point, according to a recent story by Denise Grady in The New York Times, is to include more women and Black and young people.

Early discovery of the disease, the most deadly cancer, could help "cure it in more people at high risk because of smoking," the Times piece says. In those individuals, the article indicates, "annual CT scans can reduce the risk of death from cancer by 20 to 25 percent, large studies have found."

The story quotes Robert Smith, a Ph.D. and screening expert at the American Cancer Society, as saying, "Part of the low uptake is simply lack of access to credit. Smoking in general is increasingly concentrated in lower-income populations."

He contends that "researchers have found that half the population eligible for lung-cancer screening had either no insurance, or Medicaid" — but an editorial in the medical journal "JAMA" explained that not all Medicaid plans cover the screening.

What that means, Smith says, is that there "could be a 15-year period when you might quality for screening and not have any insurance."

Grady also quotes Dr. Mara Antonoff, a lung surgeon at the M.D. Anderson Cancer Center in Houston, to the effect that some studies "have alluded to some hormonal influences in women. In terms of racial differences, we don't have an answer. We have population-based data to show they have a tendency to develop lung cancer younger and with less exposure to tobacco, but we don't have a mechanism."

The article indicates that "14.5 million people would qualify for the screening" — representing an increase of 6.4 million. But researchers "estimate that only 6 to 18 percent of those who qualify and could be helped by the screening have taken advantage of it."

One reason could well be the cost — $300. Some who need the scans most simply "may not be able to afford them," the story postulates. 

CT scans — casually called cat-scans and formally called computerized tomography — provide much more detailed information than ordinary X-rays.

The story, based on advice published in "JAMA," says the new recommendations by the U.S. Preventive Services Task Force "include people ages 50 to 80 who have smoked at least a pack a day for 20 years or more, and who still smoke or have quit within the past 15 years."

Earlier U.S. guidelines were based on males, who tend to smoke more heavily, the Times reports, further noting that women and Black Americans "tend to develop lung cancer earlier and from less tobacco exposure than white men, experts said."

Why the risk appears to differ by race and gender, the story says, "is not known."

The Times piece also suggests that Smith and other researchers believe a good portion of patients "may be missing out on lung-cancer screening because they just don't know about it" — or because some doctors may not strongly encourage it.

The statistics are grim. "There were 228,820 new cases of lung cancer in the United States in 2020," Brady writes, "and 135,720 people died from it, according to the National Cancer Institute. About 90 percent of cases occur in people who smoke, and current smokers' risk of developing the disease is about 20 times that of nonsmokers."