Florida Woman gets Prison for Michigan Medicare Fraud

The Lansing State Journal

DETROIT - A Florida woman who stole millions of dollars from Medicare while running Detroit-area clinics expanded her scheme by setting up her daughter and son-in-law with their own fraud mill.

Profits came quickly: Over one year, Daisy Martinez [PICTURED] ripped off Medicare for $10.7 million at three clinics, and her daughter got $649,000 in just four months as they billed the government for sham drug treatments while luring desperate people off the street with cash, food and painkillers.

Martinez, 51, was sentenced Thursday to eight years in federal prison by U.S. District Judge Gerald Rosen, who said he was "just appalled" by the evidence. The case shows it's not hard for unscrupulous people to fleece Medicare in Michigan - and that's the problem.

Settlements, fines and restitution in fraud cases added up to $4 billion nationally in the 2009 fiscal year, "just the tip of the iceberg," Daniel Levinson, inspector general of the U.S. Department of Health and Human Services, told Congress this month.

Court records describe a seemingly simple scheme in which Martinez migrated from the Miami area to cash in on the government's rich reimbursements for certain drug treatments given to Medicare beneficiaries. She moved to Michigan after authorities cracked down on similar scams in Florida.

In 2006-07, Martinez co-owned two clinics in suburban Detroit, Sacred Hope and X-Press Center, and had a share of another, Dearborn Medical Rehab Center. She admits lining up a doctor and dispatching recruiters to offer $50 or more to people with Medicare cards, many of them homeless, to lure them to the clinics.

The clinics regularly billed Medicare for treatments involving cosyntropin, a drug to diagnose problems with the adrenal gland. In fact, however, the treatments were not needed or never provided. Some people simply got vitamin shots.

"Her conduct resulted in hundreds of medically unnecessary infusions to HIV and hepatitis C patients for worthless services. ... The purpose of these clinics was not to help sick patients but to steal money," Justice Department prosecutors said in a court filing.

Martinez and her partner, Jose Rosario, fled to their native country, the Dominican Republic, in 2007 after authorities became suspicious of the billings and froze their bank accounts. They returned to the U.S. after being indicted last year.

Martinez and Rosario pleaded guilty to conspiracy. Nine others, including a doctor and four Medicare recipients who got kickbacks to visit clinics, also pleaded guilty in the scam or were convicted at trial.

"She was a major player in a massive series of frauds," Justice Department lawyer John K. Neal said of Martinez.

$3.2 million recovered

The government has recovered $3.2 million. A "good deal" of the rest was likely hidden overseas, Neal said. Martinez's lawyer, Juan Gonzalez of Miami, said she only got $1 million.

"I just want to apologize. ... I accept my responsibility but not for the other persons," said Martinez, speaking in Spanish.

As she spoke, jury selection began six floors below in a case against a doctor who worked at a sham clinic in Canton Township run by her daughter, Denisse Martinez and then-husband Jose Martinez. They have pleaded guilty to fraud and will be sentenced in April.

Like Daisy Martinez, the couple had no medical expertise. Denisse Martinez told investigators the fraud was "very obvious" because patients were driven to the clinic and there were no walk-ins, FBI agent Justin Shammot said in a court filing.

Jose Martinez said "he didn't want to hurt or kill any patients but ultimately only wanted to make lots of money," Shammot wrote.

Rules to be tightened

The director in charge of the Michigan Medicare program's integrity, Kimberly Brandt, said the new health care law will tighten rules on who can join the program, a move that should reduce the likelihood of fraud.

"Medicare was set up as a trust-based, any-willing-provider system," Brandt said in an interview. "The goal was to allow the widest possible array of providers and suppliers into the program so senior citizens would have as wide a choice as possible. ... Unfortunately, there are people who willfully take advantage of the system."

As Patients Flock to Medicaid, Doctors Drop Them

NY Times

With Medicaid Cuts, Doctors and Patients Drop Out

 Rebecca and Jeoffrey Curtis searched for care for their son. In the process, they felt like “second-class citizens,” Ms. Curtis said.

FLINT, Mich. — Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat.

As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.

She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.

Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.

The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.

New doctors, with their mountains of medical school debt, are fleeing Michigan because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.

“My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.

Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”

The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.

In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.



In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.

If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.

As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.

The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.

Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.

When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.

A landscaper who has been without work and without a Michigan health insurance company for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.

This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.

In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.

But surveys show the share of doctors accepting new Medicaid patients is declining. Waits for an appointment at the city’s federally subsidized health clinic, where most patients have Medicaid, have lengthened to four months from six weeks in 2008. Parents like Rebecca and Jeoffrey Curtis, who had brought their 2-year-old son, Brian, to the clinic, say they have struggled to find a pediatrician.

“I called four or five doctors and asked if they accepted our Medicaid plan,” said Ms. Curtis, a 21-year-old waitress. “It would always be, ‘No, I’m sorry.’ It kind of makes us feel like second-class citizens.”

As physicians limit their Medicaid practices, emergency rooms are seeing more patients who do not need acute care.

At Genesys Regional Medical Center, one of three area hospitals, Medicaid volume is up 14 percent over last year. At Hurley Medical Center, the city’s safety net hospital, Dr. Michael Jaggi detects the difference when advising emergency room patients to seek follow-up treatment.

“We get met with the blank stare of ‘Where do I go from here?’ ” said Dr. Jaggi, the chief of emergency medicine.

New doctors, with their mountains of medical school debt, are fleeing the state because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.

Access to care can be even more challenging in remote parts of the state. The MidMichigan Medical Center in Clare, about 90 miles northwest of Flint, closed its obstetrics unit last year because Medicaid reimbursements covered only 65 percent of actual costs. Two other hospitals in the region might follow suit, potentially leaving 16 contiguous counties without obstetrics.

Michigan Medicare and Medicaid enrollees in the state's midsection have grown accustomed to long journeys for care. This month, Shannon M. Brown of Winn skipped work to drive her 8-year-old son more than two hours for a five-minute consultation with Dr. Mukkamala. Her pediatrician could not find a specialist any closer who would take Medicaid, she said.

Later this month, she will take the predawn drive again so Dr. Mukkamala can remove her son’s tonsils and adenoids. “He’s going to have to sit in the car for three hours after his surgery,” Mrs. Brown said. “I’m not looking forward to that one.”

Medigap Info Could Overwhelm

Blue Cross denies hiding its money-losing policy
Detroit Free Press

John and Rita Cox had to find another Medicare policy this fall after Blue Cross Blue Shield of Michigan eliminated their plan.

They wanted a Blue Cross Medigap plan for $112.12 a month each, just like Rita's cousin has. An independent insurance agent at the insurer's Southfield lobby gave them an application in October.

But back home, Cox, 81, a retired salaried Ford Motor Co. construction engineer, and his wife, 77, realized the policy the agent suggested was for Blue Care Network, a subsidiary of the insurer, a plan that would cost $203.33 a month for her and $254.49 for him.

Confused, they called their son, Mike, who happens to be Michigan's attorney general.

Mike Cox successfully fought to hold down a recent rate increase in Blue Cross Medigap policies. He has also accused the insurer several times in the past year of failing to adequately promote the money-losing Medigap policies.

Blue Cross spokesman Andy Hetzel said the insurer loses $1,000 on every Medigap policy.

Cox advised his parents to get the exact name of the policy from the cousin, then go back to the Southfield office and request an application. "And don't take no for an answer," Rita said her son told her.

They went back and left with an application for Legacy Medigap, the new name Blue Cross has given its Medigap policy. They also bought a separate Part D plan to pay for prescription drugs, as most seniors do because Medigap policies don't have drug coverage.

"They are hiding it," Rita Cox said of Blue Cross. "The ones being hurt are seniors."

The Coxes' experience underscores problems seniors have in trying to find out about Blue Cross Medigap policies.

Blue Cross denies it has hidden its Medigap policy or steered customers to its subsidiary. Some 2,200 seniors enrolled in the Legacy plan in the last month alone, a sign that "clearly there isn't a widespread issue with regard to accessing the application, filling it out or getting enrolled," Hetzel said. The insurer has made improvements to more prominently list Legacy Blue applications and information on its Web site.

Hetzel attributed confusion to the dozens of Michigan Medicare plans sold. "The Coxes' family experience unfortunately is what a lot of families go through right now," he said.

Some of the confusion stems from a new Medigap policy, MyBlue, offered by Blue Care Network, a subsidiary of Blue Cross.

MyBlue policies cost more because administrators can charge higher rates based on a person's age, gender, health status, weight and county of residence.

Blue Cross can't charge higher rates because it is required by state law, as Michigan's nonprofit insurer of last resort, to offer one price for its Medigap policies.

Insurance brokers also get no commission to sell Legacy Blue plans as they do for a Blue Care Network policy. The commission typically is 20% of a plan's monthly premium.

As a result, some brokers don't tell seniors about the Blue Cross Medicare products, according to several local insurance brokers. The ones that do, like Barbara Plecas, an insurance broker in Walled Lake, tell seniors about Legacy Blue because "it's the right thing to do," Plecas said.

Louis Isabell, general manager of the Wixom-based Allchoice insurance firm, said some of his clients who requested Legacy Blue applications in October still had not gotten them, so they bought plans from other insurers.

Time To Pick Your Annual Drug Plan

The Wall Street Journal

As the year comes to a close, so does the open-enrollment period for Medicare prescription-drug plans.

The deadline to make changes to Medicare drug plans is Dec. 31, except for people who qualify for a special enrollment period like those in a low-income subsidy program.

Generally, there are two types of drug plans to choose from: a stand-alone prescription-drug plan if you are part of traditional Michigan Medicare or drug coverage that's attached to a private Medicare health plan.

You should review all of the drug-plan options, even if you are happy with your current plan, says Paul Precht, spokesman for the advocacy group Medicare Rights Center. "These plans change," he says. "There's no guarantee that if it worked for you this year, it will work just as well for you next year."

To compare plan costs, go to Medicare.gov, click on the "Compare Drug Plans" link and enter personal information, including which medications you take.

"It will show you which plan is going to be the cheapest for you over the course of the year, from the combination of premiums, deductibles, co-payments, as well as what drugs the plan covers," he says.

Focus Is On Detroit In Probe Of Medicare Fraud

Detroit Free Press

Now-shuttered Ritecare Urgent Care at 16904 Warren Ave. in Detroit was closed Oct. 28 as part of an FBI probe into fraudulent billing practices. Patients still inquire at a neighboring insurer about the clinic.

Detroit is part of expanded federal scrutiny of Medicare fraud.

Since 2007, a joint task force from the U.S. Justice and Health and Human Services departments has indicted more than 460 people  nationwide on charges of bilking the federal program out of more than $1 billion in fraudulent claims, particularly unnecessary medical tests.

The investigations started in Miami and Los Angeles and were expanded this year to Detroit, Houston and Brooklyn.

Some of the cases, including one against Ritecare LLC, a Livonia-based company with urgent care centers in Detroit and Westland, involve unnecessary medical testing and services, as well as alleged kickbacks some centers gave to staff and patients to increase business.

In Detroit, the Ritecare owners hired patient recruiters to drum up business for the company's clinic in Detroit, according to the Dec. 15 indictment brought by the U.S. Attorney's Office, Eastern District. In return, the recruiters paid people money to fake symptoms and undergo unnecessary tests, according to the indictment.

Attorneys listed in court records for Alejandro, Emilio and Maria Haber, the clinic's owners, could not be reached for comment Wednesday.

Ritecare's administrator and two patient recruiters also were indicted, as were two patient recruiters and the owner of a third clinic who referred patients to Ritecare, the U.S. Attorney's Office said in a statement. The cases are pending in Detroit's U.S. District Court, with two of the patient recruiters scheduled for a jury trial Feb. 16.

No one answered phones this week at Ritecare Inc.'s Livonia headquarters, at its Detroit center or a new urgent care center it opened in Westland at 769 S. Wayne Road. Ritecare was created in 2008 through a merger of Ritecare LLC and CompleteHealth LLC of Livonia, the indictment said.

The Detroit clinic, which opened in April, was authorized to bill Michigan Medicare and Medicaid for its services. "That was one busy place," said Katrina Daniels, a member of the State Farm office operating next door to the clinic. "The parking lot always seemed to be full," she said. The office doesn't know what to tell people who come daily to inquire about the clinic, she said.

Teri Chamberlain, Medicaid enrollment supervisor with the Michigan Department of Community Health, said the center was approved as a Medicaid provider because the clinic and its owners had no prior record of problems. Dr. Richard Chesbrough, a Bingham Farms radiologist who reads tests for Ritecare, has 20 ultrasound tests for patients he didn't know how to reach. He said he believes the incident underscores the need to better regulate diagnostic testing that occurs in doctor's offices and urgent care centers.

Too often, the work is substandard or unnecessary but no one regulates these tests, except for mammograms, the way they are in hospitals, he said. He called the quality of tests he got from Ritecare to read marginal.

Records with a second state agency, the state Department of Labor and Economic Growth, show that the clinic had incorporated as a limited liability company, which requires only cursory information. Owners and medical doctors are not required to be listed on the forms, said Ann Baker, deputy director of Commercial Services for the Michigan Department of Labor and Economic Growth.

Baker said it was up to the Department of Community Health to determine whether patients were harmed.

Priority Medicare Earns 5-Star Rating For Second Straight Year

Reuters

 

GRAND RAPIDS, Mich.-- Priority Health`s Medicare plan was recognized with a 5-star rating by the Centers of Medicare and Medicaid Services (CMS). It is the only plan in Michigan to earn the top rating two years in a row. The rating was published in the CMS annual Medicare & You handbook mailed to all Medicare beneficiaries prior to the Nov. 15 - Dec. 31 annual enrollment period. Medicare beneficiaries through a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey determine the rating.

"This rating is a testament to our ability to provide Michigan with access to excellent and affordable health care," said Kimberly K. Horn, president and chief executive officer for Priority Health. "Medicare beneficiaries can be confident when they select a Priority Health plan, that they are getting the best value available."

Priority Health`s Michigan Medicare Advantage insurance plans vary in price based on where individuals live and what benefits they need. Those individuals eligible for Medicare may choose from four Medicare Advantage plans or a prescription-drug plan Priority Health offers, including:

* PriorityMedicare ValueSM - offers the lowest monthly premiums, making it ideal for those individuals who   don`t use their medical benefits very often.
* PriorityMedicareSM - offers a slightly higher premium than PriorityMedicare Value with lower copays and out-of-pocket costs.
* PriorityMedicare PlusSM - offers medical coverage that`s similar to PriorityMedicare with enhanced prescription-drug coverage in the Medicare Part D coverage gap, called the "donut hole."
* PriorityMedicare ChoiceSM is the newest and most comprehensive Medicare Advantage plan offered by Priority Health.

In addition to Priority Health`s Medicare Advantage plans, it also provides several Michigan Medigap insurance options and a prescription drug plan.

Priority Health's Medicare Advantage plans are available in 31 counties including Allegan, Antrim, Barry, Benzie, Cass, Crawford, Emmet, Grand Traverse, Hillsdale, Ionia, Jackson, Kalamazoo, Kalkaska, Kent, Leelanau, Livingston, Manistee, Mecosta, Missaukee, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Osceola, Ottawa, Roscommon, St. Clair, Washtenaw and Wexford counties.

All Priority Health Medicare Advantage plans offer:

• Medicare Part D prescription drug coverage with no deductible
• Low out-of-pocket costs
• Preventive care
• Worldwide emergency and urgent care coverage Local in-Michigan customer service

For more information, visit prioritymedicare.com.

About Priority Health

Priority Health is a nationally recognized health benefits company based in Michigan. It serves more than half a million people with a broad portfolio of products including commercial and government health plans. As a nonprofit, Priority Health has been dedicated to providing all people access to affordable health care for more than 20 years. It continues to be recognized as one of America`s Best Health Plans by U.S. News & World Report and NCQA.

BCBS Of Michigan Awards Grants To 47 Free Health Clinics

Reuters

Blues contribution to free clinics makes health care accessible to the uninsured and underinsured.



DETROIT -- Blue Cross Blue Shield of Michigan is awarding free clinics throughout the state a total of $1 million in grants that will provide health services to individuals and families without Michigan health insurance. With the Michigan unemployment rate currently at 15.3 percent more Michigan residents than ever are going without health insurance.

"In these difficult times, free clinics are putting health care in reach for people who need it," said Lynda Rossi, Blues vice president for Social Mission and Public Affairs. "Free clinics are a place for uninsured people to turn to for quality health care. Uninsured residents who get care in free clinics often otherwise would delay seeing a physician because of the cost. Delay
often leads to more expensive care in emergency rooms and even hospital stays."

The Blues have contributed $5 million to free clinics since 2005. This year's grant program aims to help clinics provide important services like primary care and behavioral health care, case management, dental services, specialty and diagnostic care, and prescription drugs.

"Most of our patients are dealing with one or more long-term diseases such as diabetes, high blood pressure and asthma," said Dave Law, executive director of the Joy-Southfield Health and Education Center in Detroit. "We also supplement our primary care with preventive health education and disease management strategies."

About 2.5 million Michigan residents under 65 years old went without health insurance at some time between 2007 and 2008. Many of these individuals, along with the underinsured, are able to seek medical care from these clinics instead of making a trip to the emergency room or forgoing care. Access to free clinics also helps curb the rising cost of health care. In 2008, Michigan free clinics were able to provide an estimated 122,000 patient visits
combined. Most other residents over 65 are covered under Michigan medicaid or Michigan medicare.

"With this grant from Blue Cross Blue Shield of Michigan we will be able to expand our scope and quality of services while using health information technology to efficiently measure health outcomes. As a result, we will be able to deliver high-quality, low-cost health care to our patients at no cost to them," said Law.

The following free clinics received a grant from the Blues this year:

Southeast Michigan

-- Brownstown Twp. - Wyandotte Clinic for the Working Uninsured, 23050
West
Rd., Suite 260, 734-365-3560
-- Detroit - HUDA Clinic, 1605 W. Davison Ave., 313-865-8446
-- Detroit - Joy-Southfield Health and Education Center, 18917 Joy Rd.,
313-581-7773
-- Detroit - Order of Malta Medical/Dental Clinic, 4860 15th St.,
313-894-2240
-- Detroit - St. Frances Cabrini Clinic, 1234 Porter St., 313-961-7863
-- Detroit - University of Detroit Mercy Counseling Clinic, 4001 W.
McNichols, 313-993-1093
-- Mt. Clemens - Mt. Clemens Regional Medical Center Medical Outreach
Clinic, 1000 Harrington Blvd., 586-493-8000
-- Pontiac - Gary Burnstein Community Health Clinic, 90 W. University,
248-758-1690
-- Pontiac - Mercy Place Clinic, 55 Clinton Street, 248-333-0840
-- Southfield - Tri-County Dental Health Council, 29350 Southfield Rd.,
Suite 35, 248-559-7767
-- Warren - St. John Community Health, 28000 Dequindre, 586-753-1484
-- West Bloomfield - Project Chessed (Jewish Family Services), 6555 W.
Maple Rd., 248-592-2300
-- Westland - Project H, Wayne County Family Center, 30600 Michigan Ave.
-- Ypsilanti - Hope Dental Clinic, 9 S. Adams, 734-481-0111

Mid-Michigan

-- Brighton - VINA Community Dental Center, 400 E. Grand River Ave.,
810-844-0240
-- Hillsdale - St. Peter's Free Clinic of Hillsdale County Inc., 3 N.
Broad
St., 517-437-4041
-- Jackson - St. Luke's Clinic, 132 Seymour Ave., 517-783-1117
-- Lansing - Care Free Medical & Dental, 5135 S. Pennsylvania Ave.,
517-887-5992
-- Pinckney - Faith Medical Clinic, 122 Howell St., 734-474-4627


Flint/Tri-Cities

-- Essexville - Helen M. Nickless Volunteer Clinic, 1460 W. Center Rd.,
989-895-4830
-- Flint - Genesee County Free Medical Clinic, 2437 Welch Blvd.,
810-235-4211
-- Lapeer - Loving Hands Clinic, 148 Maple Grove Rd., 810-667-8933
-- Saginaw - Cathedral Mental Health Care, 705 Hoyt Ave., 989-759-3356
-- Saginaw - Community Prescription Support Program, 401 Holden St.,
989-907-5602
-- Saginaw - Healthy Futures of St. Mary's of Michigan, 2215 N. Center
Rd.,
989-907-8108

West Michigan

-- Allegan - Seeds of Grace, 311 ½ Hubbard St., 269-288-0253
-- Battle Creek - Nursing Clinic of Battle Creek, 34 Green St.,
269-962-6565
-- Coldwater - Presbyterian Health Clinic of Branch County, 15 Church
St.,
517-278-7848
-- Grand Rapids - Catherine's Care Center, 224 Carrier NE, 616-336-8800
-- Grand Rapids - Health Intervention Services, 15 Andre SE, 616-475-8446
-- Grand Rapids - Oasis of Hope Center, 522 Leonard St. NW, 616-451-8868
-- Grand Rapids - Project Access, 233 E. Fulton, Suite 226, 616-459-1111
-- Hastings - Barry Community Free Clinic, 1230 W. State St.,
269-945-4444
-- Holland - Holland Free Health Clinic, 99 W. 26th St., 616-392-3610
-- Kalamazoo - Free Clinic of Kalamazoo, 2918 Portage St., 269-344-0044
-- Marshall - Fountain Clinic, 111 N. Jefferson, 269-781-0952
-- Three Rivers - Riverside Health Clinic, 207 E. Michigan Ave.,
269-273-3744
-- Zeeland - City on a Hill Ministries Health Clinic, 100 S. Pine St.,
Suite 140, 616-748-6009

Northern Lower Peninsula and Upper Peninsula

-- Big Rapids - Hope House Free Medical Clinic, 15085 220th Ave.,
231-796-0807
-- Cadillac - Cadillac Area Community Health Clinic, 521 Cobbs St.,
231-876-7818
-- Cheboygan - Northern Care Center, 225 Water St., 231-333-3019
-- Grayling - AuSable Free Clinic Inc., 1250 E. Michigan Ave.,
989-348-0740
-- Manistee - Manistee Area Community Clinic, 385 Third St., 231-309-8940
-- Petoskey - Community Free Clinic, 820 Arlington, Suite 6, 231-487-3600
-- Traverse City - Traverse Health Clinic, 3147 Logan Valley Rd.,
231-935-0668
-- Marquette - Medical Care Access Coalition Volunteer Clinic, 1414 W.
Fair Ave., Suite 26, 906-226-4400
-- Sault Ste. Marie - Community Health Access Coalition Volunteer Clinic,
508 Ashmun St., 906-635-7451



Blue Cross Blue Shield of Michigan has a unique mission that is different from other health insurance companies. The company is committed to focusing on reducing health care costs and improving quality, increasing access to health care coverage and services, and improving the health status of Michigan's residents, particularly children.

BCBS of Michigan is also concerned with senior services, including:
Assisted Living in Dearborn
Retirement Facilities in Dearborn
Senior Living in Wayne County

Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including:

Traditional Blue Cross Blue Shield; Blue Preferred®, Community Blue(SM) and Healthy Blue Incentives(SM) PPOs; Blue Care Network HMO; BCN's Healthy Blue Living(SM); Flexible Blue(SM) plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue(SM) products in the under-age-65 individual market. BCBSM also offers dental, vision and hearing plans. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.


SOURCE Blue Cross Blue Shield of Michigan

Bill Halts Medicare Premium Increases

U.S. News & World Report

A bill passed by the house yesterday would prevent Medicare Part B medical insurance premiums from increasing next year. The legislation, which had 45 cosponsors, passed the house by a vote of 406 to 18.

About 75 percent of seniors are already protected from Medicare Part B premium increases because of a law that prohibits premium hikes from being greater than the annual boost in Social Security payments. Social Security payouts, which are tied to the Consumer Price Index, are not expected to increase in 2010. But, without congressional action, Part B premiums could increase for approximately a quarter of Medicare beneficiaries from $96.40 monthly this year to $104.20 in 2010 and $120.20 in 2011, according to the Medicare Trustees.

This increase in payments is steeper than usual because the costs are spread across a smaller share of beneficiaries. New Michigan Medicare enrollees and existing high income beneficiaries with a modified adjusted gross income above $85,000 ($170,000 for couples) are the individuals most likely to pay higher premiums next year if the bill does not become law. Medicaid, which is state and federally funded, would also have to absorb the larger Part B premiums for low-income seniors eligible for both government programs.

Honda to Sell Battery Car in U.S.

By The Wall Street Journal

Honda Motor Co. will likely launch an all-electric car in the U.S. in a few years, according to executives familiar with the matter, as rising interest in fuel efficiency prompts increasing interest in battery-powered vehicles.

According to company executives, the Tokyo-based auto maker plans to make the foray cautiously, and is likely to limit the availability of the new car, perhaps to a region within the U.S. The specific time frame was unclear.

The executives said Honda is expected to display at next month's Tokyo auto show a prototype of the battery car it plans to launch in the U.S. The knowledgeable executives said Honda is also considering selling the all-electric battery car in Japan.

The executives said the planned move is a reaction in part to prospects for tightening requirements in the U.S. for more fuel-efficient cars. They also said the move is intended as a response to growing competition in alternative-fuel technologies from Honda rivals such as Nissan Motor Co. and Toyota Motor Corp.

Honda continues to believe that gasoline-electric hybrid cars, such as its Civic hybrid and Toyota's Prius car, have the most promising future among many different alternative-energy vehicles, and said the company will continue to expand offerings of hybrid vehicles.

It has also maintained that battery and other key technologies for all-electric cars are premature. Its top leaders have said that Honda saw only a limited future in pure-electric vehicles, pointing to their insufficient driving range on a single full charge, scarce infrastructure of charging stations in most cities and questions about the safety of lithium-ion batteries that are likely to power such vehicles.

But a number of rivals plan to expand their electric-car offerings, raising the prospect that Honda could be left behind if they take off.

Honda's move follows the launch in Japan earlier this year by Mitsubishi Motors Corp. of a small battery-powered car called i-MiEV. Nissan, meanwhile, has said it plans to start selling a compact battery car, the Leaf, in the U.S., Europe and Japan late next year, while Toyota has said it will start selling an electric car in the U.S. by 2012.

General Motors Co. plans to start selling next year the Chevy Volt, a plug-in electric hybrid car with a small gasoline engine dedicated to charging batteries on board. General Motors is also re-evaluating their Michigan Medicare to help lower costs during their reorganization. By doing so, it will help get the Chevy Volt off the production line and on to showrooms around the U.S. quicker.

Toyota, the world's biggest auto maker by sales volume, appears to be changing its stance on the importance of regular hybrid vehicles such as the Prius. At an industry conference in Tianjin, China, over the weekend, Akira Sasaki, a Toyota senior managing director, said the company believes that mostly electric vehicles known as plug-in hybrids are "the most promising technology" among an array of alternative-energy vehicle technologies to replace gasoline-fueled cars for the near future.

While gasoline-electric hybrids such as the Prius run on a combination of gasoline and internally generated electricity, plug-in hybrids can be recharged via an electrical socket and drive mostly on electricity, with a gasoline engine on board used to charge the car's battery when it runs out of power. Mr. Sasaki didn't say what type of plug-in car Toyota is designing.

Toyota plans to launch a plug-in hybrid car in the U.S., Europe and Japan on a limited scale by year end.

GM Chief Talks Tough as Board Is Set to Meet on Opel, New Marketing Push

By The Wall Street Journal

The board of General Motors Co. on Tuesday kicks off a two-day meeting that is expected to determine the fate of the auto maker's ailing Opel unit in Germany. The meeting also is likely to solidify a major shift in the balance of power at GM.

For years, GM management ran the company with little interference from the board. But after the company's reorganization in bankruptcy, and the emergence of the U.S. government as GM's largest shareholder, its new board under Chairman Edward E. Whitacre Jr. has become the dominant power. It is keeping management on a tight leash and exerting increasing influence over the company's operations.

On Tuesday, the board also will review a major marketing campaign the company plans to unleash later this month. The marketing push is linked to Mr. Whitacre's insistence that GM find a way to boost revenue and halt its declining U.S. market share.

"He's said to us that 'you've been given a clean balance sheet, now apply the same focus to market share and sales,'" said one person familiar with Mr. Whitacre's views.

Mr. Whitacre declined to be interviewed for this article.

Having such an activist board and chairman would be unusual at many large corporations. At GM, it is a sea change. In the past, the company's directors almost always went along with the strategy of its former chief executive and chairman, Rick Wagoner. Rarely did the old board question management's assumptions or forecasts, people familiar with the matter said.

The hands-on style of Mr. Whitacre and other new board members carries some risk. But so far, there have been no signs of serious friction between Mr. Whitacre and the company's new CEO, Frederick "Fritz" Henderson.

After its 40-day stay in bankruptcy court, the car maker has to jump-start sales, end a streak of billion-dollar losses and formulate a global strategy while operating as a considerably smaller player in North America.

GM also has to re-evaluate their Michigan medicare and prepare for a public offering of stock to raise money to pay back some of the $50 billion U.S. taxpayers have given it. The offering is supposed to take place in the middle of next year, leaving GM only about 12 months to whip itself into shape.

Medicare Michigan and the future stock offerings of GM puts the spotlight on Mr. Whitacre. As the former CEO of AT&T Corp., the 67-year-old Mr. Whitacre came into the job with no auto experience. The straight-talking executive with a bulldozing style was selected in June by the Obama administration's auto task force, and given broad authority to safeguard the government's GM investment.

The task force also selected Mr. Henderson to serve as CEO, but made it clear to Mr. Whitacre that it was up to the board's discretion whether Mr. Henderson and his team would remain, said people familiar with the matter.

The mandate puts considerable pressure on Mr. Henderson and three of his top lieutenants: Vice Chairman Robert Lutz, Chief Financial Officer Ray Young and Vice President Mark LaNeve, who oversees sales.

Probably the clearest signal so far of the board's new power came Aug. 21, when directors convened via teleconference to discuss GM's ailing Opel unit and British sister company Vauxhall.

Mr. Henderson hoped to get a green light to sell a majority stake in Opel/Vauxhall to a group led by Canadian auto supplier Magna International Inc., the only deal the German government was willing to help finance. Mr. Henderson also was open to selling a majority stake to RHJ International Inc., a Belgian private-equity group, although it would be more difficult to fund that deal without Germany's help.

But before Mr. Henderson got very far, the board brought him to an abrupt stop. How, the directors wanted to know, would GM compete in Europe if it relinquished control of Opel, according to people familiar with the call. Did GM have to settle for the Magna deal? Why couldn't the company consider alternatives -- including keeping all of Opel?

"They needed a lot more information than we could give in a one-hour phone call," one person familiar with the meeting said.

Since then, Mr. Whitacre has continued looking into GM to understand how the company thinks and operates, even at levels well below the executive suite. The chairman spent Sept. 1 and 2 meeting with employees at GM headquarters in downtown Detroit, said people familiar with the matter. The discussions involved groups of 10 to 15 GM workers from various levels and disciplines, these people said.

The sessions are known inside GM as "diagonal slice" meetings, meant to cut across the organization and provide a view of the company's inner workings. Each lasted about 45 minutes.

While the meetings aren't a new idea -- Mr. Wagoner held them as well -- Mr. Whitacre doesn't have the management duties of a CEO that Mr. Wagoner had. And the new chairman had a tough new message for employees: deliver results or leave, said people familiar with the sessions.

Mr. Whitacre "stressed accountability at all levels" of the company and made it clear that "if we think it's going to go back to being business as usual we are mistaken," said a person who attended one of the meetings.

"People kept talking about Ed's impatience when he was first named to the job," another person familiar with Mr. Whitacre's meetings said. "Well, we're seeing that first hand."

Two areas where Mr. Whitacre wants to see progress quickly is boosting revenue and halting the decline in U.S. market share.

In August, GM's share of U.S. auto sales fell by five percentage points, to 19.5% from 24.5% a year earlier. Executives blamed a particularly strong August 2008 as one reason for the decline. GM also cut its customer-incentive spending by 8% during the month compared to August 2008.

Mr. Whitacre has told GM executives to figure out a way to lift market share while keeping inventories lean and trimming incentives such as rebates, said people familiar with the discussions. Conventional wisdom in Detroit holds that cutting incentives and inventories usually results in lower market share.