Health Highlights: July 14, 2008

Here are some of the latest health and medical news developments, compiled by editors ofHealthDay:

Auditors Getting a Portion of Medicare Payments Recovered

Private auditing firms have gotten back more than $690 million in overcharges paid by Medicare, and under a new program that's irking health care "providers," the companies that identify the overpayments are getting a portion of the monies they recover, theWall Street Journalreported.

The program has identified about $1.03 billion in "improper" payments over three years, mostly in New York, California and Florida, the newspaper said. About $992.7 million was in overpayments.

Industry groups representing the providers, mostly hospitals, call the new program an overaggressive "bounty hunter" arrangement. Nonetheless, the Centers for Medicare and Medicaid Services (CMMS) said it is planning to expand the program nationwide, theJournalreported.

Just over $187 million has been paid to the auditors, and some $60 million more was reclaimed by providers who successfully challenged the auditors' findings. That left about $694 million that has been returned to Medicare, the newspaper said.

The CMMS said the auditors don't get paid if their findings are successfully appealed, and they are paid using the same formulas whether they identify Medicare overpayments or underpayments.

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Illinois Governor: Insurers Should Pay for Autism

Insurers in Illinois should be required to absorb the skyrocketing costs of diagnosing and treating autism, Gov. Rod Blagojevich proposed Sunday.

Under the proposal, insurance companies would be bound to pay up to $36,000 annually and cover an unlimited number of medical visits for autistic children until they turned age 21, theChicago Sun-Timesreported.

Some states set a higher monetary limit, but the Illinois proposal would amount to the most comprehensive guarantee for autistic children in the United States, Mike McRaith, insurance director of the Illinois Department of Financial and Professional Regulation, told the newspaper.