Stories

The IRE Resource Center is a major research library containing more than 27,000 investigative stories.

Most of our stories are not available for download but can be easily ordered by contacting the Resource Center directly at 573-882-3364 or rescntr@ire.org where a researcher can help you pinpoint what you need.

Search results for "Medicare" ...

  • Kaiser Health News: Liquid Gold

    Doctors across the U.S. are becoming millionaires by setting up private, on-site labs and testing urine samples for legal and illegal drugs. The simple tests are costing the U.S. government and American insurers $8.5 billion a year -- more than the entire budget of the Environmental Protection Agency, a groundbreaking investigation by Kaiser Health News showed. Doctors are testing patients - even the elderly - for opioids as well as street drugs like PCP or cocaine that almost never turn up positive. And the payoff is stunning: Testing a tiny cup of urine can bring in thousands of dollars – up to $17,000 in some cases. Yet there are no national standards for who gets tested, for what, or how often.
  • Houston Chronicle and ProPublica: Heart Failure

    Heart recipients at an acclaimed hospital were dying at a high rate, and patients had been kept in the dark. After an investigation by the Houston Chronicle and ProPublica, Medicare cut off funding and the hospital replaced its lead surgeon.
  • CBS News: Healthcare Fraud in America

    For the past four years, CBS News has been committed to investigating healthcare fraud throughout the United States. Our reporting has uncovered schemes preying on veterans, cancer patients, rural communities, and opioid addicts. We’ve been the only network to expose con artists defrauding billions from private insurance companies, Medicare and even Tricare, a component of the military health system. In 2016 we produced an investigative series that found compounding pharmacies were collecting prescriptions for pain creams and billing insurance more than $1 million per week. Last year, our reporting revealed an insurance scheme involving genetic testing that cost the Pentagon trillions. This year’s entries continue our work to expose unscrupulous actors bilking insurance to cash in on the American healthcare system. Our stories go beyond examining the fiscal toll of insurance fraud, they illustrate the human impact these practices have on communities, families, and individuals.
  • Derby Pain Clinic's High Prescribing Of Cancer Drug Extends Beyond Nurse

    Culling and analyzing newly released data from the Centers for Medicare and Medicaid Services, C-HIT Senior Writer Lisa Chedekel found an interesting prescribing pattern: four nurse practitioners, all affiliated with a tiny Derby pain clinic, prescribed nearly all of the state's Medicare spending for the opioid painkiller Subsys. The nurses were responsible for 279 prescriptions for Subsys, at a cost of $2.3 million in 2014. Nationally, only 10 nurse practitioners prescribed Subsys - with the majority of prescriptions written by doctors.
  • Nursing home info scare

    The Tribune examined government inspections of nursing homes, which indentified a small group of chronic violators. Two chains owned five of the top 10 violators, indicating that ownership was a strong predictor of quality care.
  • Medicare Advantage Overcharges

    During 2015, Center for Public Integrity senior reporter Fred Schulte produced a dozen articles based mainly on previously secret government audits, including emails and other internal documents, released over the course of the year under a court order in our Freedom of Information Act lawsuit. Schulte revealed that federal officials repeatedly recognized that some health plans appeared to be ripping off Medicare by exaggerating how sick their patients were, but they failed to demand refunds, discipline the health plans, or curb other wasteful spending in the politically powerful Medicare Advantage program.
  • Connecticut Nurse Among Highest Prescribers In U.S.

    Tunneling through reams of newly-released national prescriber data in January 2015, C-HIT senior writer Lisa Chedekel came across a tiny bit of information that is fundamentally changing how Connecticut views pain treatment. Lisa found an odd nugget that lead to a flood of stories: an advanced practice registered nurse working out of a clinic in tiny Derby, Connecticut was among the nation’s top 10 prescribers of the most potent pain killers in the Medicare drug program. The ARPN, Heather Alfonso, wrote more than 8,700 prescriptions for opioids and other Schedule II drugs in 2012 – far more than any pain specialists or doctor.
  • Deficient Hospices Rarely Punished

    After mining a database of inspection records, Huffington Post determined that hospices frequently go three years -- and sometimes much longer -- without any regulatory scrutiny. It also showed that when hospices break Medicare's rules, endangering the safety and even lives of their frail patients, they are virtually never punished. Medicare’s regulator has punished a hospice provider just 16 times in the last decade, despite carrying out 15,000 inspections and identifying more than 31,000 violations. In each instance, the hospice’s license was terminated -- the sole recourse for regulators when they confront a hospice that breaks the rules. The system of oversight designed to ensure sound practices in an industry that has quadrupled in size since 2000 simply has no means to assess fines or other punishments. The service, which at its best provides a caring, home-based alternative to hospitalization for terminally ill patients, is increasingly how Americans die. Yet virtually nothing is known about the quality of the companies providing that service. This story reveals to consumers those hospices that regulators have determined have the most problems -- and hopefully spurring government authorities to act.
  • Understaffed and Underserved

    "Understaffed and Underserved: A Look Inside America’s Nursing Homes" exposed staffing discrepancies, racial disparities and billions of dollars in questionable HUD-backed mortgages granted to facilities across the country, revealing the intersection of nursing home companies’ profit-driven practices with weak governmental oversight that all too often leads to devastating, and even fatal, consequences for some of the nation’s most vulnerable citizens. The project generated widespread media pickup, resulted in the filing of federal legislation, the GAO saying it would investigate the five-star rating system and contributed to federal policy change by the Centers for Medicare and Medicaid Services Advocates throughout the nation used data from the project to advocate for legislative change, while a law professor had her students do field testing for a potential civil rights law suit and plans to request HUD Secretary Julian Castro to initiate a complaint against a Chicago-area nursing home chain.
  • Surgeon Scorecard

    ProPublica analyzed Medicare claims data, and published, for the first time, the risk-adjusted complication rates for almost 17,000 surgeons who perform certain elective operations. These operations are: hip and knee replacements, spinal fusions, gallbladder removals, and prostate removals or prostate resections. Until now, there was no national public database that named surgeons who had the lowest and highest complication rates. ProPublica found that patients are at risk of medical mishaps even when undergoing these relatively low-risk procedures. We identified more than 65,000 cases where patients were harmed or died. Surgeon Scorecard allows patients to make better-informed decisions about where to go for care. It also provides surgeons and hospitals with a benchmark for how their performance compares to their peers nationally -- which is important because the medical industry does so little now to track complications. One of our most important findings was about the distribution of these mistakes. Many surgeons had complication rates 2 or 3 times the national average. But these surgeons weren’t exclusively operating at sub-par hospitals. Instead they could be found at prestigious institutions, sometimes in positions of leadership. Even more striking was the variation between high and low complication rate surgeons performing the same procedure at the same hospital.