Just eight federal employees monitor widely varying state efforts to fight Medicaid fraud, the Government Accountability Office said. The federal Centers for Medicare and Medicaid Services has been reviewing state programs since 2000 at a pace that will take it until late 2006 to cover all 50 states and the District of Columbia, said GAO, Congress' investigative arm.

The oversight "may be disproportionately small relative to the risk of serious financial loss," GAO said.

CMS administrator Mark McClellan said his agency is beefing up its financial management staff to review Medicaid spending.

Medicaid is the government health care program for the poor. It is run by the states, and its costs are shared by the federal and state governments.

Medicaid reimbursements are expected to top $300 billion this year, more than half of that in federal money.

While the report said it could not put a dollar figure on the extent of Medicaid fraud, it detailed several schemes uncovered by state and federal prosecutors. In California, for example, 15 laboratories billed more than $20 million for tests that were never ordered by physicians.

Also in California, an eyeglasses store fraudulently billed Medicaid for 59,574 pairs of glasses between 1995 and 2001, GAO said.

In addition, there are indications - http://www.caringbridge.org/search?q=indications that Medicaid fraud involving drug pricing practices is increasing, said Sen. Charles Grassley, R-Iowa, who requested the GAO study.

Federal and state prosecutors are investigating several allegations of improper drug pricing, 구리출장마사지 - https://www.anmapop.com/%ea%b5%ac%eb%a6%ac%ec%b6%9c%ec%9e%a5%ec%83%b5%cf... following settlements in seven cases of alleged pricing and marketing fraud since 2001, said Grassley, chairman of the Senate Finance Committee.

Grassley said the government needs to do more. "CMS has a problem with Medicaid fraud and its limited oversight is insufficient to protect the integrity of the program."

By contrast, he said, the government's Medicare health care program for older and disabled Americans, is more successful in rooting out abuse.

Other studies have found that the federal government recovers 20 times more money from prosecuting fraud in Medicare than in Medicaid - $1 billion compared with $43 million in 2001, according to the Washington-based Taxpayers Against Fraud Education Fund.

McClellan said the government is taking steps to look at both programs together since schemes to defraud one also often target the other.

A pilot program in California in one year produced a reported $58 million in savings and more than 80 cases against health care providers suspected of fraud, GAO said.

By Mark Sherman

Almost five years after treatment, six men in the radiation-only study group died of prostate cancer; none of the men who got combined treatment died of prostate cancer. The study involved about 200 men.

Of the more than 200,000 U.S. men diagnosed each year with the disease, nearly half have the kind cancer involved in the study: An exam and imaging indicates it hasn't spread but other tests indicate it might have.

Treatment for such men often involves radiation alone or radiation combined with long-term use of hormone-fighting drugs, often for as long as three years or more. But long-term drug use may cause thinning bones, heart abnormalities that can lead to sudden death and impaired mental function.

The study found that using hormone-blocking drugs for six months had the same survival benefits as long-term use but without the potential health risks. Some men did have side effects including impotence, but that can occur with other prostate cancer treatments, including surgery and radiation.

"It's a very important and useful study and should have nearly immediate impact on the fashion in which men are treated," said Dr. Durado Brooks, director of prostate cancer programs at the American Cancer Society.

"Significant numbers of men are getting radiation only," Brooks said. That's partly because many men reject hormone-suppressing drugs when they learn about all the bad side effects from long-term treatment, he said.

Brooks said radiation plus short-term medication is likely to become prevalent given the study results.

Researchers studied 206 men aged 49 to 82 randomly assigned to receive about seven weeks of daily radiation treatments, or radiation plus six months of medication overlapping the radiation treatment. Six of those only on radiation died from prostate cancer while none of those getting combined treatment died from prostate cancer.

More than twice as many radiation-only men had evidence of cancer recurrence, 46 versus 21 in the combined treatment group.

The study by researchers at Boston's Brigham and Women's Hospital and Dana Farber Cancer Institute appears in Wednesday's Journal of the American Medical Association.

The patients had prostate cancer that physical exams and imaging tests indicated had not spread. But they also had high blood levels of PSA - prostate specific antigen - and high Gleason scores, which measure the degree of abnormality found in cancer tissue.

The high levels raise the possibility of cancer elsewhere, said lead author Dr. Anthony D'Amico, a radiation oncologist at both institutions.

The drug treatment studied involved flutamide pills three times daily with periodic injections of either leuprolide acetate or goserelin. The drugs suppress production of testosterone, which can fuel prostate cancer growth.

Men in the drug-radiation group had more severe impotence and more breast tissue enlargement than the radiation only group. But they had no obvious evidence of the potentially more debilitating complications of long-term treatment. Although those weren't specifically measured, they usually don't appear until after at least a year of treatment, D'Amico said.

In a JAMA editorial, Dr. Theodore DeWeese of Johns Hopkins University, said the study did not address how the drug treatment affected patients' quality of life. He also said the radiation dose - https://www.vocabulary.com/dictionary/radiation%20dose was lower than is frequently given, 포천출장마사지 - https://www.popanma.com/%ed%8f%ac%ec%b2%9c%ec%b6%9c%ec%9e%a5%ec%83%b5%cf... which might explain the differing survival rates.

Still, he called the study "extremely important" because of the survival advantage shown.

By Lindsey Tanner

Almost five years after treatment, six men in the radiation-only study group died of prostate cancer; none of the men who got combined treatment died of prostate cancer. The study involved about 200 men.

Of the more than 200,000 U.S. men diagnosed each year with the disease, nearly half have the kind cancer involved in the study: An exam and imaging indicates it hasn't spread but other tests indicate it might have.

Treatment for such men often involves radiation alone or radiation combined with long-term use of hormone-fighting drugs, often for as long as three years or more. But long-term drug use may cause thinning bones, heart abnormalities that can lead to sudden death and impaired mental function.

The study found that using hormone-blocking drugs for six months had the same survival benefits as long-term use but without the potential health risks. Some men did have side effects including impotence, but that can occur with other prostate cancer treatments, including surgery and radiation.

"It's a very important and useful study and should have nearly immediate impact on the fashion in which men are treated," said Dr. Durado Brooks, director of prostate cancer programs at the American Cancer Society.

"Significant numbers of men are getting radiation only," Brooks said. That's partly because many men reject hormone-suppressing drugs when they learn about all the bad side effects from long-term treatment, he said.

Brooks said radiation plus short-term medication is likely to become prevalent given the study results.

Researchers studied 206 men aged 49 to 82 randomly assigned to receive about seven weeks of daily radiation treatments, or radiation plus six months of medication overlapping the radiation treatment. Six of those only on radiation died from prostate cancer while none of those getting combined treatment died from prostate cancer.

More than twice as many radiation-only men had evidence of cancer recurrence, 46 versus 21 in the combined treatment group.

The study by researchers at Boston's Brigham and Women's Hospital and Dana Farber Cancer Institute appears in Wednesday's Journal of the American Medical Association.

The patients had prostate cancer that physical exams and imaging tests indicated had not spread. But they also had high blood levels of PSA - prostate specific antigen - http://www.ehow.com/search.html?s=specific%20antigen - and high Gleason scores, which measure the degree of abnormality found in cancer tissue.

The high levels raise the possibility of cancer elsewhere, 대구출장안마 - https://www.opanma.com/10-daegu said lead author Dr. Anthony D'Amico, a radiation oncologist at both institutions.

The drug treatment studied involved flutamide pills three times daily with periodic injections of either leuprolide acetate or goserelin. The drugs suppress production of testosterone, which can fuel prostate cancer growth.

Men in the drug-radiation group had more severe impotence and more breast tissue enlargement than the radiation only group. But they had no obvious evidence of the potentially more debilitating complications of long-term treatment. Although those weren't specifically measured, they usually don't appear until after at least a year of treatment, D'Amico said.

In a JAMA editorial, Dr. Theodore DeWeese of Johns Hopkins University, said the study did not address how the drug treatment affected patients' quality of life. He also said the radiation dose was lower than is frequently given, which might explain the differing survival rates.

Still, he called the study "extremely important" because of the survival advantage shown.

By Lindsey Tanner

"Minnesota may be the land of a thousand lakes, but we're the land of thousands of abandoned swimming pools," says Will Humble, head of disease control for the Arizona Department of Health Services.

Those swimming pools, plus irrigation canals that slice through parts of the city, patio misters and lush lawns designed to remind transplants of gardens they left behind have inadvertently turned neighborhoods into oases for mosquitoes.

"It didn't use to be this bad. You never saw a mosquito," said resident Gary Clark, 62, who takes his morning walk in an area where a high number of cases have been reported. "It's even trouble sitting out in your back yard now."

So far this year, at least 290 of the nation's more than 500 West Nile cases are in Arizona; three of the 14 deaths were in Arizona. Nearly all the cases have been in the state's most populous county, Maricopa, which includes the Phoenix metro area.

State health officials estimate at least 30,000 Arizonans may have the virus without knowing it. Some people never have symptoms at all. Only about 1 percent of West Nile victims develop the potentially dangerous inflammation of the brain or spinal cord — meningitis or encephalitis.

Last year was the first time the virus appeared in areas west of the Continental Divide. It hit Colorado hard and drifted slowly into Arizona's northeastern tip, then down south. It's now spreading in California, where at least 116 cases have been reported and at least five people have died.

Several factors have contributed to Arizona's outbreak.

"It's like the planets, everything has to align" for an outbreak to occur, said John Roehrig, chief of the CDC's arboviral diseases branch in Fort Collins, Colo.

While more humid climates have more mosquitoes, they are also more prepared to deal with "nuisance mosquitoes," while Arizona isn't.

And while Arizona doesn't have a lot of mosquitoes because of long stretches of 100-plus degree days, one type of mosquito thrives here: the Culex tarsalis. The species is one of the best carriers of West Nile virus.

It does well in suburban settings and likes to feed on humans.

The species can breed in small pools of standing water, such as in wheelbarrows, kiddie pools and plant saucers. Since the species is so dominant here, it doesn't have to compete with other types of mosquitoes for breeding spots.

The water that people surround themselves with to combat the heat can be another major factor. From the air, pools form a checkerboard pattern across the desert landscape.

Of the approximate 600,000 residential swimming - http://mommysavers.com/?s=residential%20swimming pools in the state, state health officials estimate about 10,000 are capable of breeding mosquitoes.

"What we've done is create miniature swamps in our back yard," said David Ludwig, who oversees county health inspectors treating so-called green pools with larvicides.

Backyard pools are to Arizonans what ice scrapers are to Alaskans. Pools are everywhere and considered a necessity by some. But sometimes they are neglected — by cash-strapped owners who may have a broken pump or owners who have moved before the house has sold. The pools can turn to stagnant pond green in no time.

Also, many of the city's older neighborhoods still use irrigation flooding for lawns, sometimes leaving standing water for days. They also have tall, mature trees. Besides mosquitoes, birds love these spots, and 강진출장안마 - https://www.anmatoto.com/14-op they can carry West Nile, too.

So far, the primary weapon has been to spray pesticide at night with fogging trucks that roam the neighborhoods. Maricopa County officials recently voted to spend more money to increase the spraying.

But they also opted against the aerial spraying recommended by the CDC.

"I think it was the right choice," Humble said. "If you spend $3 to $6 million on aerial spraying, your whole budget is gone in a matter of days. What are you going to do for the rest of season?"

The CDC's Roehrig said his agency still believes aerial spraying is superior. However, that recommendation was made before county officials decided to beef up spraying efforts, he said.

Federal officials are watching to see if the county is able to slow the virus' spread.