P2JW360000-2-A00200-1--------XA
CMYK
Composite
CL,CN,CX,DL,DM,DX,EE,EU,FL,HO,KC,MW,NC,NE,NY,PH,PN,RM,SA,SC,SL,SW,TU,WB,WE
BG,BM,BP,CC,CH,CK,CP,CT,DN,DR,FW,HL,HW,KS,LA,LG,LK,MI,ML,NM,PA,PI,PV,TD,TS,UT,WO
A2 | Friday, December 26, 2014
THE WALL STREET JOURNAL.
* *
U.S. NEWS
Unemployment Rolls Shrank Sharply in 2014
BY ERIC MORATH
AND JONATHAN HOUSE
Nearly two million fewer
Americans are receiving jobless
benefits than a year ago, in part
the result of the elimination of
an extended benefits program
last December.
A steadily improving labor
market has reduced layoffs in
recent months and cut the number of people receiving continuing state benefits by more than
500,000 from a year earlier.
Last December, the federal
government cut a special program put in place during the recession that provided extended
benefits to about 1.4 million
Americans at the time of its
elimination.
The numbers point up the
marked shift in the labor market over the past year and particularly over the past several
months, which have put 2014 on
pace to be the best year for job
creation since 1999. Today,
many fewer people are relying
on government assistance and
many more people have jobs.
Most of those who lost benefits likely didn’t remain unemployed, separate data suggest.
The number of Americans who
were unemployed fell over the
past year, while both the ranks
of employed and those outside
the labor force grew.
“We have seen a continuation
of dropouts,” said Lindsey
Piegza, economist at Sterne
Agee, referring to the number of
people who have stopped looking for work.
But after the expiration of
the federal program, Ms. Piegza
said, “some decided to take an
alternative job that they may
not have taken if the program
was extended.”
In total, 2.4 million Americans received some form of unemployment assistance in the
first week of December, down
more than 40% from the same
week in 2013, the Labor Depart-
ment said Wednesday. And the
number of unemployed Americans declined by 1.7 million in
November from a year earlier,
the Labor Department said earlier this month.
Others previously receiving
jobless
benefits
probably
dropped out of the labor force.
The number of Americans neither employed nor looking for
work grew by 1.1 million since
November 2013.
Hiring in low-wage fields was
robust in 2014. The leisure and
hospitality sector added 374,000
positions in November from a
year earlier, accounting for better than 1 in 8 jobs added to
nonfarm payrolls in the past
year.
Retailers hired an additional
260,000 workers over the 12
months.
In contrast, higher-paying
construction jobs grew by
231,000 and manufacturing positions increased by 186,000.
Meanwhile, fewer layoffs by
Claims Check
The number of Americans receiving unemployment beneﬁts returned to prerecession levels in 2014 (F).
U.S. residents receiving government unemployment beneﬁts
12 million
2,413,615
10
in the week
ending Dec. 6
Recession
8
6
4
2
0
1990
’95
2000
’05
Source: Labor Department
firms has also helped to bring
down unemployment.
The number of Americans applying for initial unemployment
benefits fell last week to
280,000, a reading only slightly
above the 14-year low touched
in early October. The unemployment rate was 5.8% in Novem-
ber, down from 7% a year earlier.
As a share of those covered
by unemployment insurance, the
number of Americans filing for
jobless claims last week was
only slightly ahead of early November readings, which were
the lowest on records back to
Zuma Press
FEED THE HUNGRY: Rosann Kaufman, left, and Zenobia Lee chop celery for tuna salad as volunteers prepare Christmas Day meals for the
homeless at Congregation Beth Shalom for ‘Mitzvah Day,’ a joint Jewish and Muslim day of service that is a tradition in the Detroit area.
Error Exposes CDC Worker to Ebola
WASHINGTON—A laboratory
technician working at the Centers for Disease Control and Prevention in Atlanta may have
been exposed to the Ebola virus,
federal officials said.
The technician will be monitored for 21 days following the
mishap, which occurred in a CDC
lab and was discovered and reported on Tuesday, according to
agency officials.
Roughly a dozen other individuals who entered the lab were
rector Tom Frieden in a
statement. “I have directed that
there be a full review of every
aspect of the incident and that
CDC take all necessary measures.”
Mishandling of samples of anthrax and avian influenza at the
CDC earlier this year drew criticism from lawmakers on Capitol
Hill.
The CDC took several actions
after the latest incident, including closure of the lab, notification of staff, initiation of an internal review and notification of
1971.
“It shows how reluctant firms
are to lay off labor at the present,” said John Ryding, economist at RDQ Economics. “As the
labor market gets tighter,
skilled workers are harder to
find and companies hold on to
the workers that they have.”
U.S. WATCH
TEXAS
GEORGE H.W. BUSH REMAINS
IN HOUSTON HOSPITAL
Former President George
H.W. Bush remained in
Houston Methodist Hospital on
Christmas Day after
experiencing shortness of
breath two days earlier. Family
spokesman Jim McGrath said
the 90-year-old is “still doing
well,” but didn’t offer details.
He previously said Mr. Bush
was hospitalized as a
precaution.
Mr. Bush, the oldest living
former American president,
suffers from a form of
Parkinson’s disease that has
forced him to rely on a
motorized scooter or
wheelchair.
—Associated Press
contacted
and
determined
through an assessment not to
have been exposed, officials said.
The incident occurred when a
sample that may have contained
the live Ebola virus was transferred from a high-security laboratory to a lab that wasn’t
equipped to handle the sample.
There was no possible exposure outside the CDC lab, and no
exposure or risk to the public,
CDC officials said.
“I am troubled by this incident in our Ebola research laboratory in Atlanta,” said CDC Di-
’14
The Wall Street Journal
In Detroit, Christmas Means Volunteering for Many Jews, Muslims
BY STEPHANIE ARMOUR
’10
regulatory oversight agencies,
officials said.
The agency also will report
the event to its external advisory
committee, which provides advice and direction for laboratory
science and safety. The CDC also
notified Sylvia Mathews Burwell,
secretary of the Department of
Health and Human Services.
“We take this incident very
seriously,’’ the health department said in a statement. “CDC
will be conducting a thorough
review and we will take all appropriate future steps.”
MISSOURI
ANOTHER SHOOTING LEAVES
ST. LOUIS REGION ON EDGE
After two nights of
demonstrations, the St. Louis
region remained on edge after
a white police officer in
Berkeley, Mo., killed a black 18year-old who police said
pointed a gun at him. The
death late Tuesday night of
Antonio Martin, 18 years old,
comes as tensions run high in
U.S. cities over the use of
deadly force by police.
The shooting happened just
miles from the town of
Ferguson, where the killing of
an unarmed black teenager by
a white police officer in August
sparked demonstrations that
turned violent at times.
Berkeley officials moved
quickly to keep the public from
drawing a connection to
Ferguson. Berkeley’s
population is more than 80%
black, and Mayor Theodore
Hoskins pointed to its large
number of black police officers
and African-American elected
officials. In Ferguson, the city’s
population is two-thirds
African-American, while its
city council and police force
are largely white.
The mayor also said, unlike
Ferguson, the shooting was
captured on a surveillance
camera and a weapon was
recovered from the scene.
—Ben Kesling
LOUISIANA
MALL SHOOTING CAUSES
HOLIDAY BEDLAM
A man who was shopping at
a suburban New Orleans mall
on Christmas Eve was shot to
death at close range and a
suspect was in custody, police
said. The incident caused
bedlam among shoppers less
than two hours before the
Oakwood Center mall in Gretna
was scheduled to close for the
holiday, said Jefferson Parish
Sheriff Newell Normand.
The victim had just
purchased something from
Foot Locker and had turned
from the cash register when a
man walked within 3 or 4 feet
of him and began shooting, Mr.
Normand said. No one else was
injured. Sheriff’s office
spokesman Col. John N.
Fortunato identified the victim
as 24-year-old James Vaughn
of Harvey. Mr. Normand said
the 25-year-old shooter was
apprehended several blocks
from the mall.
—Associated Press
NEW JERSEY
WOMAN RUN OVER AFTER
CHRISTMAS EVE MASS
Authorities say a woman
leaving Christmas Eve Mass in
New Jersey was struck and
killed by a minivan while
crossing the street.
Hammonton, N.J., police
said the 77-year-old woman
was struck by a Chevy Venture
after leaving St. Anthony of
Padua Roman Catholic church
on Wednesday evening. The
crash occurred at around 5:30
p.m. on Route 206 while the
woman was trying to get to
her car. She was pronounced
dead a short time later. The
50-year-old driver stopped at
the scene and police said no
charges have been filed.
—Associated Press
Program Struggles to Fight Fraud Without Restricting Care
Composite
Continued from Page One
50 million people who depend on
the program. “Preventing fraud,
abuse and waste are priorities”
and “hold equal importance with
creating and maintaining transparent and viable patient-doctor
relationships,” CMS said in a written statement.
Fixing some of the system’s
most pervasive problems—such
as doctors billing for lots of procedures that may not be medically necessary—would require
Medicare to change how it pays
providers, some former Medicare
officials said. That, in turn,
would necessitate an act of Congress, they said.
“Unless you change the rules
of the game in terms of how
Medicare pays, you’ll never fix
it,” said Gail Wilensky, who ran
Medicare in the early 1990s. Congress is “not going to voluntarily
make major changes in a program that is as popular as Medicare,” she said.
Two improvements could be
made without congressional involvement: tighter screening of
medical providers when they enroll
in the program, and more rigorous
enforcement to kick out bad actors.
CMS said it has implemented
stricter measures to vet new enrollees in recent years. And this
month, the Obama administration strengthened CMS’s authority to revoke billing privileges of
doctors and other providers with
a suspicious pattern of billing.
Current and former law-enforcement officials estimate that
fraud accounts for as much as
10% of Medicare’s yearly spending, or about $58 billion in fiscal
2013. Federal antifraud efforts
clawed back $2.86 billion in
Medicare funds that year.
CMS hasn’t publicly set a specific monetary goal for fraud reduction. In government programs, as in business, attempting
to eradicate all fraud is considered close to impossible—and
perhaps not even cost-effective,
given how expensive it can be.
One problem is that CMS
doesn’t have the resources to
deal with the sheer volume of
providers flooding the system.
Every month, some 45,000 new
providers, from doctors and
physical therapists to nursing
homes and ambulance operators,
apply to enroll in Medicare.
CMS has tightened some
screening requirements since
2011, hiring new contractors that
specialize in site visits. The
agency also has begun looking
for bad actors by checking the
fingerprints of, among others,
providers of home-health care
and durable medical equipment
like wheelchairs, two categories
with a history of fraud.
In some fraud hot spots around
the country, CMS has imposed
moratoria on the enrollment of
new home-health agencies and
ambulance operators. And it now
requires suppliers of prosthetics
and orthotics to submit $50,000
Booted
Number of medical providers
excluded from Medicare by the
Ofﬁce of Inspector General of the
Health and Human Services
Department
5,000
4,017
4,000
3,000
2,000
1,000
0
FY ’10 ’11
’12
’13
’14
Source: Health department’s Ofﬁce of
Inspector General
The Wall Street Journal
“surety” bonds before they can
start billing Medicare.
The most stringent vetting is
limited to provider categories
deemed to carry the highest risk of
fraud and abuse. Visiting every
new provider would be impractical, former Medicare officials say.
“If the cops stop and hassle
every single motorist, two things
happen: traffic congestion, and
you get political blowback,” said
Ted Doolittle, a former deputy
director of CMS’s antifraud unit.
Yet simple improvements to
the screening process would
make it easier to spot fake medical providers.
“Even to get a driver’s license,
you need to take a driver’s education course and pass a test,”
said Ryan Stumphauzer, former
head of the Medicare Fraud
Strike Force in Miami. “Why not
perform this type of commonsense screening before handing
out Medicare billing privileges?
Ask basic questions: Does the applicant have education, training
or experience in health care? Are
they versed in basic Medicare
rules and regulations?”
Some legislators say that once
bad providers are in the program,
CMS and its contractors aren’t
quick enough to kick them out.
Sen. Orrin Hatch, a Utah Republican, is expected in January
to become chairman of the Senate
Finance Committee, the committee that oversees Medicare. He
said much more needs to be done
“to weed out the bad actors.”
Sen. Hatch and Tom Coburn,
an Oklahoma Republican, in September 2011 sent CMS a list of
34 individuals who still had their
Medicare-billing privileges despite being convicted of, or
pleading guilty to, felonies such
as health-care fraud, tax evasion
and lewd and lascivious behavior.
CMS responded with a variety
of reasons why they might still
be enrolled, including that some
of the felonies were “not excludable offenses.”
Calling the response unacceptable, the senators criticized the
agency for not taking immediate
action. And they raised a 35th
name: Conrad Murray, Michael
Jackson’s personal physician.
Dr. Murray remained “a legitimate Medicare provider,” they
noted, even though California
had suspended his medical license and a jury had recently
convicted him of involuntary
manslaughter for providing the
pop star with the sedative that
caused his death.
Dr. Murray wasn’t excluded
from Medicare and Medicaid by the
health department’s Office of Inspector General until June 2012, although data show no billing by him
that year. He was released from
custody last year after serving two
years of a four-year sentence. His
lawyer, Valerie Wass, said “it’s going to be very difficult for him to
get a medical license again in this
country because of his conviction.”
A complicating factor is that
CMS and the inspector general—
two separate agencies within the
health department—have separate rules about when they can
act against medical providers.
Of the 34 felons on Sens. Hatch
and Coburn’s original list, 15
eventually were excluded from
Medicare and Medicaid by the inspector general, but some of the
exclusions didn’t take effect until
two to three years after a conviction or guilty plea. Another 16 are
no longer listed as program participants on Medicare’s website.
Three remain Medicare providers.
CMS declined to comment on
the individuals, citing the federal
Privacy Act. A spokesman for the
inspector general said the exclusion process takes time because
providers have extensive appeal
rights. He said the inspector general excluded 4,017 providers in
the 2014 fiscal year, up from
3,214 the proceeding year.
P2JW360000-2-A00200-1--------XA
MEDICARE
When CMS does act to curb
questionable billing, recouping the
money can be difficult. Providers
prevailed at least in part in 62% of
the nearly 600,000 Medicare appeals decided by administrativelaw judges since 2005, according
to a Journal analysis of data published by the health department’s
Office of Medicare Hearings and
Appeals. The government won just
26% of the time, and 12% of cases
were dismissed.
—Christopher Weaver
contributed to this article.
CORRECTIONS 
AMPLIFICATIONS
Readers can alert The Wall Street
Journal to any errors in news articles
by emailing [email protected] or
by calling 888-410-2667.
THE WALL STREET JOURNAL (USPS 664-880)
(Eastern Edition ISSN 0099-9660)
(Central Edition ISSN 1092-0935)
(Western Edition ISSN 0193-2241)
Editorial and publication headquarters:
1211 Avenue of the Americas,
New York, N.Y. 10036
Published daily except Sundays and general legal
holidays. Periodicals postage paid at New York, N.Y.,
and other mailing offices.
POSTMASTER: Send address changes to The Wall
Street Journal, 200 Burnett Rd., Chicopee, MA 01020.
All Advertising published in The Wall Street
Journal is subject to the applicable rate card,
copies of which are available from the Advertising
Services Department, Dow Jones & Co. Inc., 1155
Avenue of the Americas, New York, N.Y. 10036.
The Journal reserves the right not to accept an
advertiser’s order. Only publication of an
advertisement shall constitute final acceptance of
the advertiser’s order.
Subscriber Customer Service:
http://customercenter.wsj.com or
1-800-JOURNAL (800-568-7625)
Letters to the Editor:
Fax: 212-416-2891. Email: [email protected]
MAGENTA
BLACK
CYAN
YELLOW