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. 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