In yet another victory against medical fraudsters, federal officials running the Health Care Fraud and Abuse Program have been getting an average of $7.90 in returns for every dollar spent on health care fraud investigations — an all-time record.

As the Huffington Post reports, “the Justice Department opened more than 1,100 criminal health care fraud investigations last year involving 2,148 potential defendants, and over 800 defendants “were convicted of health care fraud-related crimes during the year and the department opened nearly 900 new civil investigations.”

Cutting down on Medicare and other health care fraud has been a top priority for the Obama Administration, and so far their efforts have been paying off. Last year, the Justice Department carried out one of the largest Medicare fraud busts in history, and the agency collected a record $3 billion in settlements from physicians and pharmaceutical companies under the auspices of the False Claims Act last year.

Fraud and abuse is an enormous source of waste in health care spending, with some studies estimating that it accounts for anywhere between a third and half of national health expenditures. Much of the initial projected savings in Obamacare stems from combating fraud — it would appear that, so far, those projections are correct.

Four-year-old Torrie Smith, a little girl in a low-income Colorado household, suffers from devastating dental health issues. Her plight could have been avoided with regular preventative dentist check ups, which would have been free for Torrie under Medicaid — but her mother Wendie didn’t know about the dental health benefits afforded to Torrie under the public insurance program until it was far too late.

Torrie’s issues underscore the considerable gaps in America’s dental health coverage system. Dental insurance remains elusive even for many who have employer-sponsored health coverage — some estimates peg the number of Americans forgoing dental care at over 100 million, with children and the poor being disproportionately affected. That’s particularly bad news considering that dental problems are lifelong problems, and poor dental health early on in life leads to a status quo in which over a quarter of elderly Americans over the age of 65 lose all of their teeth.

And as the Coloradoan reports, even Medicaid beneficiaries face a dearth of coverage due to low reimbursement rates for dentists accepting Medicaid patients:

State Medicaid data reported to the federal government show that less than half of the 453,000 Coloradans under age 21 who were eligible for benefits in federal fiscal year 2011 received some kind of dental service. Only a quarter of Colorado counties met a 2010 state goal of getting at least 44 percent of Medicaid-eligible residents under age 19 to visit a dentist, according to an I-News analysis of state records.

“Dental disease is not self-resolving,” says Diane Brunson, director of public health for the University of Colorado’s School of Dental Medicine. “It’s not like catching a cold and you put up with it for a week or 10 days and you’re fine. You have to get treatment. And it’s so much more beneficial all the way around — to the child, to their family, to taxpayers — if dental problems can be prevented.”

While the state appears to be making strides in improving its numbers, part of the problem is the paucity of dentists willing to see Medicaid children. Only 10 percent of Colorado’s 3,500 or so dentists are considered “significant” Medicaid providers, meaning that they are reimbursed for at least 100 visits per year. Moreover, 20 of Colorado’s 64 counties do not have a dentist who accepts Medicaid.

A large part of the problem has to do with a lack of knowledge regarding essential health care benefits, which leads to the vast majority of Americans not claiming preventative dental care that they are eligible for. “When she came along,” Wendie said of Torrie, “they gave me a (Medicaid) card and said it was for her doctor visits. They didn’t say dental or anything like that.” That’s nothing new when it comes to Americans and their preventative care benefits — only one in five Americans in high-deductible insurance plans know that much of their preventative care is free.

But as the Coloradoan’s article points out, it also has to do with Medicaid’s historically low reimbursements for doctors. Since states share a considerable amount of authority along with the federal government when it comes to determining Medicaid’s budget, the program is often an easy target for budget cuts. But those cuts carry with them a considerable human cost for some of America’s poorest residents. As ThinkProgress has consistently reported, that makes implementing Obamacare’s optional Medicaid expansion a medical imperative for the American poor — but as Torrie’s story shows, educating families about the care that they are eligible for is just as important.

Abortion opponents have rushed to introduce a slew of new abortion restrictions in the 2013 legislative session, attacking reproductive rights from all angles. But it’s not just about restricting access to existing medical procedures. Anti-choice activists are also looking ahead to the future, attempting to prevent medical technology from advancing to better accommodate women’s reproductive care.

Even though telemedical abortion services — which allow doctors to consult with their patients over a video conference and prescribe the RU-486 abortion pill remotely — can help expand reproductive care to women who wouldn’t be able to access it otherwise, abortion opponents are scaling a coordinated attack against the new technology. Decrying “webcam abortions” as an unsafe medical practice, despite the significant evidence to the contrary, anti-abortion lawmakers are increasingly advocating legislation to outlaw it. Here are five facts to keep in mind as the anti-choice community gears up for this fight:

1. Telemedicine is increasingly becoming a routine medical practice, and abortion is the only type of telehealth procedure that is tightly restricted. Telehealth, which first began being used in the 1960s to treat astronauts in space, has advanced over the past few decades to become a standard medical practice. In the past five years, telemedicine’s reach has quadrupled to treat 10 million Americans. The federal government has adopted the practice to treat chronically ill veterans. According to the chief executive officer of the American Telemedicine Association, abortion is the only area where lawmakers have restricted telemedicine. As Jordan Goldberg, the state advocacy counsel at the Center for Reproductive Rights, explained to Bloomberg, “There is a very clear division: Women are different, women who are attempting to access medication abortion are different.”

2. Nearly 95 percent of women who have telemedical abortions feel “very satisfied” with the procedure. Several studies have proven that telemedical abortion consultations are safe and effective. Despite anti-choice activists’ insistence that women must be face-to-face with their doctors, there is no difference between the women who visit a doctor’s office for a follow-up appointment after an abortion and the women who simply call to follow up instead. And 94 percent of women who terminate a pregnancy with the help of video technology report they feel “very satisfied” with their procedure.

3. Restricting telemedical abortion services disproportionately hurts low-income women in rural areas. Women who live in rural areas typically lack access to nearby abortion providers, and low-income women in particular often can’t afford the transportation to the closest health clinic. That problem is exacerbated by the mounting number of restrictions imposed on abortion providers, which narrows the pool of available abortion doctors even further. But after Iowa piloted the nation’s first telemedical abortion program, rural women’s abortion access significantly increased.

4. Allowing health clinics to practice telemedicine decreases the number of second-trimester abortions. If women in rural areas have more readily available options to access the reproductive care they need, they won’t have to put off having an abortion until they can travel to a surgical abortion clinic. The case study in Iowa proved that expanding access to the abortion pill through telemedical services can help lower second-trimester abortions. While abortion is still a very safe procedure when it is performed in the second trimester, earlier abortions do have a slightly lower chance of complications — and, of course, women who decide to terminate a pregnancy should not be forced to wait months to have the voluntary medical procedure.

5. Most of the states that are restricting telemedical abortion consultations don’t offer those services in the first place. At least ten states have banned the use of telehealth services to provide abortion care over the past several years, and another five are considering passing legislation to do so this year. But Bloomberg points out that telemedical abortions weren’t even being offered in the majority of those states the first place; Iowa is the sole state where lawmakers are considering a ban that would restrict a medical practice that is already in place. The anti-choice community — led by Americans United for Life, the anti-abortion group that drafted the language for the telemedicine bans — is working proactively to prevent the expansion of telemedical abortion services, particularly through indirect abortion restrictions that would require doctors to show women an ultrasound in person.

The Obama administration has ruled out raising the Medicare eligibility age from 65 to 67 as a means of reducing spending, White House Press Secretary Jay Carney announced during a briefing on Monday.

The measure — which the President floated as part of a larger deal to reduce the deficit in 2011 — is widely supported by Republicans, but would only save the federal government a net $5.7 billion, while shifting an added $11.4 billion in health care spending to states, employers, and individuals.

The proposal could also devastate the majority of seniors. While the richest Americans have fared well during the sluggish economic recovery, most Americans continue to struggle with falling wages and job uncertainty. According to a recent report from the Conference Board, 62 percent of workers between 45 and 60 plan to delay their retirements, a stark jump from 2010 — when 42 percent of workers planned a delay.

In an effort to cut costs, Gov. John Kasich (R-OH) is planning to hire a private food vendor to feed 50,179 inmates in the Ohio prison system. The administration argues the decision to outsource prison food will save as much as $16 million a year.

Motivated by a huge state deficit, Ohio has become a laboratory in prison reform — with mixed results. The state sold a prison to Corrections Corporation of America, a private prison company, in 2011, only to discover abysmal conditions far below state standards in sanitation, food quality, hygiene, and health care. However, Ohio’s new sentencing reforms are saving the state millions while diverting nonviolent offenders away from prison and into educational and rehabilitative programs.

Ohio’s taste for privatization is likely to make prison food even less appetizing than it already is. Private vendors can skimp on food quality, quantity, and staff in order to make a profit. Unlike state-run cafeterias, private vendors servicing juvenile detention facilities can skip the federal nutrition guidelines for school lunches:

The state Department of Youth Services, which has 469 youths at four detention facilities, spends $6.18 million a year, or $27.60 per inmate per day for food service, said spokeswoman Kim Parsell. The costs are higher because youths don’t help with food prep or cooking, the meals adhere to federal guidelines for school lunches and the teen-aged detainees have higher caloric needs, she said. The state receives $5.51 per day per youth as reimbursement from the national school lunch program. Switching to a private vendor is expected to save DYS about $1.2 million a year, she said.

The Ohio Civil Service Employees Association, the union that represents some 10,000 prison workers, warns that a contractor will pay lower wages, hire fewer people and dish out less food to make a profit. Roughly, 450 state workers in DYS and DRC could end up losing their jobs, though some could apply for other state jobs or perhaps be hired by the contractor.

Tim Shafer, OCSEA operations director, said complaints about inmate food may sound like whining but they contribute to the safety and security of a prison.
“As a former corrections officer, I can tell you one of the best things in the world is a full inmate. They want to sit down and chill out,” Shafer said. Inmates are fed a heart healthy diet that features a rotating menu of dinners such as sloppy joes, fajitas, and chicken and biscuits.

Poor food quality and sanitation have sparked multiple deadly riots at private prisons run by corporations like CCA and GEO Group. In one prison, inmates were fed soup filled with worms, while other prisons served burritos and brownies contaminated with human feces.

The cost-saving claim of the plan is also dubious; Ohio’s last flirtation with Aramark in 1998 ended because the company insisted on being paid by daily inmate count rather than by actual meals served, which drove up costs by $2 million.

U.S. teen birth rates have dropped to a record low, down nearly 50 percent since 1991, according to the most recent data from the National Center for Health Statistics. There was only a slight decline in the number of teens having sex, suggesting that more adolescents are preventing pregnancy by practicing safer sex.

Experts caution that since the new study didn’t investigate teen behavior, they can’t say exactly what caused the drop in teenage pregnancies — but they suspect some encouraging trends in contraceptive use played a role. Laura Lindberg, a senior researcher at the Guttmacher Institute, told NBC News that teens are increasingly opting to use more effective forms of birth control as soon as they become sexually active, and the adolescents who use birth control during their first sexual experiences are more likely to use it down the road.

And Lindberg explained that several new policies — including guidelines encouraging doctors to prescribe long-lasting forms of contraception, new Obamacare rules removing cost barriers to birth control, and guidelines easing some of the hurdles to obtaining a birth control prescription — have helped ensure that teens now have better access to the best forms of birth control:

The Centers for Disease Control and Prevention has changed its guidelines on contraception, and now recommends long-acting birth control methods such as IUDs, which are devices implanted in the uterus, and hormonal birth control drug implants, as the first-line contraceptives offered to teens. “The reason that is important is failure rates are much lower,” Lindberg said. [...]

The Obama administration rules now require health insurers to provide birth control care for free, without even a co-pay.

Another important change — fewer doctors now require teenagers to get full pelvic exams before they will prescribe birth control. New federal guidelines say a woman doesn’t need such an exam before she’s 21, even if she is sexually active.

“We think that’s lowered what we call the psychic barrier to getting prescription contraception methods,” Lindberg said. “For teenaged girls that first (exam) can be frightening.”

But there’s even more the U.S. could do to make contraception more readily available to the young women who need it. The United States currently uses an antiquated system of tying birth control prescriptions to annual gynecological check-ups, and the American College of Obstetricians and Gynecologists has recommended that the U.S. put an end to that practice and make birth control available over the counter — which most countries around the world already do.

And increasing access to all types of birth control, including emergency contraception, could also make a difference. The Department of Health and Human Services still requires women under the age of 17 to obtain a prescription for Plan B, even though health officials have come out in opposition to the unnecessary federal policy. Particularly since a right-wing smear campaign has falsely construed emergency contraception as an abortifacient, the stigma surrounding Plan B can make it difficult for young adults to access that type of birth control — but, as a pilot program in New York City demonstrates, making Plan B available to teens can drastically lower unplanned pregnancies.

As part of his state’s new budget, Virginia Gov. Bob McDonnell (R) and his administration are trying to force potentially tens of thousands of public sector employees in the state to work fewer hours so that the government can avoid providing them health care.

Under Obamacare, employers are required to offer health insurance options for any employee working 30 hours or more per week. So McDonnell and his team have slipped language into the state’s budget bill requiring that any hourly waged workers employed by the state put in no more than 29 hours a week.

The rule applies to a range of state employees, including adjunct college professors:

The 29-hour limit is on its way to becoming state law, thanks to language inserted into the state budget at the request of Gov. Bob McDonnell’s administration. The language appears in both versions of the budget adopted Thursday by the Senate and House of Delegates.[...]

Anticipating legislative approval of the policy, the state Department of Human Resource Management has advised all state agencies to implement it now.

The state has more than 37,000 wage employees. More than 7,000 of them have been working at least 30 hours a week, according to a recent survey taken by the department.

Other public universities have made the same shift to lower hours for employees to avoid providing them with basic health benefits. But the anti-labor practice is more prevalent in the private sector, where a huge number of businesses in the restaurant industry — including Applebee’s, Olive Garden, and Denny’s — seek to pass the cost of health care onto their low-wage employees by limiting their hours. Workers who don’t receive employer-based coverage will be able to find insurance through the public exchanges.