Ricky Martin finds new home on small screen

NEW YORK (AP) — Ricky Martin is saying goodbye to Broadway's "Evita." But don't cry for him.

The Latin superstar has a slew of new projects in the works, including two television series and a children's book.

"It's about growing," said Martin in an interview Friday. "It's a moment in my life where I just need to absorb and be surrounded by amazing actors and musicians and grow as an entertainer. I think this is going to be an amazing year for that."

Martin takes his final bow in the Andrew Lloyd Webber revival on Jan. 26. Then he heads down under to join the second season of the Australian edition of "The Voice." But the Grammy winner says not to expect any biting, Simon Cowellesque critiques.

"I don't believe in tough love. I believe in love, and I believe in being nurturing to new talented men and women," he said at an M.A.C. Viva Glam event for Saturday's World AIDS Day. Martin partnered with the cosmetics brand to raise awareness and funding for HIV/AIDS programs worldwide.

The "Livin' la Vida Loca" singer is developing a new series for NBC, expected in 2013. He's producing, writing and will star in the currently untitled dramedy, where he hopes to tackle social issues with humor.

He's also writing his second book and admitted he didn't have to look far for inspiration.

"I think it's time to write about things that I've been through with my kids that I'm sure many daddys out there will understand," said the father of 4-year-old twins Matteo and Valentino.

The family-friendly story about self-esteem is slated for release next summer.

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AP writer Sigal Ratner-Arias contributed to this story.

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Follow Nicole Evatt on Twitter at http://twitter.com/NicoleEvatt

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Opinion: A Health Insurance Detective Story





I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?




After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?


The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.


Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.


But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?


A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.


Here’s a snapshot of my surreal experience:


NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.


Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”


I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.


NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.


NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.


My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.


NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.


Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.


But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.


NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.


CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.


NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.


Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.



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After a billion, what next for Facebook?









MENLO PARK — In just eight years, Facebook signed up more than half the world's Internet population.


Now it's going after the rest.


Facebook wants to reach every single person on the Internet whether they are logging on from a laptop in Santa Monica, an iPhone in Tokyo or a low-tech phone with a tiny screen in Nairobi.





It's parachuting into market after market to take on homegrown social networks by currying favor with the locals and venturing where many people have spotty — if any — access to the Internet.


In Japan, it lets users list their blood types, which the Japanese believe — like astrological signs in the Western world — give insight into personality and temperament. In Africa, Facebook markets a stripped-down, text-only version of its service that works on low-tech mobile phones.


International growth is crucial to maintain its dominance as the world's largest social network. The company's scorching pace of growth has cooled especially in the United States. Facebook must coax users to sign up — and make sure it remains popular with the users it already has — or risk being knocked from its lofty perch.


"We're not a company that is just trying to add more people," said Chris Cox, Facebook's vice president of product. "What we are trying to do is build a service that everyone in the world can use."


But overseas growth that once seemed to come so easily is slower now. Facebook has already saturated most major markets around the globe. Eight out of 10 Facebook users are outside of the U.S.


"I don't think that Facebook has a chance of attracting another billion users," Wedbush Securities analyst Michael Pachter said.


Inside Facebook's Menlo Park, Calif., headquarters is a small army out to prove naysayers wrong. Above their desks they have hung flags from around the world that represent their nationalities. They obsessively scan screens that track user growth around the world.


They cheered and popped open champagne in September when the number of active Facebook users crossed 1 billion. But the moment of jubilation quickly passed as they redoubled their efforts to spread Facebook around the globe.


Naomi Gleit is the soft-spoken, headstrong 29-year-old product manager in charge of growth at Facebook. She says Facebook's future is on mobile devices, the medium by which most people will experience the Web in coming years. Facebook now works on more than 2,500 different phones, helping it gain a foothold in emerging markets. And it is forging relationships with mobile phone operators around the world.


Gleit's 150-member team has boots on the ground in far-flung places armed with low-tech phones and cheap data plans. Even team members here carry Nokia phones alongside their iPhones to update their status or check their News Feed.


"We originally built a product for ourselves," Gleit said. "This is different. Now we need to understand the experience of users who are not like us."


Analysts say Facebook already has established an impressive track record of uprooting entrenched competitors. In Britain, it displaced the dominant social network Bebo, forcing AOL to sell it at a huge loss. In Germany, Facebook overtook the homegrown StudiVZ. Facebook even broke Google social network Orkut's stranglehold on Brazil and India.


In 2009, it launched a clever tool to help Facebook users find their Orkut friends on Facebook and instantly send them friend requests. Two years later it swiped Google's top executive in Latin America, Alexandre Hohagen. Facebook sprinted ahead of Orkut one year ago, and now has 61 million active users in Latin America's largest country.


Facebook is treating India as a test lab for how it can spread in other emerging markets such as Indonesia. Facebook, which has offices in Hyderabad, India, has grown from 8 million users in 2010 to 65 million users today. It is aggressively targeting India's youth. A few hundred young Indian programmers recently jammed a Facebook hackathon at a Bangalore convention center to chug chai and brainstorm new apps that would appeal to their friends.


But Facebook has its eyes on a much bigger prize beyond the country's 100 million Internet users: the 900 million-plus Indians on mobile phones. Some analysts predict India will have more Facebook users than any other country including the United States by 2015.


The company also faces significant challenges in India. It must make the service captivating on low-tech mobile phones with unreliable Internet connections and it must gingerly navigate demands from the Indian government to remove objectionable content without alienating users.


Facebook is making some of its biggest moves in Russia, South Korea and Japan, the only major markets where it operates but has penetration of less than 50%, according to research firm ComScore.





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Student scores may be used in LAUSD teacher ratings









After months of tense negotiations, leaders of the Los Angeles Unified School District and its teachers union have tentatively agreed to use student test scores to evaluate instructors for the first time, officials announced Friday.


Under the breakthrough agreement, the nation's second-largest school district would join Chicago and a growing number of other cities in using test scores as one measure of how much teachers help their students progress academically in a year.


Alarm over low student performance, especially in impoverished and minority communities, has prompted the Obama administration and others to press school districts nationwide to craft better ways to identify struggling teachers for improvement.





The Los Angeles pact proposes to do that using a unique mix of individual and schoolwide testing data — including state standardized test scores, high school exit exams and district assessments, along with rates of attendance, graduation and suspensions.


But the tentative agreement leaves unanswered the most controversial question: how much to count student test scores in measuring teacher effectiveness. The school district and the union agreed only that the test scores would not be "sole, primary or controlling factors" in a teacher's final evaluation.


"It is crystal clear that what we're doing is historic and very positive," said L.A. Supt. John Deasy, who has fought to use student test scores in teacher performance reviews since taking the district's helm nearly two years ago. "This will help develop the skills of the teaching profession and hold us accountable for student achievement."


Members of United Teachers Los Angeles, however, still need to ratify the agreement. Many teachers have long opposed using test scores in their evaluations, saying test scores are unreliable measures of teacher ability.


The union characterized the agreement as a "limited" response to a Dec. 4 court-ordered deadline to show that test scores are being used in evaluations and said negotiations were continuing for future academic years. The deadline was imposed by Los Angeles County Superior Court Judge James C. Chalfant, who ruled this year that state law requires L.A. Unified to use test scores in teacher performance reviews.


In a statement, the teachers union also emphasized that the agreement rejected the use of the district's method of measuring student academic progress for individual instructors. That measure, called Academic Growth Over Time, uses a mathematical formula to estimate how much a teacher helps students' performance, based on state test scores and controlling for such outside factors as income and race. Under the agreement, however, schoolwide scores using this method, also known as a value-added system, will be used.


For individual teachers, the agreement proposes to use raw state standardized test score data. Warren Fletcher, teachers union president, said that data give teachers more useful information about student performance on specific skills.


Critics of using test scores in teacher reviews praised Los Angeles' proposed new system, saying it uses a wide array of data to determine a teacher's effect on student learning.


Deasy said he will be developing guidelines for administrators on how to use the mix of data in teacher reviews and has said in the past that test scores should not count for more than 25% of the final rating.


"This is a complex agreement and possibly the most sophisticated evaluation agreement that I have seen," said Diane Ravitch, an educational historian and vocal critic of the use of test scores in teacher evaluations. "It assures that test scores will not be overused, will not be assigned an arbitrary and inappropriate weight, will not be the sole or primary determinant of a teacher's evaluation."


Teacher Brent Smiley at Lawrence Middle School in Chatsworth said: "I will vote yes. I have no doubt that my union leaders negotiated the best they could, given the adverse set of circumstances they faced."


Labor-relations expert Charles Kerchner called the agreement "a shotgun wedding," but added, "I think it's unabashed good news."


He said it's notable that value-added measures and test scores have been accepted in some form by the teachers union.


"UTLA has moved beyond a strategy of just saying no to a strategy of trying to craft a useful agreement," said Kerchner, a professor at Claremont Graduate University.


The district is currently developing a new evaluation system that uses Academic Growth Over Time — along with a more rigorous classroom observation process, student and parent feedback and a teacher's contributions to the school community. The new observations were tested last year on a voluntary basis with about 450 teachers and 320 administrators; this year, every principal and one volunteer teacher at each of the district's 1,200 schools are expected to be trained.


The teachers union has filed an unfair labor charge against the district, arguing that the system is being unilaterally imposed without required negotiations.


Some teachers who have participated in the new observation process say it offers more specific guidance on how they can improve. Other educators — teachers and administrators alike — complain that it is too time-consuming.


The tentative agreement, acknowledging the extra time the new evaluations would take, would extend the time between evaluations from two to as long as five years for teachers with 10 or more years of experience.


Bill Lucia of EdVoice, the Sacramento-based educational advocacy group that brought the lawsuit, said he was "cautiously optimistic."


But he expressed dismay that the union did not reach agreement a few weeks earlier, which he said would have given L.A. Unified a shot at a $40-million federal grant. The district applied for the Race to the Top grant without the required teacher union support and was eliminated from the competition this week.


Negotiations over the tentative pact, however, nearly fell apart. Earlier this week, the union pulled away from the deal on the table, L.A. Unified officials said. And the district discussed holding a Monday emergency school-board meeting to craft a formal response to the court order in anticipation that no deal would be reached. The options included adopting an evaluation system without the union's consent.


Some members of the Board of Education, who also will need to approve the pact, praised the agreement for taking student growth and achievement into account but gauging this growth through multiple measures. Steve Zimmer said that, just as important, this milestone was achieved through negotiation.


School board President Monica Garcia praised the tentative deal as "absolutely, by all accounts, better than what we have today."


teresa.watanabe@latimes.com


howard.blume@latimes.com





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Zynga shares slide after privileged status with Facebook ends












(Reuters) – Shares of gaming company Zynga Inc fell as much as 10 percent, a day after the “Farmville” creator reached an agreement with Facebook Inc that reduces its dependence on the social networking giant.


The companies reported in regulatory filings on Thursday that they have reached an agreement to amend a 2010 deal that was widely seen as giving Zynga privileged status on the world’s No.1 social network.












Zynga gets a freer hand to operate a standalone gaming website, but gives up its ability to promote its site on Facebook and to draw from the thriving social network of about 1 billion users.


“Although Zynga investors have reacted negatively to Thursday’s announcements so far, we view them as a long-term positive for both companies,” Wedbush Securities analyst Michael Pachter said in a note to clients.


“Zynga now has an advantage to offer more payment options which could result in additional subscribers who are not Facebook users,” he said, maintaining his “outperform” rating and price target of $ 4 on the stock.


Both internet companies have been trying to reduce their interdependence, with Zynga starting up its own Zynga.com platform, and Facebook wooing other games developers.


In recent quarters, fees from Zynga contributed 15 percent of Facebook’s revenue, while Zynga relies on Facebook for roughly 80 percent of its revenue.


Francisco-based Zynga’s shares were down 7 percent at $ 2.44 in morning trading on the New York Stock Exchange on Friday.


Facebook shares were down more than 1 percent at $ 26.98.


(Reporting By Aurindom Mukherjee in Bangalore; Editing by Don Sebastian)


Tech News Headlines – Yahoo! News


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Glen Campbell considering more live shows in 2013

NASHVILLE, Tenn. (AP) — Glen Campbell may be wrapping up a goodbye tour but that doesn't mean he's done with the stage.

Campbell is considering scheduling more shows next year after playing more than 120 dates in 2012.

The 76-year-old singer has Alzheimer's disease and has begun to lose his memory. He put out his final studio album, "Ghost on the Canvas," in 2011 and embarked on the tour with family members and close friends serving in his band and staffing the tour.

Campbell's longtime manager Stan Schneider said in a phone interview from Napa, Calif., where the tour wrapped for the year Friday night, that recent West Coast shows have been some of the singer's strongest. Campbell will break for the holidays and if he still feels strong he'll begin scheduling more shows.

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Online:

http://glencampbellmusic.com

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First marine wilderness in continental U.S. is designated









The federal government cleared the way Thursday for waters off the Northern California coast to become the first marine wilderness in the continental United States, ending a contentious political battle that pitted a powerful U.S. senator against the National Park Service.


Interior Secretary Ken Salazar settled the dispute by refusing to extend a permit for a commercial oyster farm operating in Point Reyes National Seashore. Congress designated the area as potential wilderness in 1976 but put that on hold until the farm's 40-year federal permit ended.


As the expiration date approached, the farm became the center of a costly and acrimonious fight that dragged on more than four years, spawned federal investigations and cost taxpayers millions of dollars to underwrite scores of scientific reviews.





"I believe it is the right decision for Point Reyes National Seashore and for future generations who will enjoy this treasured landscape," Salazar said Thursday. The area includes Drakes Estero, an environmentally rich tidal region where explorer Sir Francis Drake is believed to have made landfall more than 400 years ago.


Salazar's decision drew a sharp response from Sen. Dianne Feinstein, who had championed the Drakes Bay Oyster Co. in its fight with the government. Feinstein said in a statement that she was "extremely disappointed" with Salazar's decision.


She had argued that the National Park Service contorted scientific studies to make the case that oyster harvesting operations caused environmental harm to Drakes Estero, a dramatic coastal sweep of five bays in Marin County north of San Francisco.


"The National Park Service's review process has been flawed from the beginning with false and misleading science," her statement said. "The secretary's decision effectively puts this historic California oyster farm out of business. As a result, the farm will be forced to cease operations and 30 Californians will lose their jobs."


Feinstein had attached a rider to an appropriations bill giving Salazar the unusual prerogative to extend the farm's permit. The company was seeking a 10-year extension of its lease.


Salazar said he gave the matter serious consideration, including taking into account legal advice and park policies. He directed the park service to develop a jobs-training plan for the oyster company's employees and to work with the local community to assist them in finding employment.


The company will have 90 days to remove its racks and other property from park land and waters. When that occurs, the 2,500-acre Drakes Estero will be managed as wilderness, with prohibitions on motorized access to the waterway but allowances for snorkeling, kayaking and other recreation.


The new wilderness will become only the second marine protected area in the national park system and the first in the Lower 48 states. The only current marine wilderness is 46,000 acres in Alaska's Glacier Bay National Park and Preserve.


Environmental groups applauded the decision, which they lobbied for.


"We are ecstatic that this ecological treasure will be forever protected as marine wilderness," said Amy Trainer, executive director of the Environmental Action Committee of West Marin.


The heart of the debate is an agreement that Kevin Lunny and his family inherited when they took over a failing oyster operation in the park in 2004. That lease with the park service stipulated that the business would cease operations in 2012.


Kevin Lunny has from the beginning sought to stay on the property and continue harvesting oysters. His farm has an extensive record of violating state and federal agreements and permits. The California Coastal Commission has fined the farm for various violations, issued two cease and desist orders and repeatedly requested that the Lunnys acquire a coastal development permit.


The state agency initiated another enforcement action against the farm earlier this month.


Lunny could not be reached for comment.


The farm's mariculture operation has found support among west Marin County's advocates for sustainable agriculture, who agreed with Lunny that federal and state agencies were unfairly hounding his operation.


His travails have caused alarm among the historic cattle and dairy ranches that operate within the national seashore in a designated pastoral zone. Park officials have repeatedly said they have no intention of curtailing ranching operations, and Salazar echoed that, adding that he wished to extend the terms of the ranch leases from 10 to 20 years.


The Lunny family also has a cattle operation in the park.


julie.cart@latimes.com





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Taking a page from Louis C.K., Chill launches online store for films, comedy specials












NEW YORK (TheWrap.com) – Chill, a social video platform with close to 20 million users, has launched Chill Direct, a new store for creatives like Maria Bamford and Michael Urie to sell their movies, specials and documentaries directly to fans.


Comedian Louis C.K. sent shockwaves through the entertainment industry this summer by selling a comedy special directly online rather than making a distribution deal with a television network or online service. He made millions, and various others have followed suit, including Jim Gaffigan and Aziz Ansari.












Chill sees an opportunity to enter this emerging market, empowering artists and offering them an opportunity to control the distribution and monetization of their ongoing projects.


“The community gives filmmakers and comedians the ability to distribute premium video directly to fans,” CEO Brian Norgard told TheWrap. “The common analogy is to Louis C.K. and his ‘Live at Beacon Theater.‘ That was a seminal moment in the entertainment business and a lot of things now allow direct-to-fan to become a viable model.”


Artists who choose to sell through Chill also can sell their videos elsewhere, but Chill Direct launches with eight videos exclusive to the site. That slate includes “Maria Bamford: the Special Special Special!,” an hour-long comedy special starring Bamford, “Thank You For Judging,” a documentary from “Ugly Betty” actor Urie about high school speech and debate and “Unknown Sender,” a suspense series from “48 Hrs” and “Die Hard” scribe Stephen E. de Souza.


Starting Thursday, any artist can create a page for a project and has complete creative control over the page, from information about the project to trailers to pricing. Meanwhile, Chill handles distribution across devices as well as payments.


Artists retain rights to their own intellectual property while Chill takes a 30 percent cut of any transaction.


“What Chill does is let anyone build out socially integrated marketing pages – we call them story pages – beautiful, high-resolution tantalizing receptacles of premium videos,” Norgard said.


Chill, funded by WME and Kleiner Perkins Caulfield & Byers and others, has previously enabled frictionless uploading, consumption and sharing of the web’s most popular videos. This maintains a social layer, allowing for commenting and offering bundles that combine the video with other perks like merchandise or meeting the creator.


“The land of premium video is still a very closed marketplace,” Norgard said. “If you have tremendous business development skills or connections to sell a film to Netflix or Hulu, you’re lucky. The ad-supported model doesn’t fit every type of content. There is plenty of stuff out there like documentary films and comedy specials where creators are between a rock and a hard place and wan to get it out there, distribute it, own the right but not put it on a free streaming site like YouTube.”


Selling direct to fans also offers a new revenue stream to a company that until now was mostly luring people a few times a day for videos.


Internet News Headlines – Yahoo! News


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Adkins explains Confederate flag earpiece

NEW YORK (AP) — Trace Adkins wore an earpiece decorated like the Confederate flag when he performed for the Rockefeller Center Christmas Tree Lighting but says he meant no offense by it.

Adkins appeared with the earpiece on a nationally televised special for the lighting on Wednesday. Some regard the flag as a racist symbol and criticized Adkins in Twitter postings.

But in a statement released Thursday, the Louisiana native called himself a proud American who objects to any oppression and says the flag represents his Southern heritage.

He noted he's a descendant of Confederate soldiers and says he did not intend offense by wearing it.

Adkins — on a USO tour in Japan — also called for the preservation of America's battlefields and an "honest conversation about the country's history."

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Online:

http://www.traceadkins.com

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Medicare Is Faulted in Electronic Medical Records Conversion





The conversion to electronic medical records — a critical piece of the Obama administration’s plan for health care reform — is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators.







Mike Spencer/Wilmington Star-News, via Associated Press

Celeste Stephens, a nurse, leads a session on electronic records at New Hanover Regional Medical Center in Wilmington, N.C.







Centers for Medicare and Medicaid Services

Marilyn Tavenner, acting administrator for Medicare.






The use of electronic medical records has been central to the aim of overhauling health care in America. Advocates contend that electronic records systems will improve patient care and lower costs through better coordination of medical services, and the Obama administration is spending billions of dollars to encourage doctors and hospitals to switch to electronic records to track patient care.


But the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.


Medicare “faces obstacles” in overseeing the electronic records incentive program “that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements,” the investigators concluded. The report was prepared by the Office of Inspector General for the Department of Health and Human Services, which oversees Medicare.


The investigators contrasted the looser management of the incentive program with the agency’s pledge to more closely monitor Medicare payments of medical claims. Medicare officials have indicated that the agency intends to move away from a “pay and chase” model, in which it tried to get back any money it has paid in error, to one in which it focuses on trying to avoid making unjustified payments in the first place.


Late Wednesday, a Medicare spokesman said in a statement: “Protecting taxpayer dollars is our top priority and we have implemented aggressive procedures to hold providers accountable. Making a false claim is a serious offense with serious consequences and we believe the overwhelming majority of doctors and hospitals take seriously their responsibility to honestly report their performance.”


The government’s investment in electronic records was authorized under the broader stimulus package passed in 2009. Medicare expects to spend nearly $7 billion over five years as a way of inducing doctors and hospitals to adopt and use electronic records. So far, the report said, the agency has paid 74, 317 health professionals and 1,333 hospitals. By attesting that they meet the criteria established under the program, a doctor can receive as much as $44,000 for adopting electronic records, while a hospital could be paid as much as $2 million in the first year of its adoption. The inspector general’s report follows earlier concerns among regulators and others over whether doctors and hospitals are using electronic records inappropriately to charge more for services, as reported by The New York Times last September, and is likely to fuel the debate over the government’s efforts to promote electronic records. Critics say the push for electronic records may be resulting in higher Medicare spending with little in the way of improvement in patients’ health. Thursday’s report did not address patient care.


Even those within the industry say the speed with which systems are being developed and adopted by hospitals and doctors has led to a lack of clarity over how the records should be used and concerns about their overall accuracy.


“We’ve gone from the horse and buggy to the Model T, and we don’t know the rules of the road. Now we’ve had a big car pileup,” said Lynne Thomas Gordon, the chief executive of the American Health Information Management Association, a trade group in Chicago. The association, which contends more study is needed to determine whether hospitals and doctors actually are abusing electronic records to increase their payments, says it supports more clarity.


Although there is little disagreement over the potential benefits of electronic records in reducing duplicative tests and avoiding medical errors, critics increasingly argue that the federal government has not devoted enough time or resources to making certain the money it is investing is being well spent.


House Republicans echoed these concerns in early October in a letter to Kathleen Sebelius, secretary of health and human services. Citing the Times article, they called for suspending the incentive program until concerns about standardization had been resolved. “The top House policy makers on health care are concerned that H.H.S. is squandering taxpayer dollars by asking little of providers in return for incentive payments,” said a statement issued at the same time by the Republicans, who are likely to seize on the latest inspector general report as further evidence of lax oversight. Republicans have said they will continue to monitor the program.


In her letter in response, which has not been made public, Ms. Sebelius dismissed the idea of suspending the incentive program, arguing that it “would be profoundly unfair to the hospitals and eligible professionals that have invested billions of dollars and devoted countless hours of work to purchase and install systems and educate staff.” She said Medicare was trying to determine whether electronic records had been used in any fraudulent billing but she insisted that the current efforts to certify the systems and address the concerns raised by the Republicans and others were adequate.


This article has been revised to reflect the following correction:

Correction: November 30, 2012

An article on Thursday about a federal report critical of Medicare’s performance in assuring accuracy as doctors and hospitals switch to electronic medical records misstated, in some copies, the timing of a statement from a Medicare spokesman in response to the report. The statement was released late Wednesday, not late Thursday.



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