Category Archives: fraud

Consumer Alerts for ACA Enrollment: Watch Out for Half Truths and Scams

False Notices:  Some health plans in Washington State are sending letters to their current individual policy subscribers to tell them their current plan will end and they will be transferred to another one at the end of the year.  Some … Continue reading

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Feds Propose Major Shakeup of ER Billing; New research on Cadillac Tax; Virtual Health Care Expanding; $3.6 million in Life Sciences Grants; Deaths from Drug Resistant Germs; Showdown over ACA and Economy; Even Forbes Thinks ACA Will Help Small Businesses; Most States Expand Medicaid After All; and The Brain and Pain

In a major turnaround of allowed charges, the Feds want to change how hospitals are paid for ER and related care:  http://www.publicintegrity.org/2013/09/13/13420/feds-propose-shakeup-emergency-room-billing?utm_source=email&utm_campaign=watchdog&utm_medium=publici-email A first research study on the impact of the upcoming ACA Cadillac Tax coming in 2018:   http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=99 Franciscans expand … Continue reading

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Beware Insurance Exchange Scams; Win A Video Contest

I ran into this earlier when doing some research on health insurance exchanges in Florida for a friend. Scams are going to abound, especially in states where the Governors do not like Obamacare: http://www.kaiserhealthnews.org/Stories/2013/September/12/lookalike-exchange-websites.aspx Want to win a video contest? … Continue reading

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New Washington State Innovation Model (SIM) Grant; Lessons from IPAs and PHOs for Smaller Physician Practices; New Medical Malpractice Toolkit

Washington One of Three States to Receive Innovation Model Grant:  Plan to Create  Multi-Payer Payment and Health Care Delivery System:  Washington is one of only three states to receive a SIM Pre-Testing Award. The grant will enable state health care … Continue reading

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New Consumer Reports Ranks Hospitals on Safety; 2,225 Hospitals Fined for Readmissions; Behind the Scenes look at Quality, Outcomes and Physician Pay; and Now Drug and Medical Device Companies Must Report Financial Ties to Physicians and Hospitals

While the press focuses on exchanges and ACA enrollment and rates, much behind the scenes activities promise to transform health care.  Pricing and payment changes promise greater transparency, and now add to that transparency, the new move to shed light on … Continue reading

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Hot off the Press: Cost of Hospital Errors; DC Brinksmanship on ACA; New Online Coverage Options; Better Patient Safety with Improved Hospital Discharge; Coverage for ‘Alternative’ Providers; Now Is Not the Time to Cut Back on Fraud; And More!

Hot off the Press:  Leapfrog Group’s Calculator to Uncover Costs of Hospital Errors and Readmissions The Leapfrog group has developed a white paper and a calculator that uncover the hidden surcharge Americans pay for hospital errors. “We examine the costs purchasers … Continue reading

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Ugly, Expensive Fight Over ACA Implementation; Factors Impacting Rates and Costs in CA; A World of Scams Already; and Winners and Losers in Medicare Payment Reform

It’s going to be a long, ugly and expensive ACA implementation fight. http://www.thedailybeast.com/articles/2013/07/08/the-opening-salvo-of-2014.html?utm_medium=email&utm_source=newsletter&utm_campaign=cheatsheet_afternoon&cid=newsletter%3Bemail%3Bcheatsheet_afternoon&utm_term=Cheat%20Sheet http://www.washingtonpost.com/politics/white-house-ramps-up-effort-to-sell-obamacare/2013/07/09/f11e046c-e8a3-11e2-a301-ea5a8116d211_story.html?wpisrc=nl_politics http://www.nytimes.com/2013/07/10/us/politics/house-gop-pushes-delay-on-individual-mandate-in-health-law.html?nl=todaysheadlines&emc=edit_th_20130710 http://www.nytimes.com/2013/07/10/us/at-restaurant-delay-is-help-on-health-law.html?nl=todaysheadlines&emc=edit_th_20130710 A Summary of Factors Determining Insurance Premium Increases in California.  Must Read Chart on Page 6: Figure 1  See What Subsidies Do:  This is … Continue reading

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Hot Off the Press: State 2013 Health Care Budgets, ACA Implementation Headaches, New Approach to Drug Effectiveness Research and the High Cost of Maternity Care

While we are working on finishing our story on price transparency and executive compensation, here are some current highlights: Hot Off the Press: Health care measures and budgets passed out of Olympia: http://www.wsha.org/files/83/2013budgetproposalcomparisonchartFINAL.pdf Challenges to ACA Implementation: Sibelius told, stop … Continue reading

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Breaking News: Challenge to Catholic Hospital Mergers in Washington State, Medicare Solvency and More

Challenge of Catholic Hospital Systems and affiliations/purchase of publicly funded hospitals in Washington State. The ACLU and 10 Women’s Organizations sent a letter to Washington Governor Jay Inslee on May 31st, requesting a moratorium on any additional purchases/alliances of Catholic … Continue reading

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Special Report: Health Care as Creed, Greed and Compensation

Introduction:  Listening to all the debates, accounts and news about the Affordable Care Act took me back to my  book:  The Buck Stops Nowhere:  Why America’s Health Care Is All Dollars and No Sense, first published in 2001. In Chapter 4, … Continue reading

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