It’s that time of year again. Insurance companies that participate in the Affordable Care Act’s state health exchanges are signaling that prices will risedramatically this fall.And if insurance costs aren’t enough of a crisis, researchers are highlighting deficiencies in health care quality, such as unnecessary tests and procedures that cause patient harm, medical errors bred by disjointed or fragmented care and disparities in service distribution.While critics emphasize the ACA’s shortcomings, cost and quality issues have long plagued the U.S. health care system. As my research demonstrates, we have these problems because insurance companies are at the center of the system, where they both finance and manage medical care.If this system is so flawed, how did we get stuck with it in the first place?Answer: organized physicians.As I explain in my book, “Ensuring America’s Health: The Public Creation of the Corporate Health Care System,” from the … [Read more...] about Viewpoints: Why insurance companies control your health care
Government employee insurance company
CHARLESTON — Secretary of State Mac Warner said Monday he continues to stand behind his decisions to fire 16 workers shortly after taking office in 2017 even if the state insurance company doesn’t. Warner’s comments came hours after it was announced the state Board of Risk and Insurance Management had decided to settle four of the 12 lawsuits filed against Warner. “The way this State handles lawsuits by way of insurance settlements needs to be completely redone,” Warner said in a statement, calling on the state legislature to revamp the process. Currently when an agency head is sued the case goes directly to BRIM and the elected official or agency head doesn’t have a say in whether a lawsuit should be settled. “It’s a process with no oversight, where the lawyers keep getting richer off the deep pockets of the state, the state’s insurance carrier and the taxpayers,” Warner said. According to Warner, BRIM spends an average … [Read more...] about Former Secretary of State employees settle wrongful termination lawsuit for $1M; Warner says firing was warranted
Bill Moak Consumer Watch Published 6:00 AM EST Nov 12, 2018 Health care has become a big issue for many Americans over the past few years. As the costs of health care continue to rise, families without health insurance are looking for ways to afford those costs. That can make them vulnerable to companies that take their money without providing needed services. This week, the Federal Trade Commission requested that a federal judge shut down a Florida-based operation that it accused of collecting more than $100 million “by preying on Americans in search of health insurance, selling these consumers worthless plans that left tens of thousands of people uninsured.” In a news release, the FTC accused Simple Health Plans of “misleading customers into thinking they were buying comprehensive health insurance” but instead provided little in exchange for the $500-per- month cost. Many customers found themselves holding the bag for thousands in unreimbursed medical … [Read more...] about Is that health insurance company a sham?
Insurance companies used to be able to consider New York state drivers' occupation and level of education when setting auto insurance rates. No longer. State regulators say the practice punished lower-educated workers in lower-paying jobs, without proof that those drivers were a higher risk behind the wheel. The state Department of Financial Services implemented the change last year, and it has filtered down to customers as their policies have been renewed. Some drivers – mainly those with more advanced educations and what are perceived by insurers to be low-risk jobs – are paying more than they were before. Some of the increases approached 10 percent. And others are paying less. Maria T. Vullo, the state Department of Financial Services superintendent, said the change stemmed from a "multiyear investigation" that found some insurers were using a person's education level to help determine what to … [Read more...] about Education, occupation no longer factors in New York State auto insurance rates
BOSTON – A physician convicted of fraudulently billing Medicare and private insurance companies while operating a “dangerous pain management practice” and dispensing large quantities of narcotics to addicted patients was sentenced to more than 6 years in prison and ordered to pay $1.8 million in restitution.Moustafa Moataz Ibrahim Aboshady, 36, of Lake Forest, Calif., was found guilty of one count of conspiracy to make false statements in connection with health care benefit programs and two counts of making false statements in connection with health care benefit programs by a federal jury in September.He was sentenced Wednesday by U.S. District Court Judge Nathaniel M. Gorton to 75 months in prison, three years of supervised release and ordered to pay restitution in a scheme to conspire to falsify patient medical records to obtain insurance payments for medical services that were not performed, said Christina DiLorio-Sterling, spokeswoman for U.S. Attorney Andrew E. … [Read more...] about Physician sentenced to 6 years in prison for operating ‘dangerous pain clinic,’ bilking insurance companies