“Carondelet Health Network, a Tucson, Ariz.-based division of Ascension Health, has agreed to pay $35 million to settle allegations that two of its hospitals inappropriately billed Medicare and other federal health programs for inpatient rehabilitation care.
The settlement is the highest amount paid in Arizona under the False Claims Act, according to the U.S. attorney’s office in Phoenix. From 2004 to 2011, the Justice Department alleged, the Carondelet hospitals billed the government for inpatient rehab services for patients who didn’t meet coverage criteria.
The Roman Catholic hospital system “expressly denies” the allegations in the settlement agreement.”
“Investigative journalist Sharyl Attkisson is taking the federal government to court.
Attkisson, a senior independent contributor to The Daily Signal, filed the lawsuit against the Department of Health and Human Services to obtain information about the troubled Obamacare rollout last year.
The former CBS News reporter and Emmy award-winning journalist won’t be going alone; the legal group Judicial Watch will represent her in court.
The lawsuit follows four unsuccessful Freedom of Information Act requests. In October 2013 and again in June of this year, Attkisson requested information from the Centers for Medicare and Medicaid Services (CMS) concerning the efficiency and security of the HealthCare.gov website.
All four requests went unanswered.”
“An Indiana man who purchased health insurance through Obamacare’s federal exchange says he was assured he had dental coverage. When he needed care, though, he learned that his insurance provider wouldn’t cover the work. Now, he’s warning others they could also be getting misleading information. “You might be very surprised you’re not covered when you were told that you were,” he says.”
“In April 2014, the Centers for Medicare & Medicaid Services (CMS) published detailed information on the $77 billion that 880 000 health care practitioners billed for some 6000 Medicare Part B services in 2012. This commentary by a former CMS administrator discusses how these data can be helpful, what is missing that might lead to misinterpretation, and why such transparency is here to stay.”
“A majority of people are worried about employers moving them on to insurance exchanges, with Republicans reporting the highest level of concern at 72 percent. But once they actually get insurance on the exchange, most Democrats and Independents, 43 percent and 39 percent respectively, think the shift would have “no impact” on their coverage. In contrast, most Republicans, 41 percent, think it would have a “very negative” impact. The majority of Republicans and Independents say they would consider looking for another job if they were shifted onto an exchange, at 62 percent and 52 percent respectively. Democrats reported that they would look for another job at a rate ten percentage points below Independents, at 42 percent.
Republicans are the most worried that their employer will shift health coverage to the insurance exchanges, with 72 percent reporting some level of concern. Independents and Democrats are less worried, with 60 and 53 percent respectively reporting some degree of concern.”
“Instead of shutting down Obamacare’s insurance exchanges, the government should expand them so that they also include patients who now are covered by Medicaid, Medicare, and veterans health programs.
That’s the gist of a big new health care policy proposal that’s getting a lot of attention.
It’s newsworthy in part because it’s so counter-intuitive. It comes from a think tank, the Manhattan Institute, that’s generally known for conservative, free-market, center-right policy ideas. You’d expect them to be in favor of repealing Obamacare entirely, not expanding it.
The proposal is attracting respectful praise from other conservative voices. Steve Forbes, the former Republican presidential candidate, tweeted a link about the proposal with the words “what true patient-centered, consumer-driven healthcare reform would look like.” (The plan’s author, Avik Roy, is the opinion editor of Forbes in addition to being a senior fellow at the Manhattan Institute.)
At the conservative web site Townhall.com, Conn Carroll wrote, “Some conservatives will oppose Roy’s plan since it does not begin by repealing Obamacare.” But he insists, “fetishizing full repeal at the expense of smaller, more popular reforms would be a huge mistake… Progressives did not create the modern welfare state in one fell swoop. They did it by incrementally building it up over time. Conservatives should steal a page from their playbook and begin to cut the size and scope of the federal government whenever they can. If we wait to do at all at once, we may be waiting forever.””
“Arkansas, the first state to establish the conservative private-plan model for expanding Medicaid under the Patient Protection and Affordable Care Act, now is looking to join several other conservative-leaning states in requiring low-income beneficiaries to make monthly contributions to their health coverage in the form of a health savings account.
The state has proposed to the CMS that, beginning in 2015, its Medicaid beneficiaries would have to contribute to Health Independence Accounts (PDF). Beneficiaries with annual incomes between 50% and 99% of the federal poverty level would contribute $5 a month to their accounts, while those earning between 100% and 138% of poverty would pay between $10 and $25. The state would provide a matching contribution of $15 into their accounts. Money would be drawn from the accounts for copayments on medical services. Any unused funds in the accounts would be rolled over annually with a cap of $200, which the beneficiary could use for paying private insurance costs.”
“Health insurance giant Anthem Blue Cross faces another lawsuit over switching consumers to narrow-network health plans — with limited selections of doctors — during the rollout of Obamacare..
These types of complaints have already sparked an ongoing investigation by California regulators and other lawsuits seeking class-action status against Anthem and rival Blue Shield of California.
A group of 33 Anthem customers filed suit Tuesday in Los Angeles County Superior Court against the health insurer, which is a unit of WellPoint Inc. Anthem is California’s largest for-profit health insurer and had the biggest enrollment this year in individual policies in the Covered California exchange.
In the latest suit, Anthem members accuse the company of misrepresenting the size of its physician networks and the insurance benefits provided in new plans offered under the Affordable Care Act.”
“Maryland Gov. Martin O’Malley’s administration is confident that its rapid rebuilding of the state’s health insurance Web site is progressing as planned and will be ready before the next enrollment period begins in November.
The state’s first attempt at launching a site was riddled with technical problems that made it much more difficult for residents to sign up for health insurance made possible by the Affordable Care Act. Maryland is now rebuilding the site using technology developed by Connecticut. The fix is estimated to cost at least $40 million, if not much more.”
“he Internal Revenue Service is struggling to collect a new tax that’s critical to financing the president’s health care law – and auditors say the IRS’s flawed collecting process is allowing it to raise only three-quarters or so of the revenue that was originally expected.A new report from the Treasury Inspector General for Tax Administration (TIGTA) flags the enforcement of the medical device excise tax, one of a handful of new taxes imposed under the Affordable Care Act.Related: Obamacare’s Next Challenge: IRS VerificationThe Affordable Care Act’s excise tax – equal to 2.3 percent of the sales price of medical devices – took effect in January and is estimated to bring in about $20 billion through 2019, the Joint Committee on Taxation has said.Auditors say the IRS had originally estimated that the tax would bring in about $1.2 billion in the second and third quarters of 2013 – but it’s only received $913.4 million.”