Archive for September 21st, 2011

“The PPO Networks Aided & Abetted the Hospital’s Billing Fraud”

Wednesday, September 21st, 2011

……….Double billing, billing for services not provided, insurance company claim examiners dont check claims, PPO networks aid and abet fraud, hospitals and PPO networks engage in direct fraud by selling illusory discounts, PPO contracts preclude meaningful review of bills specifically prohibiting line item review of bills, PPO networks get paid a percentage of purported discounts…………………………….

California legal action – Executive Summary (05-08-2011) (2)

See previous posting – http://blog.riskmanagers.us/?p=5858

But It Is Only 1% – Don’t You Care About The Poor?

Wednesday, September 21st, 2011
LANSING, Mich.—Michigan Gov. Rick Snyder on Tuesday signed into law legislation, S.B. 348, that will impose a new 1% tax on paid health care claims.The tax will be paid starting Jan. 1, 2012, by insurers that provide fully insured plans and by third-party claims administrators in the case of self-funded plans.The tax, which is intended to help fund Michigan’s Medicaid program, will be paid quarterly starting April 30, 2012.

Exemptions

Certain plans will be exempt from the tax, including Medicare Advantage plans, Medicare prescription drug plans and plans covering federal employees.

In addition, the tax will not be assessed on services provided in Michigan to non-Michigan residents, according to the law.

The tax is intended to generate $400 million in annual revenues for the state. If the revenue collected exceeds that amount, insurers and TPAs would receive a credit against their assessments due the next year.

Other states that have similar taxes include Maine, which is phasing out its tax, Massachusetts and New York.

Editor’s Note: Medicaid “insurance” in Texas is the best insurance in the world. Better than what Federal Employees get. It’s free, and it’s good coverage – $5 co-pay to see a doctor, little or no out-of-pocket expenses. Hell of a deal for those than can afford a $5 co-pay. Why work, earn too much, and have to pay those exhorbitant health insurance premiums for lousy benefits? What do you mean I have to pay a deductible? That’s outrageous!