Continue reading Are All Texas Insurance Consultants Properly Licensed?
Month: February 2016
Paying Cash Cuts Medical Bills
San Antonio Institutions Get Millions To Address Doc Crisis
Texas Hospital Association President and CEO Ted Shaw said the funds are needed to address the state’s “serious physician shortage” and the lack of adequate medical access that has created.
Continue reading San Antonio Institutions Get Millions To Address Doc Crisis
Insurance Thought Leadership
Please enjoy these six recent articles from Insurance Thought Leadership………………….
Texas Political Leadership To Study Telemedicine
Texas political leadership has recognized the significance of telemedicine related to access to care and has issued “Interim Charges” to study the issue in 2016.
The Interim Charge designation indicates the potential for the issue to become priority legislation during the next legislative session, which will reconvene in January 2017.
Continue reading Texas Political Leadership To Study Telemedicine
Contraceptive Coverage – Oral Argument Set For 23 March
“Contraceptive Coverage at the Supreme Court Zubik v. Burwell: Does the Law Accommodate or Burden Nonprofits’ Religious Beliefs?”
“Given that the Court will be operating with only 8 Justices, what would be the impact of a tie (4-4) decision? “
Continue reading Contraceptive Coverage – Oral Argument Set For 23 March
Watchdog Finds Billions in Possible Fraudulent Obamacare Payments
“The government has made billions of dollars in Obamacare subsidy payments to individuals that may have been committing fraud……….”
Continue reading Watchdog Finds Billions in Possible Fraudulent Obamacare Payments
Unaffordable “Affordable Health Care” Creates Tax Loophole
“I can’t afford to buy health insurance. And I can’t afford to pay the punishment tax! Can you please give me a break Uncle Sam!!!!!!!!!”
Continue reading Unaffordable “Affordable Health Care” Creates Tax Loophole
Zenefits Directive: “No Sex In The Office”
Medicare Supplemental Insurance
David Belk
Are Medicare supplemental insurance a good buy? This article by Dr. David Belk provides clues…………..
Baby Powder
Undercover Work Exposes Bonus Arrangement For Insurance Consultants
“Yes, and it’s beautiful! The client does not have a clue about this. It will not show up on the 5500 Form either! It simply is not disclosed at all to the client.”
Continue reading Undercover Work Exposes Bonus Arrangement For Insurance Consultants
Texas- Stop Loss Regulations to be Dropped
Two well-placed sources in Austin report that the Texas Department of Insurance (TDI) has decided to drop the pursuit of stop loss regulation.
Owe Medical Bills? Don’t Pay Promptly, Pay Late & Join The 50% Club
If you owe a medical bill to a hospital, for example deductibles and co-insurance amounts, is it better to pay your share promply or delay payment?
Continue reading Owe Medical Bills? Don’t Pay Promptly, Pay Late & Join The 50% Club
How to Cut Your Health-Care Bill: Pay Cash
Asserta Health assists employers with Cash Pay strategies
Hospitals and other providers increasingly are offering cash prices far below what they charge through insurance………….“I’m paying $530 a month in premiums and I get charged more than someone who just walks in off the street?
City of San Antonio Seeks Competitive TPA Proposals
The City of San Antonio’s (“City”) Human Resources Department are soliciting for a firm with broad knowledge and experience as a third party administrator…………….
Continue reading City of San Antonio Seeks Competitive TPA Proposals
A Novel Plan For Health Care: Cutting Costs, Not Raising Them
“A nonprofit health system in Salt Lake City, is trying something virtually unheard-of: promising to sharply cut costs rather than pass them on.”
Continue reading A Novel Plan For Health Care: Cutting Costs, Not Raising Them
20 Things To Know About Balance Billing
Balance billing complaints are up 1,000 percent in Texas…………the patient was balance billed $1,170 for a total of five stitches ………… patient was served a $117,000 balance bill for an out-of-network physician’s assistant he never knew was present during surgery……………..physician charged Aetna $31,939 to treat abdominal pain in the patient. After Aetna paid the amount it deemed reasonable — $2,811, based on Medicare rates — the physician balance billed the patient for an additional $10,635.
Why Pay Employees to Exercise When You Can Threaten Them?
When it comes to getting people to participate in workplace weight loss programs, financial rewards may not be much of an incentive. Penalties, on the other hand, work great.
Continue reading Why Pay Employees to Exercise When You Can Threaten Them?
Employer Eyes Significant Rx Cost Reduction
As we all know, prescription drug costs are very hard to quantify over time. Costs are a moving target, changing constantly. Comparing PBM’s cost basis is next to impossible.
Continue reading Employer Eyes Significant Rx Cost Reduction
Florida Insurance Regulator Approves Aetna’s Acquisition of Humana
Florida’s insurance regulator approved Aetna Inc.’s acquisition of Humana Inc., and required no divestitures, an important win for the companies from a state that is a key market.
Continue reading Florida Insurance Regulator Approves Aetna’s Acquisition of Humana
Hospital Held To Ransom – Perpetrators Demand $3.4 Million
The hospital has confirmed the attack took place, but has not commented on the ransom.
Continue reading Hospital Held To Ransom – Perpetrators Demand $3.4 Million
1942 Hospital Bill
BCBS vs Methodist Hospitals of Dallas
A Texas statute requires healthcare insurers to make coverage determinations and pay claims made by preferred healthcare providers within a specified time or face penalties……Court finds statute is not applicable to BCBSTX’s activities as administrator of the self-funded plans………..
HIPPA Is Expensive, Even Without The Fines
Data breaches from EHRs are only getting worse, making stricter enforcement of HIPAA requirements inevitable.
The Zero Card
Mayors and Cities Can Revolutionize Healthcare
“At a time when virtually every municipality is finding ways to cut back health benefits in order to balance its budget, the city of Kirkland, WA, decided to create a moonshot goal–slay the healthcare cost beast while simultaneously improving the health of the city employees.”
Continue reading Mayors and Cities Can Revolutionize Healthcare
Texas House Bill 1295
In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the Government Code. The law states that a governmental entity or state agency may not enter into certain contracts with a business entity unless the business entity submits a disclosure of interested parties to the governmental entity or state agency at the time the business entity submits the signed contract to the governmental entity or state agency.
High Cost of Health Care
“How is it that (health care) prices can continue to skyrocket? Unique to the healthcare market, increases in price fail to impact demand.”
Gaming The System
Misappropriation of Healthcare Funding
“Preferred Provider Organizations (PPOs) perpetuate overpayments…………. average payments to hospitals of 250% of Medicare or more is horrendous, in many markets payment levels are twice that level and employers have no idea.”
Doctor’s Conviction May Reshape How Doctors Handle Prescriptions
Doctor sentenced to 30 years to life in prison for the murders of three of her patients who fatally overdosed…………..
Continue reading Doctor’s Conviction May Reshape How Doctors Handle Prescriptions
Brand Name Drugs Inflation Rate 56% Over 3 Years
“Market forces clearly have no effect whatsoever on the prices of brand name medications…………..”
Continue reading Brand Name Drugs Inflation Rate 56% Over 3 Years
Do Your Assignment of Benefits Clauses Need a Checkup?
Do Your Assignment of Benefits Clauses Need a Check-up? Recent Southern District of Florida Decision Highlights the Importance of Carefully-Drafted Provider Assignment Clauses
Continue reading Do Your Assignment of Benefits Clauses Need a Checkup?
Cash Pay Plan Option Produces Significant Savings For Texas County
Cash pay reimbursement strategies should be an integral part of any self-funded employee health insurance plan………..
Continue reading Cash Pay Plan Option Produces Significant Savings For Texas County
The Donald – Government Should Negotiate Rx Prices
“THE PRICE IS TOO DAMN HIGH!”
Trump’s proposal is just the latest indicator of the increasing bipartisan support for government action on drug pricing……
Continue reading The Donald – Government Should Negotiate Rx Prices