Month: March 2016

FBI Says School District Consultant Helped Insurance Broker Get Contracts

William O. Haff leaves the John Wood Federal Courthouse Thursday March 31, 2016. Haff pleaded guilty to conspiracy to commit wire fraud stemming from an F.B.I. public corruption investigation. Photo: John Davenport /San Antonio Express-News / ©San Antonio Express-News/John Davenport

William O. Haff leaves the John Wood Federal Courthouse Thursday March 31, 2016. Haff pleaded guilty to conspiracy to commit wire fraud stemming from an F.B.I. public corruption investigation.

William Oliver Haff, 46, of San Antonio admitted that while working for the consulting company hired by the school districts — Wortham Insurance and Risk Management — he was also getting paid on the side by an insurance agent/broker so its clients would land contracts to provide employee insurance there.

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ACA – The Individual Mandate Does Not Exist

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SOURCE: Benefitrevolution.com

“You can simply “believe” that Obamacare plans are too costly or experience any of another limitless form of hardship and get yourself out of the law.  So in reality, the 4 million Americans that are estimated to pay this fine should receive an “F” in creative writing and imagination. The individual mandate does not exist.  It is a mirage.”

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Free Market Medical Association – TPA Call To Action

freemarket“Self-funded employers have been forced to rely on PPOs to give a percent off billed charges from these providers.  This has done nothing to curb the rising cost of care as most PPOs are taking a portion of ‘savings’ as an additional revenue stream.  It benefits them if the billed charge is excessive.  In additional to the PPO, many more layers between the patient and the provider further add to the cost. “

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Repeal-Obsessed Republicans Don’t Understand Obamacare Is Kind Of A Gift

angrydoctor1“In Dallas, Texas Blue Cross, in its Exchange plan, is paying 10 percent less than what Medicaid pays. So these are low rates. They take all the doctors who accept that fee—and that typically doesn’t include the best doctors, by the way—and that’s how they get their premiums down. They’re convinced that healthy people buy on price.” – John Goodman

Editor’s Note: Nothing in the ACA mandates the reimbursement levels paid to medical care givers. In this case BCBSTX is paying less than Medicaid on their narrow network If BCBSTX can pay an arbitrary number which is less than Medicaid reimbursement rates, what prevents an employer doing the same thing? The employer could build a Base Plan with reimbursement rates half of Medicaid’s and thus limit risk while complying with the ACA. The employer could then offer a Buy Up Plan for those who want “real” insurance

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The Narrowing of the Network

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“Narrow networks are simply an aggregation of health caregivers willing to earn less. For example, if Dr. Jones wants $250 for a routine office visit while Dr. Smith wants $55, and if Hospital “A” wants 450% of Medicare while Hospital “B” will take 115% of Medicare, guess which providers are invited to join these narrow networks?“- Homer G. Farnsworth M.D.

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Former Hospital President Blows Whistle on Predatory Pricing

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“The price is too damn high!”

Florida attorney Steven I. Weissman agreed to become interim president of a Miami hospital when its founder, a friend and client of 35 years, died. He quickly got an insider’s view of the healthcare system and found it sickening. Risking long-standing relationships, he has gone public.

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Insurance Company Has A Deal For Utah Employers

aaaaaaaaaam“I gotta a deal for you!”

“The insurance company owned by Intermountain Healthcare is promising employers an annual 4% growth in healthcare costs……”

Is a 4% annual increase in health care costs a good deal? No says Homer G. Farnsworth, M.D. – “That’s outrageous! Under Reference Based Pricing, Direct Contracting, and the Asserta Health Cash Plan our clients are reducing health care costs, not increasing them!”

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