Lawsuit alleges Rx price fixing – read Summary for a synopsis……………..
Lawsuit alleges Rx price fixing – read Summary for a synopsis……………..
“340B is a well-intentioned drug discount program gone awry………..” Has the program departed from its statutory foundation?
“Members of the Health, Education, Labor and Pensions (HELP) Committee approved a sweeping measure Wednesday that tackles a range of big-ticket health care concerns.
Continue reading Senate Panel Makes Surprisingly Fast Work of ‘Surprise Medical Bills’ Package
A benefits veteran has read the new final regulations. He’s not impressed.
HOSPITAL PRICES ARE TOO DAMN HIGH!
Several states have implemented forms of reference pricing for public plans…………..
“The recommendation of this agenda is to recommend to the Board of Trustees the firm that will provide the best value as the Consultant to help guide the district in reviewing options related to our employee benefits program.”
Continue reading Brownsville ISD Awards Insurance Consulting Contract
California to punish (tax) citizens who don’t buy health insurance but will not punish (tax) illegal immigrants. Instead California will provide government funded (taxpayer paid) health insurance to low income young adults coming from anywhere on the planet and living in the U.S. illegally. (See California – Free Health Insurance For Planet Inhabitants).
Continue reading California Legislature OKs Health Insurance Mandate
Politicians want to rein in aggressive tactics used by nonprofit hospitals to collect unpaid bills, including suits and garnishing of wages………….
Continue reading When Patients Can’t Pay, Many Hospitals Are Suing
The shared vision of RiskManagers.us and clients who retain our services is to establish and maintain a comprehensive employee health and welfare plan, identify cost areas that may be improved without cost shifting to any significant degree, and ensure a superior and sustained partnership with a claim administrator responsive to members needs on a level consistent with prudent business practices.
California Assembly Bill No. 72 – OUT OF NETWORK REIMBURSEMENT
House Bill 3987 was filed this session to create a committee to review health benefits from TRS, but the bill did not move past the House Pensions, Investments & Services Committee.
Continue reading Texas School District Chaffs Under Government Health Plan
The El Paso Independent School District (EPISD) is the second Texas public school district ( See Texas School District Challenges TRS ActiveCare Plan Mandates) to challenge TRS ActiveCare by offering district employees a choice between the state sponsored program and a commercial health plan alternative.
Continue reading Second Texas School District Challenges TRS ActiveCare Mandate
HOSPITAL ADMINISTRATORS REACTS
Hospitals and insurers say they are against the idea of transparency. Sunshine adverse, these pasty faced third party intermediaries say transparent pricing will lead to increased costs. That must mean the cost of goods and services in this country can be reduced by adopting health care pricing strategies of Don’t Ask And We Won’t Tell!
Continue reading President Trump to Issue Executive Order on Health Care Price Transparency
The way out of this mess is for Americans to remove themselves from the health insurance market altogether—or to participate in other forms of health insurance such as health sharing ministries and short-term insurance plans. Individuals can actually pay a doctor, hospital, or outpatient center for a service performed without filing claims or getting pre-approval from a clerk in a cubicle.
Continue reading Gateway to Health Care: The Clerk In The Cubicle
Major boon to Reference Based Pricing plans…………………..
Continue reading It’s Xmas In Texas – State Passes “No Credit Ding Law”
Frustrated by a lack of response to our previous inquiries among numerous sources we approached (including several well known benefit experts) in seeking a definitive answer to a burning ACA question we have, it was decided by staff to attempt one last hopeful effort in peeling back the regulatory onion in search of the truth. Will Ted and his staff come to the rescue?
Hundreds of millions of dollars and medical care for more than half a million people are at stake in what amounts to a game of chicken over a cut in how much the largest health insurance plan in North Carolina pays for care.
A major new health care and health insurance cost control bill still includes a long agent and broker compensation provision — but senators don’t seem to be eager to talk about it.
Continue reading Senators Avoid Agent Comp Topic at Health Cost Bill Hearing
“It looks like we are entering the “shipping & handling” awareness phase of healthcare costs.”
Continue reading Why Can’t I Get A Total Price On My Healthcare Procedure Before I Go?
Purveyors of Reference Based Pricing strategies can’t seem to agree on what the reference benchmark should be. Thirteen years ago J. Patrick Rooney (1927-2008) said it was 125% of Medicare. Was he right?
The state of North Carolina has received considerable push back from the medical community in their efforts to reign in rising health care costs for public employees. Scheduled to implement Reference Based Pricing strategies beginning January 1, 2020, the state’s medical industry (primarily hospitals) have pushed back so hard there is now doubt the plan will ever take effect.
Sharing plans are not new. They have been around for years. While not insurance, these programs can offer affordable access to health care.
HealthComp Hosts “Lunch & Learn” with H-E-B and Baptist Integrated Health Partners in San Antonio
Some marriages are just not meant to be…………………..
“Businesses are really angry about the system, and there is a lot of frustration with its rising costs and dysfunction………”
Continue reading Medicare-For-All Gaining Support Among Businesses?
“How Much Did You Say That Xray’s Gonna Cost?
A little ole housewife with cash in her purse has more bargaining power than Blue Cross, United HealthCare and Aetna combined………………………
Continue reading The Best Discounts In Health Care Are Not Through Your Health Insurance Company
It pays to be sick in San Antonio and Dallas these days………………………
Continue reading San Antonio Flu Epidemic Season Is Winter, Spring, Summer & Autumn
SOURCE: Frenkel Benefits
“The largest single Sun Life claim was $7.5 million and the largest injectable drug claim was $1.8 million. Injectable drugs account for 9.2% of the total cost of large cost claims.
“It’s evident that many brokers believe the (PPO) networks are not the long-term answer, but brokers and consultants continue to push business to the traditional model or utilize TPAs with carrier or independent networks because it’s the status quo, what we have always done.”
Continue reading Survey Reveals “Me Too” Brokers In The Majority
Continue reading One Election Away From Free Single Payer System
There has not been a competitive health care market for years. Managed care contracts have contributed to that. Some employers have fixed health care buy most haven’t. This blog has written about the former in the past so if you are a regular reader you know exactly what we are talking about.
Continue reading If We Don’t Fix Health Care Big Government Will
Government control of health care (a precursor to a single payer system) continues to manifest itself with constant dictates from bureaucrats in Washington. . The newest and latest message from the swamp is “we’ve placed a new limit on what you can save tax free towards your personal healthcare……………….” Our in-box receives numerous daily updates like the one below:
Massachusetts hospitals stash $1,600,000,000 in offshore accounts…………….
Ralph Weber
Ralph says bundled health care pre-negotiated cash pricing comes in at an average of 108% of the Medicare rate. That’s a very good number in case you’re wondering……………….
Continue reading MediBid is Pleased to Announce Its New Medicare Allowable Lookup