Health Insurers Ask to Keep Rate-Increase Data Secret. Health Insurers Ask to Keep Rate-Increase Data Secret. “How these companies are setting these rates is vital for the public to know, and should not be treated like a state secret,” Benjamin M. Lawsky, the state superintendent of financial services, said on Tuesday. “Transparency will promote healthy competition and enable the public to rigorously comment on proposed rates, two goals that all of us should favor.” Mr. Lawsky, whose new agency oversees the state insurance division, has ordered that the memos be made public. His decision, which will go into effect by the end of November unless the companies obtain a court injunction, ends a longstanding policy that exempted the insurance companies from public access under a “trade secret” exception. The decision followed a battle by a consumer advocacy coalition, Health Care for All New York, which had first sought information for a policyholder in Queens who faced a 76 percent increase in his family’s Emblem Health premium.
Mr. The companies, notified of Mr. Rising Costs of American Employee Benefits Eating Paychecks. With jobs scarce and pay raises slight, workers can take heart in at least one positive trend: Businesses are restoring some of the benefits they axed during the recession. The flip side of the trend is not so encouraging: Firms seem resolute in holding the line on benefit costs. So workers who want new benefits from their firms will probably have to pay for many of them themselves. "Employers are not willing to take on any more" costs of benefits, says Chris Covill, of the national integrated benefits practice at Mercer, a New York-based human-resources consulting firm.
"They're looking for ways to mitigate cost increases and to shift the financial responsibility" for benefits to employees. The most obvious move is that benefits cut during the recession are starting to reappear. FedEx Corp., the shipping service based in Memphis, Tenn., announced in late 2009 that it would resume merit raises and restore company 401(k) contributions to half their prerecession levels. Pfizer and Xanax another Big Pharma #fail | Jason Gooljar: The Working Families Party Man | Fighting in the Class War.
Doctors Avoid Penalties in Suits Against Medical Firms. Drugmaker Eli Lilly pleaded guilty to illegally marketing its antipsychotic Zyprexa for elderly patients and paid $1.4 billion in criminal penalties and settlements. (AP file photo/Darron Cummings) Last year, Alpharma paid $42.5 million to settle federal allegations [2] that it paid kickbacks to doctors to prescribe its painkiller Kadian. "Health-care decisions must be based solely upon what is best for the individual patient and not on which pharmaceutical company is paying the doctor the biggest kickback," Rod J. Rosenstein, U.S. attorney for the District of Maryland, said in a statement announcing the settlement. But the doctors accused of trading prescriptions for paid speaking gigs faced no consequences. At least 15 drug and medical-device companies have paid $6.5 billion since 2008 to settle accusations of marketing fraud or kickbacks.
In many of the cases, it appears that not even a cursory investigation was done to see whether the physicians had behaved inappropriately. Sen. "Dr. IBM's Watson to offer medical advice to doctors | Cutting Edge. IBM has inked a deal with health insurer WellPoint that will let the latter use the technology behind "Jeopardy"-playing computer Watson to suggest patient diagnoses and treatments.
The arrangement, which marks the first time the Watson technology will be used in a commercial application, will be announced Monday, according to The Wall Street Journal. The terms of the deal have not been disclosed. WellPoint hopes the technology will help improve the quality of patient care and help reduce costs. It will be introduced next year and will initially be used by nurses who review treatment requests from doctors and others and manage involved patient cases, the Journal reports. After that it will be introduced to a selection of oncology practices and will likely be made accessible to doctors through their own computing devices.
The Journal quotes WellPoint's chief medical officer, Sam Nussbaum, as saying that the project is "not about limiting care; it's about assuring the right care is given. " Falsified-patient-records-are. Health-Care Reform Rules Would Restrict Public Reporting. Last year’s health-care reform law promised to use Medicare billing data to increase public reporting about the performance of doctors and health-care facilities. Now, proposed government rules could prevent consumer groups from getting the data and would give medical providers the right to review any quality findings in advance. Health and Human Services Secretary Kathleen Sebelius at a press conference regarding the health care reform law. (File photo by Chip Somodevilla/Getty Images) It’s estimated that hundreds of thousands of patients die annually from preventable harm suffered while undergoing medical care. Last year’s sweeping health-care reform law — the Patient Protection and Affordable Care Act — promised to improve the problem by allowing outside groups to use Medicare billing records to analyze and publicly report on the quality of care.
Agencies typically adopt rules to administer laws like the health-care act. Pay up to $200,000 for the data. Health Insurers Ask to Keep Rate-Increase Data Secret. Private Health Care Provider Settles Over Massive Fraud Scheme. Maxim Healthcare Services agreed to a wide-ranging Deferred Prosecution Agreement (DPA) with federal and state authorities on charges that the company participated in a conspiracy to commit health care fraud, the Department of Justice announced this week. The criminal complaint against Maxim details how the company allegedly defrauded Medicaid and Veterans Affairs programs through false billings from 2003 to 2009.
As a private health care service provider, Maxim primarily provides home health care services and medical staffing to hospitals and assisted living facilities. As part of the DPA, Maxim signed a Statement of Facts agreeing with the allegations made in the complaint - the text of which suggests the extent of the company's fraud may have affected the quality of care it provided. While the agreement allows Maxim to avoid conviction on charges of health care fraud, it requires the company to pay out up to $150 million in criminal and civil penalties. Although the U.S. Wendell Potter: My Apologies to Michael Moore and the Health Insurance Industry. In advance of my appearance with Michael Moore on Countdown with Keith Olbermann tonight on MSNBC (8 and 11 p.m. ET), I would like to offer an apology to both Moore and his archenemy, the health insurance industry, which spent a lot of policyholder premiums in 2007 to attack his movie, Sicko. I need to apologize to Moore for the role I played in the insurance industry's public relations attack campaign against him and Sicko, which was about the increasingly unfair and dysfunctional U.S. health care system.
(I was head of corporate communications at one of the country's biggest insurance companies when I left my job in May 2008.) And I need to apologize to health insurers for failing to note in my new book, Deadly Spin, that the front group they used to attack Moore and Sicko -- Health Care America -- was originally a front group for drug companies. Which Industry Was Really Behind 'Health Care America'? Well, shucks. Now, Even More Info About 'Health Care America' (Note to Ms. Go ahead. Wendell Potter on the Anti-SiCKO Smear Campaign on Countdown with Keith Olbermann -- 11/17/10. November 18th, 2010 4:03 AM Countdown with Keith Olbermann OLBERMANN: Last night, we told you about the anti-government health care congressman-elect who demanded his government health care the very day he starts his new job. Today, the anesthesiologist from Maryland attempted to remove the foot from his mouth and botched the procedure.
Also, in our fourth story, more details on the health care industry's covert attempt to submarine the health care reform they promised to facilitate -- and explosive revelations from health insurance company whistleblower Wendell Potter who says his own company, CIGNA, was so scared of what Michael Moore's 2007 documentary "SiCKO" would do to its bottom line that they sought a, quote, "campaign to push Michael Moore off a cliff. " Michael Moore has responded, Wendell Potter is our guest next.
First, to doctor-elect, congressman, whatever, Andy Harris. Today, in an interview with FOX, Dr. Publicly, AHIP was onboard with health care reform. POTTER: Oh, yes. Health costs rise while insurance coverage declines. Preserving Cabrini-Green's images In the sharp sun of an April afternoon, Nate Lanthrum walks through the remains of Cabrini-Green giving away what he has taken. He looks out of place, a white guy carrying a $1,500 Nikon D700 camera, but the residents are used to him by now and greet... Blackhawks thrilled to have Brent Seabrook back Starting with Game 6 Sunday, Brent Seabrook's timeout will be over and the defenseman will be back on the ice — so long as he promises to play nice.
NFL draft preview: Defensive ends As the NFL draft nears — it takes place May 8-10 — we're taking an 11-day, position-by-position look at what's out there and what the Bears need. In May 1974, Tribune delivered 2 Watergate bombshells Forty years ago this Thursday, Tribune readers found an extraordinary special section in their morning paper — a 44-page transcript of taped Oval Office conversations, the long-sought smoking gun of Watergate, perhaps the greatest political crisis... Northwestern women win at Wrigley. Drug Company Payments to Doctors | Dollars for Docs - ProPublica. Has Your Doctor Received Drug or Device Company Money?
In disclosed payments Top 20 Companies Click on a company to see how its payments break down by drug, device or doctor. Or, see all companies » Payments in Your State Click on a state to see payments made to doctors there. Highest-Earning Doctors Doctors Paid the Most Often Teaching Hospitals Paid the Most Often See all teaching hospitals » Top 10 Drugs Includes all general payments to doctors and teaching hospitals.
Top 10 Devices Source: The Centers for Medicare and Medicaid Services Open Payments data. Additional reporting, design & development by Ken Schwencke, Moiz Syed, Madi Alexander, Al Shaw, Annie Waldman, Tobin Asher, Eric Sagara, Jeremy B. Note: We have made some effort to normalize the data and eliminate duplicates, but the data is primarily as it has been reported by the companies to the Centers for Medicare and Medicaid Services. TED Talk: How Big Pharma Is Subverting Science - Duly Noted. Physician and epidemiologist Ben Goldacre gives a great TED Talk on battling bogus health science, in the media and in science itself: Goldacre starts out with fairly standard debunking of bad science journalism.
Too often, he says, a news story about how "red wine prevents cancer" turns out to be based on a paper about how dripping red grape extract onto cancer cells in a petri dish affects the behavior of a particular enzyme. It might be a perfectly good paper and even an exciting result, but it has nothing to do with whether drinking red wine would prevent cancer. Goldacre goes on to talk about badly designed studies: observational studies with huge confounds, clinical trials with no control group, and so on. The most interesting part of the talk is Goldacre's discussion about how pharmaceutical companies distort scientific evidence to favor their own products. Industry-sponsored trials are four times more likely to deliver positive results than independently sponsored trials.
For Profit Health Insurance is Government Sanctioned Extortion. Podcast: Play in new window I’ve said it many times before, and repeated that assertion on my show this morning. I got a bill in the mail yesterday from a collection agency. Not from the imaging clinic where I had a thyroid ultrasound done in May, but from a collection agency. Honestly, when I got the bill for $504.60, I couldn’t imagine what it was for. But when I went online to MyUHC.com to check my claims, I found out that it, indeed, was what the bill was for. I guess I’m fortunate enough to have health insurance through a part-time employer. That $504.60 bill I got yesterday? A better example of this comes from last year. But the total amount the hospital billed for the surgery was a whopping $21,500.39.
If I didn’t have insurance pay the monthly extortion fee, I would have been charged $21,500.39 for the same surgery that the insurance company extortionists are charged only $3834? Can you say Medicare for All? Which Way Will He Go? In the other corner, we have the Wall St. ANALYSIS: Cynical attempts to undo health care reform. House Republicans, unable to repeal President Obama’s health care reform law outright, have decided to go after it piece by piece. If they are successful, what’s likely to remain is the kind of reform the insurance industry dreamed of but never really thought could be the law of the land. Although the Republican-controlled House passed legislation to repeal the Affordable Care Act several months ago, the Senate, controlled by Democrats, rejected it.
Bills are now being considered in the House that would strip some of the most important consumer protections from the new law. If the bills’ sponsors are successful, health insurers would be free to spend as little of our premium dollars on our health care as they want, and they would be able to continue setting lifetime limits on policies and cancel our coverage at the time we need it most—when we get sick. Lobbyists for agents and brokers have joined the insurers in supporting the measures to gut or abolish the MLR provision. American Medical Association. The American Medical Association (AMA) is the main professional trade group representing American doctors.
The AMA publishes a medical journal, the Journal of the American Medical Association (JAMA). A face lift for the AMA In 2005, hoping to improve its image and boost sagging membership, the AMA launched a $60 million dollar marketing campaign. It included "heart string tugging ads" portraying doctors as "everyday heroes. " The AMA's membership has been declining for the previous five years. [1] History of pharmaceutical interests In the early half of the 20th century, petrochemical giants organized a coup on the medical research facilities, hospitals and universities.
The Rockefeller Foundation was originally set up in 1904 as the General Education Fund. See also pharmaceutical industry. Eliminating competitors to drug based paradigm In his 1994 book, The Assault on Medical Freedom, author P. AMA's 'anti-quackery' campaign See also alternative medicine. See also animal testing. AMA & tobacco. Economic Development and the Health Care Arms Race. By Gwen Sharp, PhD, Sep 19, 2011, at 09:47 am American Public Media’s Marketplace posted a short animated video summing up the potential problems with health care as an economic development strategy.
Many cities are building large, fancy medical facilities with the hopes of drawing “medical tourists,” patients from other areas who would travel to receive care at state-of-the-art facilities, thus creating jobs and injecting money into the surrounding community. Given that we hear that the need for health care providers will grow greatly in the future, this seems like a risk-free plan. But as the video shows, these development strategies can lead to over-supply of services and increased overall cost of health care, without the promised benefits to local economies: Oh The Jobs (Debt?) You’ll Create! For another example of economic development fads that don’t necessarily pay off, see our previous post about sports stadiums.
Senate Cites Medicare Abuses by Home Health Firms. California’s Proposed Medicaid Cuts Could Hit Insurers - Stocks To Watch Today. ANALYSIS: Health insurers win big in Maine. New Drug Tests Target the Poor. Rare flu-like virus on the rise: U.S. U.S. Drug Shortage: Big Pharma, Big Phuck-Up. Blog.