A phone conference had been arranged. They wanted to talk to me about a denial for payment on a portion of a patient’s pre-authorized procedure after the fact. It’s participants: the regional medical director of a large insurance company, his female assistant administrator, and me.
Insurance
Want cheaper life insurance? Have an ablation!
Over-stenting doc submits to 10-year prison sentence
A Louisiana interventional cardiologist accused of performing heart procedures on patient unnecessarily began his 10-year prison sentence this month after years of attempting to appeal his verdict.
Dr. Mehmood Patel, 64, was convicted in 2009 of 51 counts of fraudulently billing Medicare and other insurance groups for medical procedures that were deemed unnecessary. Patel was given a 10-year prison sentence, which was to start in July 2009.
No insurance a death sentence for some
Wal-Mart offers no-cost heart, spine, transplant surgeries to employees
Retail goliath Wal-Mart (NYSE:WMT) is changing the shape of employer insurance programs by offering its workers no-cost heart and spine surgeries through a new "Centers of Excellence" initiative.
Wal-Mart selected 6 nationwide centers at which employees enrolled in the company’s medical program can seek consultations and care without paying anything out of pocket, beginning in January.
Obamacare has already cost $27B, think tank says | MassDevice.com On Call
MASSDEVICE ON CALL — According to calculations by conservative think tank American Action Forum, President Barack Obama’s healthcare reform measures have cost states and private businesses more than $27 billion.
That’s about $20 million for compliance costs shouldered by private companies and just over $7 billion paid by state governments, Healthwatch reported.
Recalls: Insurers look to recoup costs from faulty medical devices | Wall Street Beat
There were 113 Class I medical device recalls between 2005 and 2009, according to the Archives of Internal Medicine, meaning costly medical procedures and possible explantations for 10s of thousands of patients.
Insurance companies are increasingly looking to recoup those costs, Reuters reports, citing a 10-fold increase in mass tort cases over the last decade.
Should we tax healthcare insurance as income?
Health care insurance benefits have been excluded from taxable income since 1943, when the National War Labor Board ruled employers, who were offering health plans as a way to attract workers without violating wartime wage-and-price controls, could deduct their cost as an expense without reporting their value as income for workers. As a result, employees get the benefit of the insurance without paying taxes on its value.
Asthma: Boston Scientific wins new insurance codes for Alair system
Medical device industry giant Boston Scientific (NYSE:BSX) won insurance reimbursement codes for its latest star device, the Alair bronchial thermoplasty system for asthma treatment.
The Alair system delivers precise thermal energy to lung tissue via bronchoscope to reduce excessively smooth muscle, decreasing the airways’ ability to constrict.
Is GE getting tangled in its own rope? | MassDevice.com On Call
MASSDEVICE ON CALL —GE Healthcare’s (NYSE:GE) decision to switch a large swath of its employees to a high-deductible health plan may be bad news for its own imaging business, one of the world’s largest.
The new insurance plan has cut MRI and CT imaging use by nearly 25%, which is good news for the healthcare giant’s $2.5 billion healthcare costs but could spell disaster for one of the company’s largest divisions.
Healthcare reform: Are fewer people in MA paying the individual mandate penalty?
By Joshua Archambault, for the Pioneer Institute’s Healthcare Blog
Since the Supreme Court upheld the ACA/Obamacare, there has been a renewed interest in the Massachusetts healthcare law. I have blogged many times before to caution readers and the media not to assume the two laws will lead to the same results, because they won’t, mostly as Massachusetts is not the same patient with the same ailments as New Mexico, or Michigan, or even Florida.