Coverage Denied: Medicaid Patients Suffer As Layers Of Private Companies Profit
Managed-care plans, which reap billions in taxpayer dollars to coordinate care for low-income Americans on Medicaid, outsource crucial treatment decisions to subcontractors that aren鈥檛 directly accountable to the government. In California, health officials say one firm improperly withheld or delayed care for hundreds of people.
Billions In 鈥楺uestionable Payments鈥 Went To California鈥檚 Medicaid Insurers And Providers
The money was paid on behalf of more than 400,000 people who may have been ineligible for the public program, a state audit found. One had been dead for four years before payments stopped.
Planes privados de Medicaid reciben millones, pero… 驴qui茅n supervisa el negocio?
Las aseguradoras contratistas de Medicaid, que ofrecen servicios llamados de atenci贸n administrada, est谩n en el banquillo: expertos cuestionan los servicios que ofrecen.
As Billions In Tax Dollars Flow To Private Medicaid Plans, Who鈥檚 Minding The Store?
Insurance companies profit from government contracts but are subject to little oversight of how they spend the money or care for patients. The expansion of Medicaid under the Affordable Care Act has only exacerbated the problem.
Paper Jam: California鈥檚 Medicaid Program Hits 鈥楶rint鈥 When The Feds Need Info
Amid the buzz over apps and electronic medical records rescuing modern medicine, California鈥檚 Medicaid program still clings to 1970s-era technology. A reboot may cost half a billion dollars.
As California Hospitals Sweep Up Physician Practices, Patients See Higher Bills
A Health Affairs study quantifies the financial effects of such mergers on consumers and their insurers. The hospital industry and doctor practices say the consolidation leads to better coordination of care.
Hospital baja cuenta de $109,000 a $332鈥 驴qu茅 pasa con las facturas sorpresa?
El hospital St. David’s Medical Center, en Austin, Texas, baj贸 una cuenta m茅dica dr谩sticamente. 驴Por qu茅 fue tan alta en principio? 驴Qu茅 pasa con las cuentas sorpresa?
The $109K Heart Attack Bill Is Down To $332. What About Other Surprise Bills?
鈥淚 don鈥檛 feel any consumer should have to go through this,鈥 says Drew Calver, who faced a life-changing surprise bill from an Austin hospital after a heart attack last year. After attention as a “Bill of the Month” patient, he paid the hospital $332. But he worries about other patients with surprise bills.
隆Pu帽alada! Tienes seguro, pero igual debes pagar $109 mil por un ataque al coraz贸n
Un maestro de Austin, Texas, quien sufri贸 un ataque card铆aco, tuvo que vivir una odisea cuando recibi贸 una cuenta astron贸mica.
A Jolt To The Jugular! You鈥檙e Insured But Still Owe $109K For Your Heart Attack
A Texas teacher, 44, faces a 鈥渂alance bill鈥 of almost twice his annual salary for a heart attack he never expected to have.
A Black Eye For Blue Shield: Consumers Lash Out Over Coverage Lapses
California鈥檚 third-largest insurer faces anger from customers in the individual market who unexpectedly lost their insurance despite paying premiums faithfully. In its recently filed lawsuit, the company blamed a contractor for 鈥渆gregious鈥 billing problems.
Top Trump Health Official Takes Swipes At ACA, Single-Payer In Enemy Territory
After a San Francisco speech focused mostly on Medicare, Seema Verma fielded questions that underscored the administration鈥檚 differences with California on other key health care issues.
California鈥檚 ACA Rates To Rise 8.7% Next Year
The average increase in California is smaller than the double-digit hikes expected around the nation, due largely to a healthier mix of enrollees and more competition in its marketplace. Still, health insurance prices keep growing faster than wages and general inflation.
Insurers Fall Short In Catching And Reporting Medicaid Fraud, Inspectors Find
Medicaid has struggled for years with poor oversight and billions lost to improper payments. A new report finds that despite their fraud-fighting rhetoric, Medicaid managed-care companies are not as rigorous as they should be in ensuring the integrity of the Medicaid payment system.
Could California Shape The Fate Of The Affordable Care Act In November?
With the primary now over, health care may well emerge as an issue that helps voters distinguish between candidates for governor, attorney general and other offices in the general election.
California Hospital Giant Sutter Health Faces Heavy Backlash On Prices
In a case with possible national repercussions, the state鈥檚 attorney general has sued over alleged price gouging, and other legal and legislative challenges are afoot. Sutter is pushing back hard, denying anticompetitive behavior.
Study: Nearly Three-Quarters Of Commonly Used Medical Scopes Tainted By Bacteria
The 鈥榮cary鈥 findings show a discouraging lack of progress in cleaning the devices, despite more vigorous efforts in the wake of deadly superbug outbreaks, experts say.
California Takes On Health Giant Over High Costs
The lawsuit is a bold move against Northern California鈥檚 dominant hospital chain, whose prices have drawn complaints for years. It has disputed such allegations in the past.
Calif. Bill Targets Profiteering In Addiction Treatment, Dialysis Industries
The legislation is intended to curb schemes in which some treatment providers sign patients up for private plans, pay their premiums and then rake in profits from inflated claims.
Thousands Mistakenly Enrolled During California’s Medicaid Expansion, Feds Find
California health officials do not dispute most of the findings, saying they have already made improvements in determining eligibility.
