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smurphy6600

Health Net lawsuit reveals the financial engine of drug rehab industry - 0 views

  • The only "Obamacare" health insurer in metro Phoenix and Pima County is ensnared in a legal dispute with several addiction treatment centers over the cost of care amid an Arizona opioid epidemic that is taking an average of two lives each day. 
  • Maricopa County Superior Court lawsuit
  • widespread fraud among Arizona and California drug rehab centers in 2015 and 2016, when it alleges"teams of brokers" recruited out-of-state clients to fraudulently obtain insurance policies and to seek treatment in Arizona.
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  •  residential “sober homes”
  • headaches for local government officials as they try to determine how to manage the unregulated industry.
  • Prescott, which once claimed more than 100 sober homes, has adopted regulations to provide more oversight of them.
  • Federal and state prosecutors have aggressively pursued cases in Florida and California in connection with fraudulent activities such as patient brokering.
  • There have been no criminal cases filed in Arizona, however. 
  • Six of the rehab facilities that accuse Health Net of improperly withholding payments are in Prescott: Chapter 5 Counseling, Prescott House, Compass Recovery Center, Clean Adventures of Sober Living, Decision Point Center and Carleton Recovery Centers.
  • Three others, T R U Recovery Solutions, North Ridge Counseling and Desert Cove Recovery, list Scottsdale addresses. 
  • The rehab facilities allege that Health Net improperly withheld payments to virtually every rehab center in Arizona and southern California beginning in January 2016. Health Net halted the payments as part of an investigative audit that demanded each center provide detailed records such as proof of patients' residency and assurances that patients did not receive incentives to sign up for rehab. 
  • Health Net said in court documents that claims filed by rehab centers in Arizona soared because of widespread fraud
  • Health Net's PPO plans paid $2.4 million to all Arizona rehab centers in 2014. Those payments soared to $47.4 million in 2015
  • Those plans paid more for rehab care that year than all other types of care in Arizona, including typically expensive medical care such as cancer, heart disease and child births, according to the insurer’s counterclaim.
  • Here’s how the fraud worked, the insurer said in its counterclaim:Brokers would scout out people in 12-step programs, Alcoholics Anonymous meetings, homeless shelters and jails, then refer these clients to the “highest-bidding clinic.”Clinics that were not part of the insurer’s network paid clients’ insurance premiums and out-of-pocket costs such as deductibles and co-payments.The result was that people secured Health Net coverage “arranged and bought for them by financially-interested providers for one purpose only: to obtain coverage for the limited time needed to rack up millions of dollars in substance abuse treatment.” Some clinics misrepresented the home addresses of patients, many of whom lived out of state. 
  • “a sophisticated fraud involving the fraudulent enrollment of non-Arizona residents,” who signed up for Arizona insurance policies. 
  • misrepresenting their home address
  • Clean Adventures staff member told him to list the rehab facility's address on his insurance application.
  • put him in contact with an insurance agent who suggested using Clean Adventures' address on his insurance application
  • The insurer named 10 other examples of people who lived in California, Indiana, New Jersey, New York, Tennessee and Wisconsin but represented that they lived in Prescott or Scottsdale.
  • The insurer also said the rehab centers engaged in fraudulent billing, charging for services that were not medically necessary or in amounts that exceeded what the plan allowed.
  • A 2008 law called the Mental Health Parity and Addiction Act requires insurance plans to provide equitable coverage for substance abuse and addiction treatment. The Affordable Care Act also requires health insurance plans cover essential health benefits, including behavioral health services, and it forbids insurers from denying coverage to individuals based on existing medical conditions. 
  • The unintended consequence was (some) addiction treatments centers began taking advantage of that and over-billing," said Angie Geren, executive director of Addiction Haven, a grassroots and advocacy organization focusing on addiction issues. 
  • House Bill 2333
  • curb the practice of paying referral fees to brokers who steer patients to rehab centers.
  • bill never made it out of committee.
  • Florida
  • "The scam starts with deceptive advertising at the beginning," Aronberg said. "You are lured down to sunny Florida with a free plane ticket, which is illegal. You are given illegal benefits to keep you there."
  • patients often find themselves booted from treatment when their insurance benefits run out.
  • incentive for people to relapse so they can obtain another round of coverage.
  • Sober Home Task Force targeting the practice of buying and selling patients battling addiction
  • Johnson said rehab centers that provide legitimate services are being harmed as insurance companies scrutinize payments and bad actors poach patients away. 
  • ken.alltucker@arizonarepublic.com
christian0089

Overcoming online class challenges - 1 views

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    The article talks about some of the more bigger problems that comes with online classes and the best ways to combat them
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    This is a great article. I had an article about the positive and negative things of online learning. These ways of combatting problems are great and should be taught to students in the class.
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    This article gives helpful tips to those taking online classes during these unprecedented times. These special tips are great and will allow students to become more successful if they are presented with the information.
alysa_green20

Economic Issues against middle class families - 1 views

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    In this article, it tells what happened to middle-class families during the election. Most middle-class families rely on their jobs for their main source of income. It also talks about the percentages of families who live paycheck to paycheck.
contrerasju

Racism in healthcare: Statistics and examples - 1 views

  • unable to voice their concerns about the lack of personal protective equipment and COVID-19 testing in the pandemic’s early stages.
  • Black people were 3.57 times more likely to die from COVID-19
  • Latinx population was nearly twice that of the white population.
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  • profound impact on mental and physical health
  • difficult for some to get health insurance, preventing people from getting medical care.
  • racism also exists within healthcare itself
  • 73% held at least one false belief about the biological differences between races.
  • less likely to receive appropriate pain medication than white children
  • 10% less likely to admit Black patients to the hospital
  • affect the medical care of pregnant people and newborn babies.
  • 28% more likely to already have a chronic illness
  • Latinx people of the same age accumulated chronic diseases faster than white people.
  • Asian Americans may be under-diagnosed.
  • “model minority” stereotype,
  • suggests doctors are less likely to diagnose alcohol addiction in Asian Americans compared to white people,
  • clinicians can overlook the symptoms of depression and focus more on psychotic symptoms when treating Black people.
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    This article describes the various ways that POC are treated differently. This can cause doctors to provide the wrong treatment or no treatment for the minority who don't have access to healthcare.
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    The fact that we continue to face and see discrimination when it comes to health care is appalling. When dealing with health, health care providers should not be biased on who to help due to their skin color or certain characteristics.
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    There is no reason why there should still be discrimination in health care, they're saving your life regardless of your color.
anonymous

A New Mandate on Sex Education - 2 views

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    This article talks about how New York City's public middle schools and high schools are now required to take sex ed classes. This article talks about this new mandate and its implications and the effects that it might have. The article also provides reasons on why it was decided that sex ed should be a required class and its benefits. 
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    Very interesting! I can honestly see valid points on both sides of the argument. As a parent, I feel it my responsibility to educate my children about sex. However, there are many parents who do not take the time to educate their children. This is a tough situation...not as cut and dry as other topics on this board.
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    I don't think this is a bad idea. I took sex education in middle school and am almost 30 now. I never did understand why it was phased out. Sex is real and can be dangerous and young adults should know all that comes with participating in something so mature.
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    Sex ed should be a choice for kids to take in accordance to their parents, for myself when I was younger we had to have a signed paper from our parents giving us permission to take part in the sex ed class and for those parents who said no and wanted to teach there kid themselves went to another room. I see both sides to this article and its a very well informative piece.
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    I think a semester of sex ed would be great. When I was in school it was just a 55 minute lecture with a couple of videos. I understand why some people may be upset with this, however, those people must understand that not every child has an involved parent who are capable or willing to educate their children. I think safe sex is integral for our children to learn. I believe it could help lower the stats of sexually transmitted disease and teen pregnancies.
eli2207490

Income gap: Middle class in Arizona being 'left behind' - 0 views

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    This is an article all about breaking down the statistics surrounding Arizona's growing income gap between the middle class and the elite. Like most of America, our middle class has remained just about stagnant, while from 2017 to 2019, the top 20% of income earners in Arizona has risen 1.9%, which is .5% more than the national average.
bri2209985

We need an education system that excites children - 1 views

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    The article talks about how the educational system need to be more then just math, english, and science but also teach children active life skills and young adults life skills for the future career they may want in the future, teaching that the SAT's isn't the best approach for testing, very well written article that I enjoyed reading.
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    On this topic, so many things to say. I have to admit here the educational system is very different than other countries. What really surprised me, was that the classes like history, biology, chemistry, geography..are optional. I really don't understand how you expect a child to learn and get some general knowledge, if these classes are optional. It is most likely that the child would chose none or one maybe, and then we think oh, the child can learn from internet or TV. But, the child would rather play a game online or watch a movie. The educational system needs readjustment and the curriculum changed in some classes where you have only dry material to study. We live in a society where technology is everywhere in all forms, we should take advantage of that, and create something more attractive to kids with the purpose of learning, almost like a game. I am sure that will attract children, and it will even encourage competition among them. For example, some of the educational apps, we see on all devices.
smagenot

Republicans Have Declared War Against Social Justice on College Campuses - 1 views

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    Conservative Republican lawmakers introduce bills to censor ethnic cultural classes on K-12 and College campuses.
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    I heard about that. That is a violation of the freedom of speech and expression.
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    I heard about this the other day and was blown away by it. It made me laugh that this Rep. thought that ethnic or cultural classes insight violence and discrimination. In my opinion, they do just the opposite. When you learn about another culture you are able to understand their background more. It creates an environment in which understanding occurs and you are better informed on the struggles of a specific ethnic group. Being informed is never a bad thing and if someone thinks it is then clearly they need to take a few ethnic cultural classes to get rid of that ignorance.
stevenpuckett4

Arizona House Bill On Restricting Activities of Divisiveness Not Granted Hearing - 0 views

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    Two weeks ago, the Arizona state legislature introduced HB 2120, a piece of legislation that would ban courses and events on college campuses relating to "social justice." This means that they will prohibit courses, classes, events and activities' in public schools that promote 'social justice toward a race, gender, religion, political affiliation, social class or other class of people
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    Article on House Bill 2120 that restricts any activities that promote division in universities and community colleges. Author cites Trump election as the cause of the increase in bills that effect freedom of speech and social injustice.
hvnkly

The Right to an Attorney Who Actually Does His Job - 0 views

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    Article about a class-action suit against the cities of Mt. Vernon and Burlington (both in Washington) for failing to provide meaningful representation to poor defendants facing misdemeanor charges. The lawyers handled 1,000 cases a year, way more than the cap of 400 allowed annually. In result, they were spending less than an hour per case.
tyl2148154

California College Students Walk Out Of Class To Protest Tuition Hikes - 0 views

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    This article is about students in California protesting the tuition hikes by walking out of class . This staged walk out happened all across the state.
mwest8013

Problems in Online Classes | The Classroom - 2 views

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    This article discusses the difficulties that the students and the teachers confront. It lists out some of the issues and gives a description on how both sides are affected.
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    I'm happy this was discussed because many students, including myself, have struggled very hard with online school. It has turned so many people's lives to disappointment.
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    I like this article it addresses a lot of the issues that online classes have and how it can effect students
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    I agree with you in this article and how students and teachers are having a lot of difficulties. COVID-19 really impacted everyone in a huge way and it has caused many problems for in-person learning and more.
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    this issue is one important one that many of us students face with this new way of learning. like mentioned in this article students face so many problems with the online learning.
casbautista

Hey U of Chicago: I'm an academic & survivor. I use trigger warnings in my classes.... - 0 views

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    This article criticizes the concept of political correctness preventing higher thinking in academia. The author is a survivor of rape and discusses how using trigger warnings can be helpful in a classroom setting and does not minimize the learning experience. The author provides an anecdote, as well as an example of a 'get to know you' worksheet she uses at the University she teaches at.
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    This article criticizes the concept of political correctness preventing higher thinking in academia. The author is a survivor of rape and discusses how using trigger warnings can be helpful in a classroom setting and does not minimize the learning experience. The author provides an anecdote, as well as an example of a 'get to know you' worksheet she uses at the University she teaches at.
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    I really like the use of "trigger words" in education. I don't think it matters if it is used in college or in K12. The whole point is to alert you to a possible trauma causing conversation or topic that could come up in class that could make someone uncomfortable. Unfortunately there are so many triggers in the world today that you could never call out all of them. The teacher made reference to an apple. Who would think that was a trigger? Not I.
and2177879

Human Trafficking Facts | Sex Slavery and Trafficking | Soroptimist - 3 views

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    The who, what, where, when, and why of human trafficking. Including a hotline to help prevent trafficking from occurring. The impact it has on our world. Its not limited to race gender or age but, all classes of individuals. An organization devoted to help this social injustice. (soroptimist)
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    So, sad that we live in a world where this happens. We should add to the list of human trafficking the children, new born children that are sold. I applaud the Soroptimist organization for wanting to help and reduce this type of slavery.
joseph augusta

Gun Control Debate: When Ammo Runs Short, Should Citizens Come Before Government? - 0 views

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    Private citizens don't need ammo two or three years in the future.They need it at prices the poor and middle class citizen, who needs self-protection the most, can afford. We don't need single women being raped and murdered because they couldn't afford, or couldn't buy, ammunition for their personal firearm.
Lindsay Klatt

State pushes mandatory wedding classes - 0 views

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    This is a video on how Colorado is wanting to force engaged couples to go to pre-wedding counseling before they actually get married.
dsalgado23

NYC's Plan For Prayer Break In Pre-K Classes Raises Concerns - 0 views

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    This article explains the pros and cons about introducing a break for prayer in pre kinder classes how it would interfere with church and state separations.
rhabermacher

OHCHR | List of Issues - 1 views

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    Office of the High Commissioner: United Nations Human Rights. This website lists an array of social justice issues. This may serve as a good resource for us in this class as we explore the different topics we may research for our final paper in this class.
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    What a good article to start off with! It will definitely help out with your search as you go before condensing and narrowing down ideas has to happen.
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    Excited to review the site in detail for our final paper. I think this will help me out considerably because I'm still figuring out my topic. Thank you for the list of issues!
ste2252736

The effects poverty has on children - 0 views

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    Within this article I learn about what effects poverty might bring to children. I learn that living in a poverty, it can have effects within the family, and educational outcomes.Children who grown up in poverty don't have many opportunities such as those who grown up in middle class or upper class. Poverty has many effects on a child's life and how they will live as an adult.
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    I have never researched poverty in children,but I can imagine what kind of effects it has on them as a grown up. When those children are born into that life,the cycle is really hard to get out of.
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    Poverty is a rough thing on children for sure, agree wit you and good post.
mic2174303

Of the 1%, by the 1%, for the 1% | Vanity Fair - 0 views

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    The gap between the 1% and the rest of the world is growing. The opinion that those that are in the top 1% have earned, and continue to earn that type of income. The reality is that research has proven this is not the case. Research has also proven that those who are not born to the upper class do not have nearly the same opportunities to succeed in life. The system is corrupt. The rich are growing richer off the work of the poor, who are becoming impoverished.
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