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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
christinamorgan7

Social Media and Adolescents' and Young Adults' Mental Health | National Center for Hea... - 4 views

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    With mental health issues becoming more prevalent in today's society. One has to wonder if it might be linked to the ever growing social media world we live in. With many studies speculating that social media might be the driving force behind our mental health pandemic.
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    I personally do think that social media does play a roll in today's mental health pandemic, whether the impact is big or small. Mental health is something I believe to be very important & I wish everyone took it more seriously.
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    I agree with Ash. As a race, humans tend to emulate and learn from each other, and has been proven by examining cultures and societies. With social media, anybody can "learn" behaviors, thoughts, or even actions from anybody. With this in mind, what do you think will happen to future generations on social media if they were, for example, consistently exposed (and as a result desensitized) to something like violence?
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    This is a great topic and a great find, social media has been directly linked to depression.
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    Sadly this world has truly become run by social media and the input of people we have never, and will never, meet. The importance a "like" or "comment" has now definitely leads to declining mental health statuses. Some people are so based on the likes that their entire world would crumble. Companies pay people purely based on their likes and follower count and the power they hold over their viewers.
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    Mental health is a really big deal, especially nowadays. Our predecessors commonly pushed down or ignored their mental health issues, but it's even worse for people today due to social media and other platforms. People today are becoming more mindful of social issues such as mental health and I think that's a really big deal.
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    I also think social media plays a big part in mental health issues in todays society.
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    For 3 or more hours day over 40% of girls and 20% of boys. The socials that are popular would be twitter, snapchat, Instagram, and Facebook.
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    I believe there might be a link between mental health problems and social media especially the impact it has on some peoples lives
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    Social media has really impacted adolescents and young adults in many ways. Mental health problems have sprung because of social media. Social media has its positives but it has made a lot of people see themselves in a bad light and view themselves as imperfect when in real life they are perfect.
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    this article is an interesting one to say the least. may people are affected by social media but young adults are the most affected. this article shows how young minds are most affected by these media outlets.
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    I would definitely agree with the article as it claims the correlation between time spent on social media and the symptoms of anxiety and depression. I likes how they referenced how abstaining from it can result in higher levels of happiness.
dsalgado23

Breastfeeding State Laws - 1 views

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    Includes all what can and cannot be done in the 50 U.S. states concerning breastfeeding in public. By informing accurate dates and bills, it becomes very easy to diminish what is legal and what is not.
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    This web page talks about the laws of beast feeding in the United States.
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    Health professionals and public health officials promote breastfeeding to improve infant health.
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    Health professionals and public health officials promote breastfeeding to improve infant health. Both mothers and children benefit from breast milk. Breast milk contains antibodies that protect infants from bacteria and viruses. Breastfed children have fewer ear, respiratory and urinary tract infections and have diarrhea less often.
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    This webpage gives info on the laws for women who wish to breastfeed. It has lots of links and information on what the law states.
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    Provides a 50 state summary of breastfeeding laws, including an overview of policy topics, recent NCSL publications and other resources. Lots of great information and the site tells whcih states allow breast feeding in public.
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    Provides a 50 state summary of breastfeeding laws, including an overview of policy topics, recent NCSL publications and other resources. Lots of great information and the site tells whcih states allow breast feeding in public.
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    Pediatricians and health officials promote the many health benefits of breastfeeding infants the first year of life. Breastfeeding legal rights include public breastfeeding and breastfeeding in the workplace. Lists state laws individually.
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    Pediatricians and health officials promote the many health benefits of breastfeeding infants the first year of life. Breastfeeding legal rights include public breastfeeding and breastfeeding in the workplace. Lists state laws individually.
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    Pediatricians and health officials promote the many health benefits of breastfeeding infants the first year of life. Breastfeeding legal rights include public breastfeeding and breastfeeding in the workplace. Lists state laws individually.
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    Breastfeeding moms are protected by the law to breast feed in public as discussed in this article. You can find all the laws in the US and the responsibility of an employer to provide breastfeeding accommodations to a breast feeding mother.
maryum99

How can we incorporate mental health education into schools? Consider the 5 T's - 1 views

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    According to this article, about 50% of students ages from 13-18 have their mental health negatively impacted in some way. A bad impact on mental health can lead youths into unfortunate circumstances. Mental health is just as important as physical health and should be brought up more within school curriculums.
kat2222004

5 Challenges of Mental Health Care Today - 5 views

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    Even though mental illness is a common problem it's handled very poorly. People with mental illness struggle to get help for a variety of reasons. They lack the money to pay for therapy and the support they need.
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    I agree, mental health care is very important and sadly is not always easy to get. Mental health needs more funding and more awareness. Being stable mentally is just as important as getting your yearly doctor's exam. I view mental illness's such as depression, anxiety and so on to be just as important to treat as any physical sickness or injury that requires medical attention.
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    I also agree that mental healthcare is very poor and not getting the attention it deserves. I have someone really close to me that has mental illness and they don't get all the proper things that they need to deal with it because of money.
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    As someone who has struggled with mental illness most of my entire life I know all too well the challenges that mental health faces in our country. It might help you to look at the Reagan administration and their decisions to close several mental health hospitals and programs in the late 80's. This had a huge impact on how mental health was dealt with in this country.
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    Being someone that has worked for a number of years with mentally disabled patients, I have to say that there is a lot of indifference toward this medical condition. Patients are not always receiving the best treatment option, they rather receive what is convenient for the health care provider or sometimes the cheapest alternative because family does not want to pay for treatment, whether it is a therapy or medication. It is very unfortunate that these people are ignored just because they have an ilness.
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    I work with a variety of patients and some do have mental disabilities. Most don't seek help because they have the lack of knowledge and don't know where to start. Also like the article states they don't have the support or don't want to spend the money. A lot of people who don't get the correct help they need then tend to become suicidal. Very sad.
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    Mental health definitely needs funding. A lack of funding will result in higher poverty and an increased suicide rate among the disabled. Not too long ago the mentally ill were put in asylums. Being someone who has Asperger's Syndrome I have experienced shutdowns and anxiety. At my last college I was unofficially withdrawn. When I have anxiety I often cannot leave my bedroom and school has become very difficult.
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    The main reason many do not seek professional help is not due to money, but the stigma that society places on someone with mental illness. Suffering in silence is a common way to handle the disease. Many also self medicate with alcohol and drugs. There is free help out there, just have to look for it. Catholic Family Services and Christian Church groups are there to those who ask for the help. The first step is to ask.
emi2191825

Poverty and Health - 2 views

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    This article focuses on the interrelation between poverty and health. It gets into further detail about the reasons why people may become extremely poor because of their health situations. It also implements different solutions to help those who find themselves in situations like these.
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    This article gave me information on healthcare from a perspective of the people living at the poverty level. It focuses on how different strategies and projects made directly to change the affect of this healthcare system in its current status.
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    This article does well in representing how complicated poverty is. I liked how the authors showed how health care is a cause of poverty, and poor health care is also a sign of poverty. It goes to show the dual nature of many social issues and why solutions are increasingly challenging. The solutions offered by the authors look like they would be effective, but executing them might be difficult. It would be hard because these solutions are very general, and they would cost money as many of them require the government to force the cost of healthcare down.
cfreeman2016

Debunking What the Health - 1 views

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    What the Health is a documentary on Netflix that explains the health benefits of an all plant based diet. It is a very biased documentary. It tries to get you to go Vegan. No animal products what so ever.
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    Some might say my mom is a bit of a health nut, and she definitely avoids feeding us processed foods and GMO products, but she doesn't cook vegan. The fibers and proteins packed inside of organic and dieted (grass fed) meats are very important for a balanced nutrient intake. Obviously, I agree more with the writer than the show producer.
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    I heard of this show several times. I want to watch it for myself to see what its all about. I also would never go Vegan.
pai2035626

Mandatory Vaccines for Health care professionals - 0 views

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    This article examines the issue of mandatory vaccines. The article looks specify at the health care field and health care professionals.
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    This article examines the issue of mandatory vaccines. The article looks specify at the health care field and health care professionals.
jul2193271

Human Right to Health and Health Care - 0 views

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    This site gives reasons and research as to why health care is a universal right. It stipulates the conditions for what people should get, and how.
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    This site gives reasons and research as to why health care is a universal right. It stipulates the conditions for what people should get, and how.
anonymous

Mental Health Care Access and Suicide - 2 views

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    This article goes into the relationship between access to mental healthcare and suicide. This article is important because it is crucial to be mindful of what is at stake when we're talking about why it's important to have wide access to mental healthcare.
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    I personally think that mental health has such a negative stigma around it, which is part of the reason it gets negated. Taking that negative stigma away, and providing people with access to the care they need is so important.
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    Mental health truly is something that gets disregarded a lot of the time. If anything, all the time. I agree, having access to mental healthcare is extremely important. It could be beneficial to so many people and could save numerous lives.
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    Its freightening how unaware we are as a people to mental health conditions. A condition that America has called its epidemic is obesity, but the root cause of so many conditions is actual mental health. Mental health is more than just people who struggle with a psycological problem.
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    It should be noted that at the end of the article it was concluded that the correlations between these to things do not nesssasirly entail causation.
hei2054360

Climate Change and Mental Health Connections - 2 views

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    Discussions about climate change and global warming occur on a regular basis these days, as it should. This article addresses the toll that climate change has on our mental health. This article has a lot of interesting information in it, and the points made in the illustration are very impactful.
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    As our society continues to evolve, so does our perception of mental health. I'm glad to see that external factors such as these are getting attention as to how they may cause distress on our society's mental health.
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    It's interesting because I have never really connected climate change and mental health. It makes sense when you think about it, how most people connect raining with depression and sunshine with happiness. A lot of factors go into maintaining mental health and our environment is definitely one of them.
chrisfowler94

U.S. Health Care from a Global Perspective, 2019 | Commonwealth Fund - 0 views

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    This article compares what Americans spend on health care to other high-income nations such as Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. Compared to these countries, Americans spend nearly twice as much on health care. The article goes over the causes of this such as obesity and expensive technology as well as affects such as higher rate of death from preventable causes and less doctor visits than average.
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.
kat2222004

Cost OF Note Caring:Nowhere To Go - 1 views

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    America's mental health is becoming an epidemic, yet funding for mental health is at an all time low. States are cutting funding for mental healthcare, in order to save money, yet when they do this they do not understand the repercussions. Many of the mentally ill often end up on the streets, jail or dead. When mental health is not treated we end up with many tragic events such as the 2012 Auroa shooting
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    This article talks about the effects of mental illness on the people suffering with it as well as families. It talks about how budget cuts mean less care for the sick and how that directly leads to more mentally ill people homeless, in jail, and dead. It also talks about how much money untreated mental health costs the US
Jennifer Seeglitz

Is President Obama's Individual Health Care Mandate Constitutional - 0 views

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    This article discusses whether the health care mandate is constitutional or not. The articles continues by discussing the the difference between state mandated car insurance and federally mandated health insurance.
kcreek9942

Why is Obamacare so controversial? - 0 views

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    One of the central provisions of President Barack Obama and the Democrats' healthcare reform law, known popularly as Obamacare, took effect on 1 October. Here is an explainer.
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    Obamacare was created to help American citizens receive affordable health care. It provides employees with health care they might not of had. The law aims to help the rising cost of health care.
rowan_staige

Access to Health Services | Healthy People 2020 - 5 views

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    Access to Health Services is a key issue in the Health Care domain as many people face disparities due to limited access. Many issues are covered in brief or general detail with focus on each main idea. These ideas include lack of Health Coverage, poor transportation services, deficient Health Care Resources, and how they impact vulnerable populations.
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    Healthcare barriers are a concern in today's world, with pharma gaining ever more power within the government. Healthcare prices are skyrocketing, creating an economic barrier. I learned from this article that physicians could refuse to help patients using Medicaid just because of the lower rate. The goal of Medicaid is to ensure that low-income people can receive healthcare. Physicians should not refuse healthcare to the Medicaid population based on the rate of cost.
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    This article provides in depth insight on the barriers people face accessing adequate healthcare in America. It talks about how important healthcare is and how it is a human right to have equal access to it. The website provides credible evidence and sources to support all the contributing factors.
Aaron Nichols

Public Health and personal freedom - 0 views

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    In this article the author's argument is how public health and personal freedoms conflict. The author specifically wrote about alcohol as the drug of choice. He describes the public health perspective and restrictions on drugs, then explain the benefits of alcohol and how the restrictions effect one's personal freedom.
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    The author weighs in on some of the issues regarding personal freedoms and the conflicts that it has in public health. He argues that the individual's needs and freedoms need to be taken into account, rather than just the overall public health and safety.
casbautista

Disclosing genderqueer identity for medical professionals - 0 views

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    Many nonbinary and genderqueer identities face a difficult time when attempting to transition. While transgender health care framework is available for dealing with such instances, many health professionals simply are not aware or educated on the subject to accommodate to the needs of nonbinary or genderqueer people. The lack of awareness on the subject thus can cause complications or obstacles for people as people can be denied access to these services if the health professional believes that the person is not transgender.
eli2196775

International Breastfeeding Journal - 0 views

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    The American focus on the sexual purpose of breasts, rather than the physiological function of breasts, has serious public health consequences. Discomfort with breastfeeding in public lowers breastfeeding rates, which in turn negatively affects women's and children's short- and long-term health.
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    The American focus on the sexual purpose of breasts, rather than the physiological function of breasts, has serious public health consequences. Discomfort with breastfeeding in public lowers breastfeeding rates, which in turn negatively affects women's and children's short- and long-term health.
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