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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.
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.
chy2142465

Minors and the Right to Consent to Health Care - 0 views

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    This article focuses on whether or not a minor should have the ultimate jurisdiction over their own health care. On the one hand, it seems normal to give parents the responsibility of making decisions regarding their child's health care, but on the other hand, minors should have the right to keep certain medical information private.
dia2056159

Maternity Leave in the United States - 6 views

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    This article discusses how the United States is behind when it comes to providing paid maternity leave. The United States does not guarantee paid maternity leave.
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    This is a very sad topic, i think everyone should be able to get maternity leave no matter the standards because there is nothing more beautiful than seeing a mother and father so happy with their new born baby. I believe that people should have longer maternity leave.
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    I think everyone should be able to have maternity leave because its important for the mother and father to be with their baby. I think they should also be paid while taking this time off because they still need to be able to support the child and that cant be done if they are not making money.
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    With the evidence that researchers have uncovered within their study on new mothers; these findings can be very alarming. Especially, the diagnose of postpartum depression. This is great evidence that can support this continuous debate.
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    Pregnancy is the most beautiful thing a mother can experience, but at the same the most painful. With maternity leave mothers and fathers can have that time to recover and get back to their daily routines.
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    My wife gave birth to our daughter back in August, she is a school teacher and it's very heartbreaking to know that current practices in the state of Arizona have defined pregnancy as a "short term disability." True there are aspects that are disabling, but the definition itself is what removes the obligation of the state to pay for leave, instead leaving woman in the education sector to pay for supplemental health care as current healthcare for public workers does not support pregnancy. At least in our case, I'm sure there are very rare exceptions.
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    The U.S. needs to recognize that mothers need way more time than they actually get for maternity leave! Giving birth is such a beautiful but extremely painful and tiring/draining thing that women need time to recuperate from.
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    I believe in maternity leave in just about any work place. The mother gets it rough and the thought of not getting paid maternity leave just stinks. I also believe that husbands should get maternity leave. Like, what if the mother has a higher paid job, and it is the dad that stays home?
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    With the USA coming in last in maternity leave rights, Rita Ruben talks about the injustice the work place creates by not giving mothers the time and money they need to welcome their newest member of their families. Some countries even offer paid paternity leave, but in the USA, FMLA only saves your job as a mother. No pay or fathers allowed.
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    This article points out the US is the last of the fairly developed countries when it comes to advancement in women's maternity leave. The article talks about studies that have shown how a women's maternity leave can have an impact on her overall health and well-being.
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    I think the author made a very important comment by saying, "The mother's mental and physical health can be an important route through which infants are affected by parents' employment decisions." I totally agree with this. How can we ignore our health after having a baby. I have 5 children and I was fortunate enough to not have to work. I was able to stay home and heal, and most importantly bond with my baby. I recovered well post child birth, and I was able to be the best mother I could be to my children.
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    This is a huge social injustice towards the mothers who have just given birth. Making maternity leave as a paid family leave is wrong because the mothers have to later make up all the time they took off to care for their newborn, which can be months.
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    I think new moms definitely get the shaft when it comes to maternity leave. Just watching people in my life have their kids, and the struggles that can come after besides adjusting to new life I think it is a complete injustice that new moms don't have the option to have more paid time, separate from their regular PTO.
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    It's truly heartbreaking to think about the struggles that many mothers have to face. They were just introduced to motherhood and already have to worry about not being able to have the time or money that is deserved. Most of all, the time needed to recover post birth.
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    I think that maternity leave is vitally important for a mother and her child. However, what about fathers the child is just as much theirs yet little to no maternity leave is given. Usually if they take the time off for the birth of the child it comes out of their paid time off if they would like an extended amount of time.
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    The United States definitely falls behind compared to most modernized countries in-regards to this. The fact that studies show much higher results for emotional bonding between parents, and the retention of employees for the company they're employed for, when giving maternal/paternal leave. I understand the reason why it's difficult for many American businesses to be competitive to some European industries that can have months off at a time for this, but even a couple paid weeks may make all the difference at a minimum for both parents, to adapt, and prepare for their new schedule/lives.
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    I feel like every women should be guaranteed paid maternity leave. The government constantly wants us to re produce to keep the world going, so they should encourage women that they'll be fine with money and won't have to worry about missing work.
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    Maternity leave should be a MUST. Pregnancy is tough and the delivery is life changing. Mother's go through all different kinds of changes. It is unfair for a mother to have to go through these changes all while worrying about having to go to work and missing and wondering how her child might be doing.
ale2164926

Healthcare access to everyone? - 1 views

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    Healthcare is an issue that is present today, especially with the election that just occurred. Some believe that everyone should have free access to healthcare and note that if other countries can do it, so can we. The other believe that it is the individuals personal responsibility to figure out how they are going to get it and believe that universal coverage would be too expensive.
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    I agree completely. It is possible and other countries have proven it. It's just a matter of rejecting the lobbyists, insurance companies, and pharmaceuticals that make money off of private citizens. Healthcare should be a basic human right and not something that can cause you to go bankrupt.
azrafuentes101

The Emotional Toll of Obesity - HealthyChildren.org - 0 views

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    Childhood obesity can cause a kids mental health to go bad. It is very common for a child to get made fun of by other children because of their weight. The negativity the child is receiving will soon result in a low self esteem, depression, and more.
Michelle Evrard

Paid Vacation Time Not Required in the US - 0 views

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    Forbes reports that the US is the only advanced economy not forced to provide workers with paid vacation time. Compared to other countries, the US is incredibly greedy when it comes to compensating their workers. Paid vacation is essential for the mental and physical health of hard working employees.
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    Forbes reports that the US is the only advanced economy not forced to provide workers with paid vacation time. Compared to other countries, the US is incredibly greedy when it comes to compensating their workers. Paid vacation is essential for the mental and physical health of hard working employees.
Christina Romano

Penalties for smokers and obese - 0 views

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    This weighs the options of penalizing obese people ans well as smokers. On average they die 10 years faster than the normal person. It is something they feel against the poor. "Its not about their health its about everyone else"
sebastianw1991

Information on childhood obesity and other related health concerns - 1 views

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    In general a good website for all topics concerning health. I have included a direct link to the obesity section. 2 in 3 American adults or either overweight or obese. This makes America the leading country in problems such as, diabetes and heart disease.
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    I also bookmarked an article about child obesity. It is very informative on statistics about child obesity and how much it is growing.
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    I also found that not only obesity is linked to diseases and disabilities but it can affect a person mentally. The article I found explained how a persons mental health is what makes the process of preventing obesity more challenging
krista_trigg

The Legatum Properity Index™ - 0 views

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    The Legatum Prosperity Index™ is a unique and robust annual assessment of global wealth and well being, which benchmarks 142 countries around the world in eight distinct categories. The interface is user friendly and easily shows how the United States rates against others in areas such as education, personal freedom, and health.
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    The Legatum Prosperity Index™ is a unique and robust annual assessment of global wealth and well being, which benchmarks 142 countries around the world in eight distinct categories. The interface is user friendly and easily shows how the United States rates against others in areas such as education, personal freedom, and health.
krista_trigg

Home - The Social Progress Imperative - 0 views

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    This is the website for an interesting project that details how nations compare to other nations based on certain social progress - including categories like health, ecosystem sustainability, basic education and personal safety. Though the United States ranks high in advanced education, it ranks significantly lower in basic education measures.
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    This is the website for an interesting project that details how nations compare to other nations based on certain social progress - including categories like health, ecosystem sustainability, basic education and personal safety. Though the United States ranks high in advanced education, it ranks significantly lower in basic education measures.
Chelsea Faulkner

Learning from the Health Care Systems of Other Countries - 0 views

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    Increase of U.S. health care costs and how they compare with other countries.
tri2151918

Should Health Care Cover Contraceptions? - 0 views

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    With the current debate over the funding of planned parenthood I thought it would be fitting to add this in. Should contraceptive services be provided to women regardless of their employers personal beliefs?
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    Absolutely. Contraception is a medication used for many other health issues. Even though the main use is to prevent pregnancy, should you prevent others from using it to slow ovarian cyst growth? Most diabetes medicine has a side effect of weight loss. Should this medication be stopped, because weight loss drugs aren't covered by health insurance?
suzie5050

Trump Touts Executive Orders, Preparation for Health Care Repeal After First Week - 4 views

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    This article briefly cover the changes that the new president has made in his first week in office.
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    It does list all of the big-hitting topics in the news lately. The repeal of AHA, the TPP, the pipeline, and many other first week orders. I don't recall of any other president making so many drastic changes or attempts at drastic changes this early in their term.
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    I worry about how fast he is doing things and that he isn't really thinking through consequences. I'm not a big fan of Obamacare, but when faced with that or nothing, I'd stick with it, at least until something better can be found to make sure everyone has access to affordable health care.
karlag1308

Unequal Access to Health Care Costs Us All - 3 views

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    This article discusses how corrupt the healthcare in America is compared to other countries. It shares why they make the healthcare expensive & who it ultimately benefiting from it, being the pharmaceutical industry & the rich. Also shares how even though your work may pay for you healthcare, you're still the one getting gyped.
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    I actually wrote a presentation last semester on how the U.S. healthcare system is flawed. In my presentation, I outlined issues such as these. It's refreshing to see others share my views. Personally, this is an interesting read, as I intend on being a part of the healthcare industry. That being said, I believe future generations of healthcare workers need to be educated in matters such as these, so that one day, we may hopefully be able to "fix the system."
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    America's healthcare is the most expensive amongst industrialized nations. But higher costs aren't leading to a healthier population or longer life expectancy. The high cost of healthcare negatively affects the American economy in many ways.
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    I found this article to be very fascinating indeed. I hope that one day we will have a health care system that is excess-able to all Americans. Hopefully a solution will be properly found during our life time.
Nicholas Dubs

21 graphs that show America's health-care prices are ludicrous - 0 views

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    It is a known fact that Americans are paying way too much for Health insurance. Americans pay much more for the same coverage than other counties.
anonymous

Does the U.S. Need Universal Health Care? - 2 views

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    This advocates for the implementation of universal healthcare in the United States. It also talks briefly about why Americans seem to be so resistant to a new healthcare system.
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    I feel the need for universal health care has been push to the headlines due to COVID-19, since so many people are unable to pay for healthcare.
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    I liked how the article pointed out that people are doing go fund me accounts and that is a good example because many people are unable to afford healthcare and people are depending on other individuals to pay for their medical bills and it is a huge issue.
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    I really liked the article and liked how it gives examples of what is happening due to healthcare being so expensive.
sldaly

Obesity in Children - 5 views

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    One third of children in the U. S. is overweight or obese, and this number is continuing to rise. Children have fewer weight-related health and medical problems than adults. However, overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life.
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    Obesity in children in our country happens to have the highest percentage in comparison with other countries. I think we, as parents and we, as responsible adults can change this. We should have in schools mandatory pysical education classes, at least once a week. and it would still make a difference. Also, the school snacks or lunches, the menu needs adjustment and changed to a more nutritional one, not one that is high in calories. Now, I know that kids love fast food, but if that can be limited I think would change something. Sometimes us, the parents we are making this mistake, being in a hurry out of convenience, we buy some fast food and dinner ready. Of course, the child loves it and everyone is happy, but if we do this over and over, the result is child obesity and health issues related to that. The change needs to start with us, as adults in the choices we make.
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    Diet and activity is so important especially when it comes to children. Adults are supposed to engage children in daily activities and teach them while they are young to have a clean eating diet. The U.S. definitely has the highest rates when it comes to obesity. With all the fast and processed foods around it just makes it convenient for us all to buy.
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    Parents who let their children become obese are abusive. Also these so called "healthy" menus at schools are often nothing more than calorie restrictions. For example, my former high school Ironwood often only served a slice of pizza and that is it and charged $2.75. Students would instead by 2 slices of pizza from vendors for a dollar each. Also many students just skip lunch all together and snack after they get home from school. Another problem is the budget. Cafeteria workers make very little money and have a small amount of money to spend,. As a result cafeterias serve junk food because it is cheaper. Also many parents use the busy excuse to be neglectful of their children's health.
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    To say that parents who let their children become obese are abusive have never struggled with weight. But that too is a generalization. There are so many children that are on fighting diseases and are given medication that has side effects of weight gain.One of these drugs is steroids. My daughter is fighting several different battles she was born with. She is on steroids, by the doctor, to fight one of the diseases. She is also a love vegetables and fruits. She swims every week. She takes tap, ballet, jazz and gymnastics. She is overweight, but very fit. Some diseases are ruthless. To say that being overweight is because you eat pizza and that you are unhealthy is just wrong. There are many ways that you can be unhealthy. Looks can be deceiving. Don't judge that book until you read it
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    High blood pressure at such a young age is horrible. The parents are not the only ones at fault but our society is at fault for allowing to go as far as it has gone. As "aus2127741", states about the school systems lack of nutritional value is absolutely correct, it being disgusting.
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    Obesity in children is often sad to see but it is becoming very prevalent in American society. In my opinion, a mixture of an extremely sedentary lifestyle as well as poor nutritional choices at school and at home contribute largely to this issue. Because children now have a multitude of indoor activities that don't necessarily get them on their feet and a lack of overall knowledge on what is a decent, balanced diet I'm not really surprised to see this issue skyrocketing.
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    Obesity is still rising especially because of the pandemic that we are going through which made families quarantine for a long time. It is very sad that the obesity rates only have increased.
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