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smurphy6600

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

www.azcentral.com/...907734001

personal+freedoms healthcare narcotics social+healthcare opioid+crisis

shared by smurphy6600 on 07 Sep 21 - No Cached
lizznicole liked it
  • 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.
  • ...30 more annotations...
  •  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
smurphy6600

The Ethics (or not) of Massive Government Surveillance - 0 views

cs.stanford.edu/...ethics.html

personal+freedoms government+ethics social+technology tech+surveillance

shared by smurphy6600 on 06 Sep 21 - No Cached
  • Prominent examples of surveillance include surveillance cameras, wiretaps, GPS tracking, and internet surveillance.
  • expression of control
  • profound impact with regards to the ethics of placing individual under surveillance
  • ...20 more annotations...
  • close surveillance is much more intrusive than it has been in the past.
  • Constitution protects American citizens from unreasonable searches and seizures
  • citizens have not been given the same protection with regards to electronic surveillance
  • "If you haven't done anything wrong, you have nothing to fear."
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      This statement has an Orwellian tone to it to indicate the tone of the article to the reader as cautious, paranoid even, and fearful
  • as most people are law-abiding citizens, most ostensibly will not be targeted for surveillance and it will not impact their lives,
  • safer through the elimination of criminals.
  • the government already has the ability to track a known target's movements to a reasonable degree, and has easy access to information such as one's purchasing habits, online activities, phone conversations, and mail.
  • if the individual has been treated unfairly and procedures violated, are there appropriate means of redress? Are there means for discovering violations and penalties to encourage responsible surveillant behavior
  • allowing surreptitious surveillance of one form, even limited in scope and for a particular contingency, encourages government to expand such surveillance programs in the future
  • the danger of a "slippery slope" scenario cannot be dismissed as paranoia
  • British police are now pushing for the DNA collection of children who "exhibit behavior indicating they may become criminals in later life"
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      This opens a door for discriminatory profiling from government agencies and educators who report the behavior
  • M.I.T. professor Gary Marx, who argued that before implementing surveillance we should evaluate the proposed methods by asking a number of questions, which we enumerate below:
  • does the technique cross a personal boundary without permission (
  • are individuals aware that personal information is being collected, who seeks it and why?
  • consent
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      The issue seems to be that consumers using the technology our government tracks aren't aware of what they are consenting to due to the long and overly-articulated terms and conditions presented to them in a purposefully confusing manner in order to gain access to their data
  • human review of machine generated results
  • With the expansion of surveillance, such abuses could become more numerous and more egregious as the amount of personal data collected increases.
  • security of the data be adequately protected?
  • are the goals of the data collection legitimate?
  • In general, we feel that surveillance can be ethical, but that there have to exist reasonable, publicly accessible records and accountability for those approving and performing the surveillance in question.
  • smurphy6600 on 06 Sep 21
     
    The website offers links to various sources of information on the collection and distribution of surveilled data from government agencies in an attempt to inform its readers and covers the paranoia tinted tone of those who find government surveillance in todays society to be too close to "Big Brother" methods and presents an argument for their point of view through the methods of MIT professor Gary Marx. The argument is presented in a series of questions on the ethical stance of what the government surveils, what the surveillance consists of as well as the consequences of any action taken as a result of surveillance and the reality that American citizens never consented to the constant surveillance of their personal lives. The position of inclination towards complacency is concisely summed with a strong amount of surveillance being presented by the double edged statement of "If you haven't done anything wrong, you have nothing to fear.".
smurphy6600

How Trauma Affects Kids in School - Child Mind Institute - 1 views

childmind.org/...how-trauma-affects-kids-school

personal+freedoms education+trauma education+behavioral+therapy social+education neglect+children+education

shared by smurphy6600 on 06 Sep 21 - No Cached
  • children experience trauma through ongoing exposure, throughout their early development, to abuse, neglect, homelessness, domestic violence or violence in their communities
  • children experience trauma through ongoing exposure, throughout their early development, to abuse, neglect, homelessness, domestic violence or violence in their communities
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      what is trauma for children
  • “They are masters at making sure you do not see them bleed.”
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      uniquely stated- a quotable line for a summary
  • ...12 more annotations...
  • symptoms can mimic other problems, including ADHD and other behavior disorders.
  • Trouble forming relationships with teachers Poor self-regulation Negative thinking Hypervigilance Executive function challenges
  • They’ve learned to be wary of adults, even those who appear to be reliable, since they’ve been ignored or betrayed by those they have depended on.
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      How can a child succeed in a school setting when they don't know how to ask for help when they really need it? Their trauma sets them up for failure because they have to be so self reliant at home
  • One of the challenges in giving that support is that when kids misbehave, our schools often use disciplinary systems that involve withdrawing attention and support, rather than addressing their problems
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      this re-enforces their idea of being alone doesn't it?
  • They need coaching and practice at de-escalating when they feel overwhelmed
  • they develop the belief that they’re bad, and what’s happened to them is their fault
  • “hostile attribution bias” — the idea that everyone is out to get them
  • They see negative where we see neutral
  • One of the classic symptoms of trauma is hyper-vigilance
  • This can look like hyperactivity
  • hronic trauma affects children’s memory, their ability to pay attention, plan, think things through, and other executive functions. Kids who have ADHD as well as trauma may be especially impaired in these skills.
  • Kids who have experienced chronic neglect tend to be better at getting attention by provoking the adults they depend on than by complying with expectations.
  • smurphy6600 on 06 Sep 21
     
    Caroline Miller explains the effects of trauma in children presents itself in the class room. The various ways in which a child might have socialization issues as well as difficulty asking for help from adults in a school setting after the neglect and abuse they are facing at home. The website also offers alternative teaching styles teachers could use in the classroom to help students facing trauma at home begin to from attachment styles in healthy ways.
smurphy6600

The Role that Residential Schools Play in the Socialization of Deaf Children - 1 views

www.ericdigests.org/...life.htm

personal+freedoms deaf+culture deaf+education residential+schools+deaf american+education socialization+education

shared by smurphy6600 on 06 Sep 21 - Cached
  • A residential school for students who are deaf has a comprehensive academic, health, and socialization program including dormitory living equipped for students who are deaf.
  • many view residential life as the ideal opportunity for students who are deaf to become familiar with and enculturated into the Deaf community.
  • because the language of the Deaf community, American Sign Language (ASL), is used
  • ...19 more annotations...
  • communication is not a barrier to social life
  • opportunity for socialization
  • This heritage is passed on from one generation to the next via the residential school,
  • Most schools for the deaf use some form of sign language (Padden & Humphries, 1988).
  • 78 residential schools for the deaf or deaf and blind in the United States
  • Parent/Infant program administered by the school provides much needed services until the child is ready to attend
  • child has access to role models who are Deaf.
  • Hearing parents of children who are deaf seem to have greater reluctance about sending their children because they do not want to be separated from them (Scheetz, 1993).
  • Parents who are Deaf themselves often choose a school for the Deaf over local schools because of the opportunity for their child(ren) to participate in the life of the Deaf community and culture
  • Students who are deaf and who attended mainstream schools must continue to prove their allegiance to the Deaf culture if they have chosen participation in adulthood (Reese, 1996).
  • Deaf students who are mainstreamed miss out on the feeling of belonging that individuals from the Deaf culture associate with their residential schools,
  • Mainstreamed students often are singled out in many respects.
  • The students are exposed to deaf adults with various types of careers
  • The residential school is the point of contact for the Deaf culture
  • It is like a home away from home
  • Many students who have attended residential schools and who are members of the Deaf culture will admit to some regret over missing out on a closely knit family life
  • quickly add
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      the author is biased in their writing and offers a biased perspective of this
  • the curriculum of the typical residential school tends to be less rigorous than that of other schools (Lane, Hoffmeister, & Bahan, 1996).
  • parents tend not to participate in their child's education to a sufficient degree
  • smurphy6600 on 06 Sep 21
     
    The author reviews the purpose of Residential Schools for the Deaf and how they influence the social life and wellbeing of the children who are sent there for the better. The article shows a bias leaning towards the schools although there are many hearing families who find themselves troubled by the idea of sending their Deaf children away from K-12 but the article brings forward the positive aspects of how a residential school is uniquely capable of helping deaf children develop confidence and capable social skills that would allow them to experience a proper education unlike a mainstream public school in which they would most definitely be out-casted by their lack of resources, culture, language, and role models. It shows both the pros and cons of the residential schools for the Deaf in America but with a clear bias, however this is not unreasonable. Despite the clear bias towards residential schools from the author the article offers a point of view of hearing parents finding issue with sending their child away from home for long periods of time as they would experience with a residential school.
smurphy6600

First Water Supply Cuts to Hit Arizona Farmers - 2 views

apnews.com/...f4c472fa64fe57be4b8823c5423fc0

personal+freedoms water+scarcity food+shortage arizona+water+supply climate+change

shared by smurphy6600 on 06 Sep 21 - No Cached
  • Climate change, drought and high demand are expected to force the first-ever mandatory cuts to a water supply
  • the Colorado River
  • Arizona farmers hard.
  • ...19 more annotations...
  • local economy will take a hit.
  • Pinal County, Arizona’s top producer of cotton, barley and livestock
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      This is the food shortage that our water supply shortage will lead to
  • They knew this was coming
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      A way to prevent food scarcity as much as possible while water shortage becomes a real time issue
  • rely on groundwater that’s already overpumped.
  • The nation’s largest reservoir already has hit the level that triggers mandatory shortages — 1,075 feet (328 meters) above sea level.
  • most deeply felt in Arizona
  • exchange for U.S. funding
  • canal
  • reservoirs dipped to historic lows across the West. Scientists blame climate change for the warmer, more arid conditions over the past 30 years.
  • melted snow from the Rocky Mountains
  • drinking water, nourishment for crops and habitat for plants and animals
  • storing water underground and in Lake Mead and through conservation.
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      preparing for the shortage ahead of time
  • recycled water
  • desalinating water from the Sea of Cortez in Mexico.
  • all of those things need to be done.”
  • some of the water that farmers will lose will be replaced by other sources next year.
  • e groundwater infrastructure.
  • drip irrigation that makes water use more efficient and crops more productive,
  • guayule, a drought-resistant shrub that could be used in the production of rubber.
  • smurphy6600 on 06 Sep 21
     
    The article reviews recent news from Arizona government limiting water supply allotted to farmers for 2022 due to the record breaking low of the Colorado river and the status of the drought. It reviews climate changes effects on our western water supply from the Colorado River and Arizona's share of its percentage being cut by an agreement from the early 1900s. The water supply will force farmers into seeking more resourceful ways of farming from drought proof crop to reducing their growing area and crop types but ultimately demands a change in how the western states and Arizona source their water supply as it effects our food supply for the future.
smurphy6600

Poll shows public opinion on media-bias perceptions | The Free Speech Center - 1 views

www.mtsu.edu/...ight-on-media-bias-perceptions

personal+freedoms media+bias american+politics+media american+perception+bias

shared by smurphy6600 on 06 Sep 21 - No Cached
  • Are America's news media more biased than ever before, or are we simply looking in the mirror?
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      dramatic statement, meant to frighten readers or insinuate a bias
  •  a survey conducted by the Knight Foundation and Gallup.
  • 49 percent
  • ...13 more annotations...
  • “a great deal
  • 37 percent see “a fair amount.”
  • news source they turn to most often.
  • 88 percent
  • great deal
  • political division”
  • free press as pivotal to our democracy.
  • social media combat.
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      this is a rather specific term to use. The author is very pointed in their language
  • I grew up in the Chicago area
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      author self insertion
  • series of litmus tests
  • triba
  • approach colors the perception of all news outlets.
    • smurphy6600
      smurphy6600 on 06 Sep 21
       
      a quotable line
  • we're the ones driving the traffic and ratings
  • smurphy6600 on 06 Sep 21
     
    A poll done by the Knight-Gallup foundation is reviewed in this article by MTSU in which the author, Ken Paulson, gives his thoughts on the polarizing effects of how American Media has changed from being simply separated by partisanship to a new era of inflamed division. Paulson cites the poll by Knight-Gallup to show that public opinion coincides with his own views in that our media is too heavily biased and is to blame for political division. The article has a strong close bringing readers to be introspective as to why the news articles in which they might place blame are continuously fired up by views and demand.
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