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The scams Phantom treatments. Dishonest medical providers will bill health insurers for expensive treatments, tests or equipment you never received - and for illnesses or injuries you don't even have. Double billing. Unethical providers may double- or triple-bill health insurers for the same treatments, hoping the insurer won't discover the overruns in the big stack of bills. Shoddy care. You might receive shoddy or substandard treatment for real and urgent medical problems. One eye doctor shined pen lights into patients' eyes and said he'd performed cataract surgery. Surgeons have used defective pacemakers and catheters during heart surgeries, which have killed patients or required more surgeries to correct the problems. Unneeded care. You might receive dangerous and even life-threatening treatment you don't need. One surgeon performed heart surgery on patients who didn't need it. Bogus insurers. Insurance agents or brokers sell you low-cost health coverage from fake insurance companies. Then they take your premiums and disappear. You're left without vital health coverage, and don't even know it until you make a claim. Identity theft. Cheaters steal your medical ID number, then use it to bill health programs tens of thousands of dollars for phantom treatment. Crooks steal your health info from dumpsters behind medical clinics, break into doctor offices and steal files, and hack into computer databases containing your records. Rolling labs. Mobile diagnostic labs give needless or fake tests or physical exams to consumers, then bill health insurers for expensive procedures. Runners. A person hired by a medical provider to drum up business trolls through neighborhoods, often low-income areas, enticing people to come to a clinic for tests. These runners will even round up children for unneeded tests and procedures.

How to Find Affordable Family Health Insurance http://www.westhillinsuranceconsulting.com/blog/how-to-find-affordable-family-health-insurance/ Take advantage of free quotes: Who doesn't like free, it a great price! There are many health insurance websites where you can find lot of sites with free family insurance quotes. You must take advantage of these. Not every policy is going to fit for everyone because every family is different. To know the best one for you and your family, use these quoting tools to gather prices and service offerings. And do not think about it as a waste of time, after all it is a free look into the company. It is free yet well worth the time it takes to fill out the questionnaire or quoting application. Know your priorities: You should know and you must be well aware of all your priorities regarding your health care. Are you satisfied with your current doctor or are you open to find new ones? If you are unsure, sit down and take some time listing of your top five most important things when looking for a new policy or health insurance company. This will help you narrow down exactly what you only need and what your looking for. Ask for help if you need it: It is all known to us that understanding the ins and outs of health insurance policies and coverage could sometimes be very frustrating. This is more common to those who are just new to it. Do not hesitate to ask questions if you need to ask questions, ask your questions to the health insurance company representatives. You can even ask your husband, your wife, your dad, your mom, or even your friends. But if you feel that you are not satisfied with the answers you got, don't be frightened to enlist the help of an insurance broker. They can help you find the best rates available, can explain the inner workings of the policy, and know what places are reputab

The needs of elderly parents can surprise even those who are prepared, but you don't have to support your family alone Adult children of older parents should prepare financially for the costs of care and travel. Photograph: Alamy We all want to age like the late Pete Seeger, who celebrated his 90th birthday performing onstage in front of thousands of adoring fans of all ages at Madison Square Garden, and went on to entertain the Newport Jazz Festival audiences a few months later. In our pragmatic moments, we know that the odds of living that long and in such good health aren't in our favor. We know we need to plan not only to live longer but perhaps to spend more time in costly nursing homes or care facilities. It's not just ourselves we have to worry about. Failing to develop a plan to help our parents in their final years could deliver a similar kind of blow to our emotional and financial wellbeing. In the last few months, I've watched three friends, ranging in age from their 40s to the early 60s, scramble to resolve non-medical problems for their parents. In all cases, that meant forking out on costly airfares to be there in person; in one case, it required money to hire a new accountant. "I've always been aware that at some point, there would be an emergency, but I had assumed it would be a stroke or something, not this," one told me, ruefully. A recent US Trust survey revealed that while about half of all Americans have planned for their own long-term care needs, on

Westhill Consulting Insurance - How to Avoid Health Care Fraud Mail-order medications Patients who buy drugs through mail-order companies could be rolling the dice with their health says Dr. Deborah C. Peel, a physician and founder of the nonprofit Patient Privacy Rights. There's a high probability in many cases that these drugs are counterfeit Peel added. "And you don't ever know because the fraudulent tablets look just like the real ones," says Peel. She says ordering from companies that specialize in mail-order sales that are not affiliated with a legitimate insurance company, especially from foreign countries, can be very risky. Not only could the quality be questionable, it could also be illegal. "But people are desperate because we're being so grossly overcharged for medication," she says. Peel says you can lessen costs by buying generic. You can spot it by: the best thing to do is to keep away from buying drugs from foreign or obscure pharmacies. And if you decide to go with the mail-order route, just stay with U.S.-based companies because if it's a U.S. company, you can report the health care fraud to the Food and Drug Administration while if it's a foreign company, there's little that can or will be done. False product claims According to the Federal Trade Commission, millions fall victim each year to false miracle cures. Especially vulnerable are victims of debilitating and potentially deadly illnesses such as cancer, multiple sclerosis, HIV and AIDS. The FTC website says scammers take advantage of people with a grim diagnosis such as cancer and "promote unproven - and potentially dangerous - substances like black salve, essiac tea, or laetrile with claims that the products are both 'natural' and effective." But, say physicians and other experts, simply because something is advertised as "natural" doesn't mean it works. And while a patient is experimenting with bogus treatments, he or she can squander the opportu

Tips for navigating Obamacare http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-tips-for-navigating-obamacare/ Think hard before your drop insurance entirely Tambe said that might not make good business sense despite some companies might be tempted to abolish insurance benefits completely and let employees go to marketplaces to get coverage. The problem is insurance purchased on the marketplace will be more expensive for individuals. Then the company will risk talent leaving the company for a competitor who offers them the less expensive option if the company isn't willing to compensate by raising their salary. "It may work to keep costs down but you'll have a hard time keeping talented folks," he said. Other federal programs could help you For households making under 400 percent of the Federal Poverty Level, the ACA grants subsidies available on the public marketplace under certain circumstances. Additionally there are current efforts for Ohio to spread out the Medicaid program to households making less than 138 percent of the poverty level. This in turn if acted out would make more people eligible for those programs. Not all individuals will qualify for subsidy even though most Americans will be eligible to obtain coverage through the exchange. Employer-sponsored coverage may affect an employee's ability to meet the criteria for the subsidy. If there are many employees qualify for federal assistance, it will be reasonable to let them use those plans, particularly since employees being offered insurance by an employer aren't allowed onto the marketplace if their employer is offering insurance deemed affordable, or 9.5 percent of their wage rate based on 130 hours per month for single coverage. "A lot of folks qualify for these things, and there's no penalty to employers," Tambe said. Know the paperwor

"Is 'Obamacare' like Canada's health-care system? 'Not even close,' according to critics The first major U.S. health-care reform passed in nearly 50 years is the Obamacare but regardless of critics passing judgment on "Obamacare" as "Canadian-style" health insurance, critics note that major differences between the two systems persist. The U.S. Patient Protection and Affordable Care Act, which went into effect earlier this week, is "not even close" to the Canadian system says McGill University Professor of Political Science Antonia Maioni. "Obamacare keeps in place the basic principle of health care in the United States which is: if you want to get access to care you need to buy insurance coverage," she told CTV News Channel on Friday. "Obamacare is trying to make it easier for people to be able to buy that insurance coverage and, if you are very poor, to be able to qualify for a government program. But it doesn't have the same principle as in Canada, where if you are a legal resident, you are automatically enrolled in a provincial or territorial health plan." In an op-ed published in the Globe and Mail, Maioni said the major differences between "Obamacare" and Canada's health-care system include: "Obamacare" is not a single-payer system (where one entity, usually the government, pays all costs) Care depends on the type of insurance coverage you buy Insurance coverage varies by state Wait times are based on the level of insurance coverage Obamacare" faces challenges in cost control Maioni said that while "Obamacare" was passed, in part, to address American spending on health care - the highest in the world at nearly 18 per cent of GDP, or $3 trillion - the act remains "problematic." "There's nothing in it that speaks to really serious cost control," she said. She furthermore said that while Canada also spends a lot on health care, there are mechanisms that the provinces can use to contain spen

When the Bergen County couple filing for unemployment certified they were "able and looking for work," they did so the same way thousands of others do from home every week - by logging into the state Department of Labor website. The online world, however, is not quite as anonymous as many believe. Every computer carries a unique electronic address so it can be found on the internet, and what alerted state investigators to this particular claim was the location of the network being used. It was not in New Jersey. It was registered to Royal Caribbean Cruises in Miami, and no one was under any illusion that the couple was looking for work at sea. Unemployment fraud is a multimillion-dollar business in New Jersey, say officials, with 1,600 to 2,000 attempts to bilk the system each week - from the couple on vacation certifying they were able to work while cruising to the Bahamas, to hackers from all over the world trying to game the system, to people still trying to collect unemployment benefits even after finding new jobs. "No one likes to be ripped off, but the volume of money we put out is staggering," said Harold Wirths, the commissioner of the Department of Labor and Workforce Development. New Jersey's Unemployment Trust Fund went broke in 2009, not only under the strain of the severe recession that led to high unemployment levels, but from years of fraud that went on through decades of neglect. Wirths said the fund is now solvent again, due in part to anti-fraud measures being put into play that he said have saved the state $448.7 million the past three years. "We're fighting fraud on every front," the commissioner said. It is a national issue, according to Douglas Holmes, president of UWC Strategic Services, a Washington, D.C., group that represents businesses on unemployment issues.

Consumer Alert: The Impact of Health Care Fraud on You! In 2011, $2.27 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims are fraudulent. Although they constitute only a small fraction, those fraudulent claims carry a very high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. Whether you have employer-sponsored health insurance or you purchase your own insurance policy, health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage. For employers-private and government alike-health care fraud increases the cost of providing insurance benefits to employees and, in turn, increases the overall cost of doing business. For many Americans, the increased expense resulting from fraud could mean the difference between making health insurance a reality or not. However, financial losses caused by health care fraud are only part of the story. Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures. Or whose medical records are compromised or whose legitimate insurance information is used to submit falsified claims. Don't be fooled into thinking that health care fraud is a victimless crime. There is no doubt that health care fraud can have devastating effects. What Does Health Care Fraud Look Like? The majority of health care fraud is committed by a very small minority of dishonest health care providers. Sadly, the actions of these deceitful few ultimately serve to sully the reputation of perhaps the most trusted and respected members of our society-

When investigators suspected that Houston's Riverside General Hospital had filed Medicare claims for patients who weren't treated, they moved to block all payments to the facility. Then politics intervened. Rep. Sheila Jackson Lee, a Texas Democrat, contacted the federal official who oversees Medicare, Marilyn Tavenner, asking her to back down, according to documents reviewed by The Wall Street Journal. In a June 2012 letter to Ms. Tavenner, Rep. Jackson Lee said blocking payments had put the hospital at financial risk and "jeopardized" patients needing Medicare. Weeks later, Ms. Tavenner, administrator of the Centers for Medicare and Medicaid Services, instructed deputies to restore most payments to the hospital even as the agency was cooperating in a criminal investigation of the facility, according to former investigators and documents. "These changes are at the direction of the Administrator and have the highest priority," a Medicare official wrote to investigators. About two months after that order, Riverside's top executive was indicted in a $158 million fraud scheme. The hospital was barred from Medicare this May, and the CEO was convicted in October. What happened at Riverside General Hospital shows how political pressure from medical providers and elected officials can collide with efforts to rein in waste and abuse in the nearly $600 billion, taxpayer-funded Medicare system. More than a dozen former investigators and CMS officials said in interviews that they faced questions from members of Congress about policy changes or punitive action affecting providers or individual doctors.

February 25, 2014 - The Internal Revenue Service is offering educational Health Care Tax Tips to help individuals understand how the Affordable Care Act may affect their taxes. The IRS has designed the Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year, as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices. Although many of the tax provisions included in the law went into effect on Jan. 1, 2014, most do not affect the 2013 tax returns. The Health Care Tax Tips, which are now available at IRS.gov/aca, include: * IRS Reminds Individuals of Health Care Choices for 2014? Find out what you need to know about how health care choices you make for 2014 may affect your taxes. * The Health Insurance Marketplace - Learn about Your Health Insurance Coverage Options - Find out about getting health care coverage through the Health Insurance Marketplace. * The Premium Tax Credit? Learn the basics of the Premium Tax Credit, including who might be eligible and how to get the credit. * The Individual Shared Responsibility Payment - An Overview? Provides information about types of qualifying coverage, exemptions from having coverage, and making a payment if you do not have qualifying coverage or an exemption. * Three Timely Tips about Taxes and the Health Care Law? Provides tips that help with filing the 2013 tax return, including information about employment status, tax favored health plans and itemized deductions. * Four Tax Facts about the Health Care Law for Individuals? Offers basic tips to help people determine if the Affordable Care Act affects them and their families, and where to find more information. * Changes in Circumstances can Affect your Premium Tax Credit? Learn the importance of reporting any changes in circumstances that inv

http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-retire-overseas-8-top-spots-for-quality-health-care/

Retiring overseas may seem like a fabulous idea, but the quality of health care often has post 50s thinking twice before making a move abroad. But they needn't worry.Live and Invest Overseas, an online publication devoted to helping those interested in living abroad, has a list of the eight best places to retire for quality health care. (They also published a list of the 21 best places to retire in 2013 earlier this year.)

When the subject of health insurance is discussed someone raises the argument that because Medicare or Medicaid are government programs, they are subject to fraud. This is usually an objection from politicians who support Free Enterprise and fear Big Government. Let's be honest with ourselves, any human event that involves something of value attracts fraudsters. A bank robber, a hacker, a big company submitting false claims; all fall into the category of fraud. Any googling of Medicare fraud brings up some infuriating examples. For example, health care industry giant HCA (which the New York Times notes was bought by Bain Capital in 2006) eventually settled a Medicare fraud scandal (overcharging) for more than $1.7 billion. Or, last May the feds arrested 107 health care providers, including doctors and nurses, in several cities and charged them with cheating Medicare out of $452 million. In 2010, 94 people were charged with submitting $251 million in phony claims. Fraud isn't the product of scheming low-income beneficiaries - Mitt Romney's 47 percent - it is most often committed by big companies and rich doctors, not a patient seeking a second colonoscopy. We should admit that fraud is endemic to the insurance business, whether public or private. The Coalition Against Insurance Fraud estimates that in 2006 a total of about $80 billion was lost in the United States due to insurance fraud. According to estimates by the Insurance Information Institute, insurance fraud accounts for about 10 percent of the property/casualty insurance industry's incurred losses and loss adjustment expenses. So, how to tackle any fraud. Putting more police on the streets is an acceptable way of reducing crime. Private industry is free to hire as many investigators and accountants as it takes to catch fraudsters.

Wal-Mart endorsed ObamaCare in 2009 and helped drag the bill through U.S. Congress, and so far it hasn't recanted. By holding back economic growth and incomes, perhaps the law is expanding the retailer's customer base. Another plus-at least for management-is that Wal-Mart can jettison its employees into the ObamaCare insurance exchanges. The Associated Press reported Tuesday that the largest U.S. private employer is dropping health benefits for some 30,000 workers, or about 5% of its part-time workforce. Earlier health-plan eligibility triage in 2011 had removed tens of thousands of Wal-Mart workers from the balance sheet, so this latest purge was probably inevitable. Wal-Mart cites its inability to manage higher-than-anticipated health expenses. Perhaps- wasn't ObamaCare supposed to bring those costs down? Obviously the company is also responding rationally to ObamaCare's incentives. With a subsidized government alternative now open for business, and since corporations aren't liable for a penalty for not covering people who work fewer than 30 hours a week on average, cost-control logic says to send such coverage ballast over the side. Other retail and grocery chains including Target, Home Depot and Trader Joe's have already done the same. ObamaCare's critics predicted that such insurance dumping was inevitable, and the only question now is how many and how fast other companies partake of the new all-you-caneat entitlement buffet. Get whatever you like, the bill's on taxpayers. The disruptions will be concentrated in industries with large numbers of low-skilled and low-income workers, like restaurants, hospitality and, yes, retail. The irony is that even as Wal-Mart drops insurance because it is too costly, President Barack Obama is claiming credit for lowering health costs. He boasted the other day that the law gave every U.S. family "a $1,800 tax cut" by supposedly reducing the rate of employer-premium growth. Obama