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Rose McGowan

NICB Says Stop SCAMS Act Will Help Fight Insurance Fraud - 1 views

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    National Insurance Crime Bureau (NICB) says a bill introduced in the Senate yesterday provides much needed support for fighting healthcare fraud. The Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act, was introduced by Sen. Bill Nelson (D-FL), and is co-sponsored by Sens. Susan Collins (R-ME), Tom Carper (D-DE) and Chuck Grassley (R-IA).] The bill contains important provisions to strengthen the Healthcare Fraud Prevention Partnership (HFPP). The Partnership was established last year to focus on joint efforts to fight fraud by both the public and private sectors. "NICB is particularly focused on the bill's carefully crafted provisions relating to the sharing of fraud-related information and investigative activities among the HFPP's partners," said NICB President and CEO Joe Wehrle. This language is consistent with the HFPP's anti-fraud program and with laws already in effect in many states governing anti-fraud insurance investigations. "The same fraudsters who prey on government healthcare programs and private health insurance also target the medical component of auto and workers' compensation insurance," said Wehrle. "The HFPP is the most comprehensive effort ever undertaken to bring the nation's public and private resources together to protect the integrity of medical care and insurance. The Stop SCAMS Act's support for the HFPP will strengthen it and the anti-fraud program overall." About the National Insurance Crime Bureau: headquartered in Des Plaines, Ill., the NICB is the nation's leading not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through data analytics, investigations, training, legislative advocacy and public awareness. The NICB is supported by more than 1,100 property and casualty insurance companies and self-insured organizations. NICB member companies wrote $371 billion in insurance premiums in 2013, or more than 78 percent of the nation's property/cas
Rose McGowan

Clinical Trials Supported by Insurance - 1 views

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    Trials involving human patients are crucial to the advancement of clinical science. But they're not without risk. Fortunately, insurers are willing to cover them. Westhill Insurance Consulting, one of the most trusted on-line insurance consultant that offer consumer information on reasonably priced health and medical coverage has these following things to review if you are planning to take part in a clinical test. Challenging trials One challenge for underwriters is the relatively small premium base measured against a trend for higher [insured] limits to be requested. Clinical trials policies normally have "claims made" wordings which means that insurance coverage does not automatically extend beyond the trial dates. The potential gap is where you arrange insurance, let the policy end and have no insurance for an event which may occur sometime in the future that can be attached to the clinical trial. Serious problems in clinical trials are rare, as Rossano points out. "But what I would say is that clinical trials are not without risk. The risk of a clinical trial is that the human body is very complex and in rare cases there can be unforeseen outcomes, as happened in cases like TeGenaro."
Rose McGowan

Study: More exercise, less sitting reduces heart failure risk for men - Westhill Consul... - 1 views

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    Study: More exercise, less sitting reduces heart failure risk for men More exercise, less sitting reduces heart failure risk for men By American Heart Association DALLAS - sitting for long period's increases heart failure risk in men, even for those who exercise regularly, according to new research published in the American Heart Association journal Circulation: Heart Failure. Preventing heart failure, researchers found, requires a two-part behavioral approach: high levels of physical activity plus low levels of sedentary time. The study is the first to examine the link between heart failure risk and sedentary time, said Deborah Rohm Young, Ph.D., lead researcher and a senior scientist at Kaiser Permanente in Pasadena, Calif. "Be more active and sit less. That's the message here," Young said. Researchers followed a racially diverse group of 84,170 men ages 45 to 69 without heart failure. Exercise levels were calculated in METs, or metabolic equivalent of task, a measure of the body's energy use. Sedentary levels were measured in hours. After an average of nearly eight years of follow-up, researchers found: Men with low levels of physical activity were 52 percent more likely to develop heart failure than men with high physical activity levels, even after adjusting for differences in sedentary time. Outside of work, men who spent five or more hours a day sitting were 34 percent more likely to develop heart failure than men who spent no more than two hours a day sitting, regardless of how much they exercised. Heart failure risk more than doubled in men who sat for at least five hours a day and got little exercise compared to men who were very physically active and sat for two hours or less a day. Study limitations included: Since
Rose McGowan

Westhill Consulting Insurance - Saving for your ageing parents: an easy guide to where ... - 2 views

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    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
Rose McGowan

READER'S VIEWS: Enabling or blocking health insurance fraud - Westhill Consulting Insur... - 1 views

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    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.
Rose McGowan

Westhill consulting Insurance - Tips for handling early-year medical expenses - 3 views

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    The clock on insurance deductibles reset on Jan. 1, and that means big medical bills are in store for some. Patients may be required to pay thousands of dollars before their health care coverage kicks in. Insurers typically begin or renew policies in January, and that means customers could face some daunting cost-sharing requirements in the first few months of the year. That's especially true if they need surgery or have a particularly expensive prescription. Deductibles topping $3,000 are common among plans sold on the health care overhaul's public insurance exchanges, which provide coverage for millions. Companies also have been raising deductibles for years on employer-sponsored health plans, the most common form of coverage in the United States. Plus cost-sharing requirements for Medicare prescription drug coverage renew every year. All this adds up to a business boon for organizations like the Patient Access Network Foundation, which offers grants to help cover prescription costs for dozens of life-threatening, chronic or rare diseases. The nonprofit had to hire about 80 temporary employees to help handle the heavy workload it receives at the start of the year. It fielded 4,000 calls a day last month, double its normal total. "Everybody who works doing what we do has the same challenge," CEO Daniel Klein said. Klein's foundation is one option patients can turn to if too many expenses hit at the start of the year. Here are some other tips. Understand your coverage: You can't prepare for medical expenses until you know how big the bills might be. Your insurance should come with a plan summary that lays out important numbers. Start by understanding your plan's deductibles, which can differ significantly depending on whether care is received inside or outside the insurer's network of providers. If you take prescriptions, double check how much they will cost. Drug coverage is commonly divided in
Rose McGowan

6 Tips To Reduce Your Medical Costs - 1 views

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    According to the Centers for Medicare and Medicaid Services, healthcare costs are expected to rise by 5.8% each year until 2022, which is going to make for a pretty serious hike in your expenses. Instead of getting frustrated and giving in, though, put your thinking cap on. If you're willing to roll your sleeves up and do a little research, you can find plenty of ways to reduce your medical costs. Here are six of them. 1. Use Urgent Care Facilities Instead of the Emergency Room It's a pretty decent bet that there's an urgent care facility near where you live that you can use in lieu of the emergency room. It won't cost you as much, and many such facilities offer extended hours. Don't wait for the next time an emergency occurs - do an Internet search now to find suitable locations and note their hours of operation. 2. Improve Your Health One of the simplest ways to decrease your medical costs is to improve your health. If you're overweight, join a gym or create a home workout program and adjust your diet to include more fresh fruits and vegetables. Still smoking cigarettes? Buy a patch or join a support group and quit. Got friends who encourage you to party it up on the weekends? Find yourself some new ones or convince them to participate in healthier activities. Concrete steps like these can get you more fit and less likely to need medical attention. 3. Get Generic Prescription Medication Whenever your doctor prescribes any medication, be sure to ask for a generic option. You can save as much as 85%, according to the Food and Drug Administration, which also points out that you don't sacrifice anything in quality by avoiding brand name meds. 4. Pay Your Bill Upfront If you have the means to do so, offer to pay your medical bill upfront for a negotiated discount. This is a shrewd and under-used method to reduce your medical costs. See the billing department at the hospital or your doctor's office for details. 5. Use Your Smartphone A variety of mo
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