Group items tagged

  Image: Pharmaceuticals. Flickr/Waleed Alzuhair. Some rights reserved.   Commerce has corrupted healthcare in the Irish semi-privatized insurance-based system.   Late last year Senator John Crown revealed under parliamentary privilege in Ireland's Senead that his own hospital, St. Vincent's University Hospital in Dublin, had in 2002 billed the country's largest private health insurer €1 million for the drug trastuzumab (Herceptin). But the drug had in fact been supplied to the hospital free by pharmaceutical giant Roche, as part of clinical trials for women with breast cancer.   This was not an inadvertent error as the hospital claimed, said Senator Crown, but deliberate financial fraud, which the hospital board had spent perhaps tens of thousands trying to cover up, employing 'substantial intimidation' to bury the matter.   Senator Crown is also Professor Crown, arguably Ireland's most distinguished oncologist. He had been told of the fraud in 2002 and at once notified all relevant health authorities.   An investigation started, and then stopped in its tracks. The hospital argued it had not known about this major research program me taking place on its premises.   The debacle had ended with the suspension of the drugs trial for a year, jeopardising the lives of women with breast cancer who might otherwise have participated in this important trial

Starting a business is risky enough in the best of circumstances. Most new ventures fail, and the prospect of forgoing a salary is enough to keep many would-be entrepreneurs from taking the plunge. But think about how much harder it would be if your child had a health condition, and you couldn't get her insurance if you struck out on your own. That's less of a problem in the U.S. than it was a few years ago, thanks to Obamacare, but until recently it was a very real conundrum. So does the extension of publicly provisioned health insurance prompt more people to start companies? That's the question asked by a paper released earlier this year by Gareth Olds of Harvard Business School. Olds analyzed Census data from before and after the passage of the Children's Health Insurance Program in the U.S. in 1997 to assess its impact on entrepreneurship. CHIP, or SCHIP as it was previously known, provides publicly funded health insurance to children whose families don't qualify for Medicare, but whose incomes still fall below a cutoff (typically around 200% of the federal poverty line). His results suggest that the policy did significantly increase business creation by those families affected. The self-employment rate for CHIP recipients increased from just under 15% of those eligible to over 18%. That amounts to an a 23% increase. The rate of ownership of incorporated businesses - a better proxy for sustainable, growth entrepreneurship - increased even more dramatically, from 4.3% to 5.8%, an increase of 31%. What about all the other factors that might skew this sort of analysis? Olds used several quasi-experimental statistical methods in his research to control for such variables. The basic intuition behind his methods is that a family just above the CHIP cutoff isn't all that different from a family just below it. Whether you make 199% of the poverty line or 201% doesn't matter for much, except whether or not you'll be able to enroll in the program.

Dear Savvy Senior, I just turned 65 and received my Medicare card. I see that the ID number on my card is the same as my Social Security number, and on the back of the card, it tells me I need to carry it with me at all times. What can I do to protect myself from identify theft if my purse and Medicare card get stolen? Conflicted beneficiary Dear Conflicted, Many people new to Medicare are surprised to learn that the ID number on their Medicare card is identical to their Social Security number (SSN). After all, we're constantly warned not to carry our SSN around with us, because if it gets lost or stolen, the result could be identity theft. But the Medicare ID is more than an identifier. It's proof of insurance. Beneficiaries need to show their Medicare card at the doctor's office and the hospital in order to have Medicare pay for treatment. Over the years, many consumer advocates have called for a new form of Medicare identification. The Centers for Medicare & Medicaid Services, which administers Medicare, also acknowledges the problem, but so far nothing has been done. One of the main reasons is because it would cost an estimated $255 million to $317 million to fix it. And that's just the direct cost to the federal government. It doesn't include the expense for physicians and other health care providers to adjust their systems or the cost to the states. Other government health systems like the Department of Veterans Affairs and Department of Defense have already begun using ID numbers that are different from SSNs, but no one knows when Medicare will follow suit. In the meantime, here are some tips offered by various consumer advocate groups that can help keep your Medicare card safe and out of the hands of fraudsters.

The U.S. health care system has changed significantly since the passage of the Affordable Care Act. The federal law introduced many changes to the insurance space and health care market and helped change the way that people shop for health insurance coverage. With the launch of insurance exchanges, new marketplaces were opened up to consumers, but these exchanges also represented a promising opportunity for scammers that are looking to exploit a person's private information. The U.S. Federal Trade Commission recently issued a warning about the growing prevalence of insurance scams, and there are some things that people can do to protect themselves and their information when shopping for insurance coverage. Be Careful About What You Share Online Many insurance scams seek to collect personal information through fraudulent websites. These sites can be designed to look official, but are merely fronts for criminal activity. Many fraudulent sites attempt to show that they represent an insurance or government agency, offering policies at discounted rates, but the policies that these sites offer are not real and exist only to collect information, such as medical records. Beware of Unsolicited Calls Sometimes, scammers prefer to take a more direct approach and will disguise themselves as insurance agents representing a reputable company or exchange. These people often attempt to call consumers and offer inexpensive insurance policies based on the information that they provide. Insurance exchanges do not randomly contact consumers and organizations promoting coverage through exchanges will never ask for personal information to be shared over the phone. Document Everything Keeping records of all salespeople you may come in contact with, as well as the names of their representative companies, could be valuable if your information is ever compromised. Information can be used for or against you, and collecting information from the agents or organizations trying to sell you

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

Information submitted COLUMBUS - Complications with the federal health insurance exchanges have created challenges for some consumers who have not yet received proof of their insurance coverage. As a result, many consumers are unsure if their medical treatments are covered and are unable to provide their proof of coverage. "Since open enrollment began on Oct. 1 the federal exchange has struggled to process applications and enroll consumers in coverage," Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor said. "These delays are making it more difficult and confusing for consumers to use the health insurance plans they have purchased through the federal exchange." If you recently purchased a plan, but still haven't received proof of insurance from your insurance company, Taylor offers these tips. Contact the Company The first thing you should do is contact your insurance company to verify that you do have insurance coverage. Ask your insurance company for proof of coverage, such as an insurance card or identification numbers. Take detailed notes of conversations and include the representatives names, and date and time they took place. Keep copies of written communication you received from your insurance company such as emails or letters. You may need these materials later. You should also verify that you have paid your first premium on time. Some insurers have permitted late payments for coverage that is retroactively effective to Jan. 1. Ask your insurer for their deadline and keep any records that can serve as proof of payment. If you are about to buy coverage from the federal exchange, print any paperwork or confirmations that you receive during the enrollment process. Payment Options

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

Westhill Consulting - Experimental Melanoma Vaccine Responds Positively Experimental Melanoma Vaccine Responds Positively One day late-stage skin cancer may be treated by 'Personalized immunotherapy' Researchers report a finding shows promise for personalized skin cancer treatment since six of seven advanced melanoma patients had a positive response to an experimental vaccine According to the investigators at the Washington University School of Medicine in St.

Westhill Consulting: Healthcare & Insurance - Individuals, families and the self employed Health Insurance It is hard to find a health insurance in the current situation of our marketplace. It seems impossible to get one of those as per this individual health insurance can offer you a confusing array of options more especially if you're one of the millions of Americans who buys their own health coverage. This health coverage are sometimes good but not always and worse few are expensive. Agents though are everywhere, and they are easy to find and readily available. They offer you cheap health insurance but you got to remember this: health coverage isn't cheap if it doesn't adequately cover your expenses when you need it most. Health reform legislation is recently passed and thanks to this the landscape is changing for consumers. Soon, millions of uninsured will have an access for a quality but low-cost insurance. The chief challenge could be determining options to choose the right coverage. There is nothing to worry about! Because Westhill Healthcare Consulting has everything that one has to know, all the information you needed. Learn. Compare. Save. We have library of articles and we are sure every article is fruitful. Learn how to cut your health care costs, get coverage if you're self-employed. Go trough most frequently asked questions about health coverage and be familiar with health insurance terms. Discover how health reform will affect your benefits and your budget. Otherwise find out how it stands to help populations that historically have faced barriers to affordable health coverage. It would be useful and practical if you use free, no-obligation health insurance quotes to compare private health insurance in your area, plan benefits and coverage costs. Every plan id different in every state so the first thing to do is to go trough our state guide in order to evaluate coverage options, including whether yo

SACRAMENTO, California - Aetna Inc. discontinue selling individual health insurance policies in California, just weeks after opting out of the exchange that is being established as part of the national health care reforms, a state regulator said last month. California Insurance Commissioner Dave Jones said he was disappointed in Aetna's decision because consumers need more choices. The decision does not affect people who have Aetna insurance through their employer. "This is not good news for California consumers," Jones said in a statement. "A competitive market with more choices for consumers is important, as we implement the Affordable Care Act and health insurance coverage is a requirement." In California's individual health insurance market, Aetna is a quite small player. According to 2011 figures compiled by the California HealthCare Foundation, Aetna has about 5 percent of the state's individual health market. By comparison, Anthem Blue Cross, Blue Shield and Kaiser share 87 percent. Aetna says it has about 58,000 individual enrollees in the state and expects to have about 49,000 by the end of the year. It plans to withdraw from the state at the end of the year but will continue to offer small and large group plans, as well as Medicare, dental and life insurance products. Those in search of to buying their own health insurance will be directed to Covered California, the state's new health insurance exchange starting Oct. 1. Aetna was not among 13 insurance carriers that will sell individual coverage to millions of Californians through the exchange. According to Jones' office Under state law, Aetna will not be allowed to sell individual policies in California for five years once it leaves that market. http://www.westhillinsuranceconsulting.com/blog/ http://www.westhillinsuranceconsulting.com/

Westhill Healthcare Consulting is one of the internet's oldest sites that offer consumer information on reasonably priced health and medical coverage since it was published during early 90's. It is the most-trusted independent site, respect and loyalty was earned trough the years of hard work. All the information on this site is projected to the general consumer audience. Westhill Healthcare Consulting is not selling insurance and is not an insurance agency Your concern is our business, as service to our visitors, we provide health insurance quotes from carefully chosen partners who are in the business of selling health insurance, and who meet Westhill Healthcare Consulting strict standards. It is the referrals that pay us and in turn this is what we use to pay the cost of publishing this site. http://www.westhillinsuranceconsulting.com/blog/

Not long after she signed up for health insurance under the Affordable Care Act, Judy Shoemaker received a phone call that puzzled her. The caller said she was welcoming new members to the insurance network and then asked Ms. Shoemaker to take a survey about health care issues, so information could be provided to her physician. Ms. Shoemaker declined, saying she didn't understand why her insurer would be seeking medical information to give to her doctor. "I thought it was strange," said Ms. Shoemaker, a consultant to nonprofits in Indiana. "I can talk to my doctor myself." James Tuck, who runs a dog care business in Chicago, got a similar call after signing up for insurance through the Affordable Care Act in March. The caller said he was contacting Mr. Tuck on behalf of his new insurer, Blue Cross Blue Shield of Illinois, to go over his benefits and ask him some questions. Mr. Tuck hadn't yet received his insurance card and was hesitant to answer questions, especially after he consulted a private health advocate, who had helped him evaluate insurance options. She advised him not to answer the queries. "She said their goal is to find a reason to get you booted off your insurance." Insurers say they are doing nothing of the sort. Lauren Perlstein, a spokeswoman for the Health Care Service Corporation, parent of Blue Cross Blue Shield of Illinois and plans in four other states, said in an email that the company contacted new policy holders to help "new members get the proper coverage and medical assistance they need, by helping guide them through the health care system." The company's "experts" contact new members to explain benefits and answer any questions, she said, as well as to "identify members who can benefit from our personalized medical management program so they can best manage their health."

Entrepreneurs' Outlook for the Healthcare Cloud Is ... Cloudy I've written sunny posts about the opportunity for entrepreneurs in key areas of digital healthcare: health & fitness wearables and healthcare transparency businesses. The "healthcare cloud" is a third major area of innovation, but here the opportunities for entrepreneurs will be fewer and will carry more risk. [Disclosure: New Atlantic Ventures in which I am a partner has an investment in one of the four companies cited below: TruVeris.] First, the pro's: the idea of putting data and applications in the cloud is taking hold throughout the IT world, including healthcare. Payers and providers get the fact that they are being held accountable for managing cost and outcomes for groups of people ("Population Management") and they are working hard to master this problem, which creates strong need to collect and analyze data from many sources in one logical database. And cloud technologies promise to both lower costs by strengthening care coordination, and to improve clinical outcomes, e.g., analysis of medical data in the cloud has revealed drug interactions that were not previously understood (1) Read more http://www.westhillinsuranceconsulting.com/

Practical Saver: Tips for saving money on healthcare By KARA ROZENDAAL Courier Columnist Changes in the health insurance arena have many consumers scrambling for affordable options. Don't despair; there are still ways to save significant money on healthcare. Below are a few medical resources that Prescott has to offer, as well as tips on how to pay less at the doctor's office, and an alternative to health insurance. To save money on premiums, many families opt for higher-deductible health insurance policies. High deductibles generally equate to lower monthly insurance premiums. However, in exchange, the majority of the medical expenses are paid out of pocket. In the case where doctor's visits and medical treatment are paid out-of-pocket, you can save money by asking the medical office if there is a cash pay discount. When a patient pays cash and the business doesn't need to submit the claim to the insurance company, it saves the office time.

Does health insurance increase your lifespan? Felue Chang, who is newly insured under an insurance plan through the Affordable Care Act, receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15 in Hollywood, Fla. The mortality rate in Massachusetts declined substantially in the four years after the state enacted a law in 2006 mandating universal health care coverage, providing the model for the Affordable Care Act. In a study released last week, Harvard School of Public Health professors Benjamin Sommers, Sharon Long and Katherine Baicker conclude that "health reform in Massachusetts was associated with a significant decrease in all-cause mortality." The authors caution that their conclusions, published in Annals of Internal Medicine, may not apply to all states, and other studies have shown little correlation between having insurance and living longer. Nevertheless, the Harvard study adds to a growing body of evidence that having health insurance increases a person's life expectancy.

A pair of editorials last week took up the issue of Medicare and Medicaid fraud, waste and abuse, signifying these problems are becoming a greater focus of public attention and debate "Area ambulance companies are facing deserved scrutiny for their disproportionate share of the nation's outsize[d] healthcare costs," The Inquirer wrote. Ground ambulance providers around Philadelphia collected 64 percent more Medicare dollars than the national average in 2012, with 33 area companies raking in 10 times the norm, the article noted. "No wonder Medicare has stopped taking new company enrollments while it sorts out the fraud," the article stated. The Inquirer referenced charges against eight local ambulance providers since 2011, including one's five-year prison sentence for executing a $3.6 million scam involving kickbacks for unnecessary transport. "Medicare is still not as open [as] it should be," the editorial said. "It has spurned numerous attempts by The Inquirer to get additional information on the ambulance companies that are costing the government the most." The paper wants to know if aberrant providers still collect federal money and if Medicare demanded overpayment refunds. Meanwhile, a Farmington Daily Times editorial highlighted the case of Agave Health, Inc., an Arizona mental health services company that in six months received more than $172,000 from Medicaid. Half this money was disbursed before the completion of a state audit led to a funding freeze for 15 nonprofit healthcare providers. "The question is whether those payments suggest state officials prejudged the conclusion of the audit before it was completed," the editorial stated. That audit exposed $36 million in Medicaid overpayments, the Times reported, which led New Mexico to halt Medicaid funding to in-state providers and shift business to Arizona companies like Agave. But New Mexico paid Agave more than it paid in-state providers.

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-