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Cataleya Zoe

We've jobs enough for the clever, in healthcare and finance - 0 views

Where will our children's jobs come from? It's something to ponder after the implosion of one of the manufacturing sector's linchpins. The first, broad answer is the retreats of Ford, Holden and To...

westhill consulting healthcare insurance We've jobs enough for the clever in and finance

started by Cataleya Zoe on 13 Feb 14 no follow-up yet
Rose McGowan

Westhill Consulting Insurance - How to Avoid Health Care Fraud | Westhill Consulting In... - 0 views

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    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
Nathalie Flex

Westhill Consulting Insurance - Connecticut learns less is more with state health insur... - 1 views

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    I have really bad eyes. I like to get them checked often, but since I don't have health insurance, no doctor's going to really want to take a look at me," he said. He found out that he may qualify for Medicaid, which was long-drawn-out under Obamacare. So far, 9,123 have enrolled over Connecticut's ultimate goal is to sign up 275,000 people. Kevin Counihan, chief executive officer of Connecticut's health exchange, says he's not discouraged by the number of people signing up for private health insurance. "Buying health insurance is expensive and it's expensive and it's confusing and it's complicated. So no, I am not disappointed by it. However, we clearly have a strong goal to meet by March," he said. Counihan look forward to have 100,000 people enrolled by the end of March. He credits the state's computer system with the smooth even out. "Number one is, less is more. Do fewer things well than try to do more things inconsistently. Two is test the heck out of the system and make sure that before you go live, you are pretty darn confident that you know what is going to happen. And three is hire the best people that you can," he said. Counihan was implicated with Massachusetts' health insurance rollout in 2006. He says that taught him people don't buy insurance like they do a book or car. They usually consider the options an average of 18n times before making up their minds. He foresees a sprint of people signing up between Thanksgiving and Dec. 15, which in case is the deadline for coverage beginning on Jan. 1.
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    "Tuesday, November 12, statistics put out by Connecticut demonstrate that its website is the only one to sign up more folks for private insurance than for Medicaid. Angel Medina, 21, went to talk to an Affordable Health Care act navigator in Hartford. Medina was dropped from his mother's health insurance two years ago. "I have really bad eyes. I like to get them checked often, but since I don't have health insurance, no doctor's going to really want to take a look at me," he said. He found out that he may qualify for Medicaid, which was long-drawn-out under Obamacare. So far, 9,123 have enrolled over Connecticut's ultimate goal is to sign up 275,000 people. Kevin Counihan, chief executive officer of Connecticut's health exchange, says he's not discouraged by the number of people signing up for private health insurance. "Buying health insurance is expensive and it's expensive and it's confusing and it's complicated. So no, I am not disappointed by it. However, we clearly have a strong goal to meet by March," he said. Counihan look forward to have 100,000 people enrolled by the end of March. He credits the state's computer system with the smooth even out. "Number one is, less is more. Do fewer things well than try to do more things inconsistently. Two is test the heck out of the system and make sure that before you go live, you are pretty darn confident that you know what is going to happen. And three is hire the best people that you can," he said. Counihan was implicated with Massachusetts' health insurance rollout in 2006. He says that taught him people don't buy insurance like they do a book or car. They usually consider the options an average of 18n times before making up their minds. He foresees a sprint of people signing up between Thanksgiving and Dec. 15, which in case is the deadline for coverage beginning on Jan. 1."
Rose McGowan

Westhill Healthcare Consulting | Massachusetts - N.J. Commissioner Offers Insurance Pur... - 1 views

Making the right insurance choices can have significant impact on the small business owner’s operation costs. With that in mind, New Jersey Department of Banking and Insurance Commi...

Westhill Healthcare Consulting Massachusetts NJ Commissioner Offers Insurance Purchasing Tips for Small Businesses

started by Rose McGowan on 03 Feb 14 no follow-up yet
Rose McGowan

Insurance fraud cases reduce by half, says IRA - 1 views

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    BY PETER KIRAGU Kenya: The number of insurance fraud cases reduced by more than half last year thanks to tighter supervision by the Insurance Regulatory Authority ( IRA)'s Insurance Fraud Investigation Unit. According to the just released industry report for the year ended December 31, 2013, the unit received reports and detected cases of insurance fraud totaling 57 during the period compared to 133 similar cases in 2012. The report shows that fraud remains highest in motor insurance category with 21 cases reported in the year, down from 35 the previous year. Out of this, four fraudulent accident and 14 theft claims were made. Another three fraudulent cases of forged certificates were also reported. There were three fraudulent claims in the medical insurance category down from six the previous year with two fraudulent funeral claims made in the year down from nine in 2012. Fraud related to insurance agents also dropped with only six cases reported down from 38 the previous year. All the six reported cases were theft by insurance agents. The level of fraud related to insurance companies especially theft by employees remained the same with 10 cases reported. See Also: Australia agency opens
Rose McGowan

One Reason Health Insurance Premiums Vary So Much - 1 views

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    A 27-year-old in Jackson pays $336 a month for the second-cheapest silver health plan on Mississippi's s federally run insurance marketplace. That is more than twice as much as the $154 a 27-year-old in Nashville would pay for the same type of policy, and the $138 for a similar person in Tucson. Across all 34 insurance marketplaces run by the federal government, the average is $287, about 25 percent cheaper. The reason for the higher prices in some markets? Paltry competition, say Leemore Dafny and Christopher Ody from Northwestern University, and Jonathan Gruber of the Massachusetts Institute of Technology. Jackson has only two insurers on the marketplace: Humana and Centene. By contrast, four insurance companies slug it out on Nashville's exchange. In Tucson, there are eight. Jackson's over-the-top premiums underscore one of the least-heralded shortcomings of the rollout of the Affordable Care Act: the scarcity of insurers on health plan exchanges, which is driving up the price of policies across the country. The research by Ms. Dafny, Mr. Gruber and Mr. Ody, to be published by the National Bureau of Economic Research next week, concludes that premiums on the exchanges are 11 percent higher than they would be if all the health insurance companies that sell policies in each state had participated in the new markets for health plans. More competition not only would lower premiums, but would also save the federal government money. It would spend $1.7 billion less in subsidies to low- and middle-income Americans buying policies on the health care insurance exchanges. "Half of the population in the states with health exchanges facilitated by the federal government is served by three insurers or fewer," Ms. Dafny said. "To have competition on the exchanges you need competitors." The findings are somewhat perplexing, though. By law, 80 to 85 percent of premiums must be devoted to medical spending. Insurers don't have particularly large profit margin
Rose McGowan

Special Fraud Alert: Laboratory Payments to Referring Physicians - 1 views

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    I. The Anti-Kickback Statute One purpose of the anti-kickback statute is to protect patients from inappropriate medical referrals or recommendations by health care professionals who may be unduly influenced by financial incentives. Section 1128B(b) of the Social Security Act (the Act) makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce, or in return for, referrals of items or services reimbursable by a Federal health care program. When remuneration is paid purposefully to induce or reward referrals of items or services payable by a Federal health care program, the anti-kickback statute is violated. By its terms, the statute a scribes criminal liability to parties on both sides of an impermissible "kickback" transaction. Violation of the statute constitutes a felony punishable by a maximum fine of $25,000, imprisonment up to 5 years, or both. Conviction will also lead to exclusion from Federal health care programs, including Medicare and Medicaid. OIG may also initiate administrative proceedings to exclude persons from the Federal health care programs or to impose civil money penalties for fraud, kickbacks, and other prohibited activities under sections 1128(b)(7) and 1128A(a)(7) of the Act. II. Remuneration From Laboratories to Referring Physicians Arrangements between referring physicians and laboratories historically have been subject to abuse and were the topic of one of the OIG's earliest Special Fraud Alerts. 1 In that Special Fraud Alert, we stated that, "[w]henever a laboratory offers or gives to a source of referrals anything of value not paid for at fair market value, the inference may be made that the thing of value is offered to induce the referral of business.
Rose McGowan

Westhill Consulting Insurance - Connecticut learns less is more with state health insur... - 1 views

Connecticut learns less is more with state health insurance website Tuesday, November 12, statistics put out by Connecticut demonstrate that its website is the only one to sign up more folks for p...

westhill consulting healthcare Individuals families and the self employed Health Insurance

started by Rose McGowan on 14 Nov 13 no follow-up yet
Rose McGowan

Westhill Healthcare Consulting Jakarta fraud prevention review Wonkbook: Why the Obama ... - 1 views

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    Welcome to Wonkbook, Wonkblog's morning policy news primer by Puneet Kollipara (@pkollipara). To subscribe by e-mail, click here. Send comments, criticism or ideas to Wonkbook at Washpost dot com. To read more by the Wonkblog team, click here. Follow us on Twitter and Facebook. (Photo by Mike Segar/Reuters) Wonkbook's Number of the Day: 70 percent. That's the latest estimate of the mortality rate in the Ebola outbreak in West Africa, the World Health Organization announced. Wonkbook's Chart of the Day: Oil prices are falling, and fast. Wonkbook's Top 5 Stories: (1) Obamacare October surprises and a lower sales bar; (2) Ebola treatments for U.S. patients; (3) attorney general nomination update; (4) security threats of climate change; and (5) new help for long-term jobless. 1. Top story: With a month to go, why the Obama administration won't oversell Obamacare in year two Team Obama's year-two strategy: Underselling Obamacare. "The Obama administration vastly oversold how well Obamacare was going to work last year. It's not making the same mistake this year. Gone are the promises that enrolling will be as easy as buying a plane ticket on Orbitz. The new head of HHS is not on Capitol Hill to promise that HealthCare.gov is on track. And no one is embracing Congressional Budget Office projections of total sign-up numbers.Sobered - and burned - by last fall's meltdown of the federal website, the administration is setting expectations for the second Obamacare open enrollment period as low as possible. Officials say the site won't be perfect but will be improved." Jennifer Haberkorn in Politico. Explainer: 5 things we need to know about Obamacare before enrollment begins. Jason Millman in The Washington Post. Source: Westhill Healthcare Consulting Jakarta fraud prevention review</d
juliarsantos

How to Spot and Prevent Medical Identity Theft - 1 views

Foxbusiness.com | westhill consulting insurance - While credit card breaches at retailers are grabbing headlines, identity thieves are quietly homing in on an even more lucrative area: health insur...

westhill consulting insurance how to spot and prevent medical identity theft

started by juliarsantos on 28 Aug 14 no follow-up yet
Rose McGowan

Westhill Consulting - Tips for navigating Obamacare - 1 views

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    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
Rose McGowan

Elderly Population Will Double By 2050, Taxing U.S. Healthcare System - 1 views

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    WEDNESDAY, May 7, 2014 (Health Day News) - there will be almost twice as many elderly Americans in 2050 as there are now, posing serious issues for the nation's health care system, according to two U.S. Census Bureau reports released Tuesday. "The United States is projected to age significantly over this period, with 20 percent of its population age 65 and over by 2030," Jennifer Ortman, chief of the Population Projections Branch at the census bureau, said in an agency news release. The number of people aged 65 and older is projected to reach 83.7 million by 2050, compared with 43.1 million in 2012, the bureau reported. This sharp rise is due to aging baby boomers, which were born between 1946 and 1964 and began turning 65 in 2011. An aging population "will have implications for health care services and providers, national and local policymakers," Ortman added. She said businesses will also have to adapt to meet new demands as a rising number of elderly influences both the "family structure and the American landscape." Baby boomer-influenced growth in health-care related industries began a few years ago, the agency said. According to the census bureau, there were about 819,000 health and social assistance-related facilities and businesses in 2011 - a 20 percent jump from 2007.
Rose McGowan

Health Insurance Giants To Unveil Price Information In 2015 - 1 views

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    A nonprofit organization the three work with known as Health Care Cost Institute, a nonpartisan research organization, said the insurance companies will develop and provide consumers "free access to an online tool that will offer consumers the most comprehensive information about the price and quality of health care services." Additional health plans could soon join Aetna, Humana and UnitedHealth in the effort. The move by the insurance companies comes as more Americans gain health care coverage under the Affordable Care Act. Meanwhile, these newly insured Americans and those already with coverage are demanding more information about the cost of care as deductibles and co-payments rise and they pay more out of their own pockets for medical services and treatments. "This unprecedented initiative is testament to our belief that educated consumers benefit the entire health care system," UnitedHealth Group said in a statement to Forbes. The information on prices will also include information about quality and other information in an effort to help health care become more transparent. "Consumers, employers and regulatory agencies will now have a single source of consistent, transparent health care information based on the most reliable data available, including actual costs, which only insurers currently have," David Newman, the Health Care Cost Institute's executive director said in a statement issued this morning. There will be three tiers of information provided. In one tier, any consumer will get average price information for an "episode of care" such as a knee replacement or heart surgery based on complex coding and claims data submitted to and analyzed by the Institute. In another tier, consumers with coverage from Aetna, Humana or UnitedHealth Group will get more detailed price information given the health plan subscribers in their plans already have a relationship with the companies and therefore more specific information on their networ
Rose McGowan

Critical Health Insurance Plans for Critical Health Ailments - 1 views

There are a lot of health care insurance nowadays with thousands of healthcare insurance companies scattered around the world. Individuals and organizations are slowly starting to appreciate their ...

critical health insurance plans for ailments westhill healthcare consulting jakarta usa united kingdom

started by Rose McGowan on 29 May 15 no follow-up yet
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

Fraud watchdog: Health law sign-ups dogged by data discrepancies - 1 views

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    WASHINGTON - The Obama administration has been struggling to clear up data discrepancies that could potentially jeopardize coverage for millions under the health overhaul, the government's health care fraud watchdog reported Tuesday. The Health and Human Services inspector general said the administration was not able to resolve 2.6 million so-called "inconsistencies" out of a total of 2.9 million such problems in the federal insurance exchange from October through December 2013. Of the roughly 330,000 cases that could be straightened out, the administration had only actually resolved about 10,000 during the period of the inspector general's audit. That worked out to less than 1 percent of the total. Several states running their own insurance markets also were having problems clearing up data discrepancies. Most of the issues dealt with citizenship and income information supplied by consumers that conflicted with what the federal government has on record, the report said. It marked the first independent look at a festering behind-the-scenes issue that could turn into another health law headache for the White House. President Barack Obama celebrated 8 million sign-ups as proof that technical problems which initially kept many consumers from enrolling had finally been overcome. It now turns out that some of those problems continued out of sight. The inspector general said the efforts of the administration and states to clear up the discrepancies were complicated by lingering computer issues.
Rose McGowan

If Your Kids Get Free Health Care, You're More Likely to Start a Company - 2 views

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    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.
Rose McGowan

Insure your Business in the Clouds - 1 views

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westhill consulting Insurance USA Jakarta UK

started by Rose McGowan on 19 Mar 15 no follow-up yet
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