Finding a better way to steal from Medicare!!!

Healthcare fraud in Miami!

Watch this story on 60 minutes.

http://www.cbsnews.com/video/watch/?id=5419844n&tag=cbsnewsSidebarArea.0

How can it be this easy? Remember Medicare is a public option and it is managed by the government.

Check your Medicare statements and report fraud!!!!

http://www.medicare.gov/fraudabuse/HowToReport.asp

Increasing healthcare costs have a direct effect on the ever increasing cost of health insurance. Charles Wheelan wrote a great article detailing what he thinks are the top ten reasons, click here to read the whole article:

1. Nobody shops for value
2. Medical innovations are more expensive, not less
3. Health care is a luxury good not and inferior good (technical terms in economics)
4. We don’t pay for what we consume
5. Baumol’s disease
6. The old…older people have greater health care needs
7. The uninsured…lack of primary or preventative care leads to more expensive care later in life
8. The fat and lazy…come on, smoking too much, eating too much, not enough exercise..we all know it is unhealthy
9. Any medical success begets a later medical expense and end of life care is expensive
10. Malpractice

Wheelan gives a great description of each and you should read the whole article. I like’d the way he summed it all up:

“What’s my solution? Thankfully I’ve only got space here for the diagnosis. But that should make clear that there’s no single cure — because there’s no single problem. Any serious and pragmatic fix for the system will require six or eight pills, not one. And even that will be treatment, not a cure.”

In order to be eligible for a Medicare Prescription Drug Plan you must be eligible for Medicare Insurance

1. There are 2 ways to get Medicare prescription drug coverage, either a stand alone plan or through a Medicare Advantage Plan (HMO, PPO, PFFS, or other Part C plan).
2. If you don’t enroll in a Medicare Part D prescription plan when you first become eligible then you will pay higher premiums if and when you do eventually enroll. This is known as the “late enrollment penalty”.
3. Depending on the plan you choose you have a monthly premium, annual deductible, copayments, coinsurance, and “coverage gap”.Make sure you completely understand the coverage gap or “donut hole”, copayments, and your deductible.
4. Catastrophic coverage starts after you have spent $4,550 in out of pocket prescriptions.
5. Your prescription drug coverage will be subject to plan rules like prior authorization before filling certain prescriptions, Quantity limits on how much medication you can get at a time, and step therapy where you must try a similar lower cost medication before they will cover the prescribed medication.
6. Medicare drug plans classify all the prescription drugs into different tiers. Each tier has a different cost, lower tiers cost less and higher tiers cost more.
7. Medicare prescription drug plans also cover commercially available vaccines if they are medically necessary.
8. You can have your monthly premium billed to you each month, deducted from your social security check, deducted from your bank account, or charged to your credit card.

Download and read “Your Guide to Medicare Prescription Drug Coverage”

Brief:

More employers are starting to offer their employees Health Savings Accounts as an option for their health care coverage. Since the HSA’s can only be obtained with High Deductible Heatlh Plans premiums are much lower. Employers can then take a portion of the premium savings and add it to the employee’s Health Savings Account.

If the Employee incurs any qualified medical they can pay for them out of the Health Savings Account. If the money is not used it is rolled over and accrues interest on a tax deferred basis.

Consumer driven health insurance plans like HSA’s aim to transfer cost-managing responsibility to the health care consumers themselves.

Many of Florida’s (and the rest of the the U.S.) best health insurance companies offer HSA’s - Health Savings Accounts to both groups and individuals. Humana, Aetna, Blue Cross Blue Shield, Golden Rule, Time, Assurant Health, United Healthcare, just to name a few.

You can read the full article here.

Brief:

This is another example of how Health Savings Acounts - HSA’s can drastically lower the cost of health care coverage.

The article also offers helpful tips on how to encourage employees to participate.

You can read the full article here.

Find your Senators click here.

Of course if your opinion is different and you want a system like the one described below then you should also voice your opinion. After all it is a free country.

Dear Senator or Congressman (Congresswoman),

I have major concerns with the healthcare bill before Congress. I actually have read the bill and am shocked by the brazenness of the government’s proposed involvement in the patient physician relationship. The very idea that the government will dictate and ration patient care is dangerous and certainly not helpful in designing a healthcare system that works for all. Every person I speak with agrees that we need to fix our healthcare system, but the proposed bills currently making their way through congress will be a disaster if passed.

I ask you respectfully and as a patriotic American to look at the following troubling lines that I have read in the bill. You cannot possibly believe that these proposals are in the best interests of the country and our fellow citizens.

Page 22 of the HC Bill: Mandates that the Govt will audit books of all employers that self insure!!

Page 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get.

Page 29 lines 4-16 in the HC bill: YOUR HEALTH CARE IS RATIONED!!!

Page 42 of HC Bill:The Health Choices Commissioner will choose your HC Benefits for you. You have no choice!

Page 50 Section 152 in HC bill: HC will be provided to ALL non US citizens, illegal or otherwise

Page 58 HC Bill: Govt will have real-time access to individuals finances & a National ID Healthcard will be issued!

Page 59 HC Bill lines 21-24: Govt will have direct access to you ur banks accounts for elective funds transfer.

Page 65 Sec 164: is a payoff subsidized plan for retirees and their families in Unions & community organizations: (ACORN).

Page 84 Sec 203 HC bill: Govt mandates ALL benefit packages for private HC plans in the Exchange.

Page 85 Line 7 HC Bill: Specifications for of Benefit Levels for Plans = The Govt will ration your Healthcare!

Page 91 Lines 4-7 HC Bill: Govt mandates linguistic appropriate services. Example - Translation: illegal aliens.

Page 95 HC Bill Lines 8-18: The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan.

Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans. AARP members - your Health care WILL be rationed.

Page 102 Lines 12-18 HC Bill: Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.

Page 124 lines 24-25 HC: No company can sue GOVT on price fixing. No “judicial review” against Govt Monopoly.

Page 127 Lines 1-16 HC Bill: Doctors/ American Medical Association - The Govt will tell YOU what you can make! (salary)

Page 145 Line 15-17: An Employer MUST auto enroll employees into public option plan. NO CHOICE!

Page 126 Lines 22-25: Employers MUST pay for HC for part time employees AND their families.

Page 149 Lines 16-24: ANY Employer with payroll 401k & above who does not provide public option pays 8% tax on all payroll.

Page 150 Lines 9-13: Business’s with payroll btw 251k & 401k who doesn’t provide public option pays 2-6% tax on all payroll.

Page 167 Lines 18-23: ANY individual who doesn’t have acceptable HC according to Govt will be taxed 2.5% of income.

Page 170 Lines 1-3 HC Bill: Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)

Page 195 HC Bill: Officers & employees of HC Admin (GOVT) will have access to ALL Americans finances /personal records.

Page 203 Line 14-15 HC: “The tax imposed under this section shall not be treated as tax” Yes, it says that!

Page 239 Line 14-24 HC Bill: Govt will reduce physician services for Medicaid Seniors, low income and poor are affected.

Page 241 Line 6-8 HC Bill: Doctors, doesn’t matter what specialty you have, you’ll all be paid the same!

Page 253 Line 10-18: Govt sets value of Doctor’s time, proffession, judgment etc. Literally value of humans.

Page 265 Sec 1131: Govt mandates & controls productivity for private HC industries.

Page 268 Sec 1141: Federal Govt regulates rental & purchase of power driven wheelchairs.

Page 272 SEC. 1145: TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!

Page 280 Sec 1151: The Govt will penalize hospitals for whatever Govt deems preventable re-admissions.

Page 298 Lines 9-11: Doctors, treat a patient during initial admission that results in a re-admission -Govt will penalize you.

Page 317 L 13-20: PROHIBITION on ownership/investment. Govt tells Doctors what/how much they can own!

Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion- Govt is mandating hospitals cannot expand.

Page 321 2-13: Hospitals have opportunity to apply for exception BUT community input is required. Can u say ACORN?!!

Page 335 L 16-25 Pg 336-339: Govt mandates establishment of outcome based measures. HC the way they want. Rationing.

Page 341 Lines 3-9: Govt has authority to disqualify Medicare Advance Plans, HMOs, etc. Forcing people into Govt plan.

Page 354 Sec 1177: Govt will RESTRICT enrollment of Special needs people! Unbelievable!

Page 379 Sec 1191: Govt creates more bureaucracy - Tele-health Advisory Comittee. Can you say HC by phone?

Page 425 Lines 4-12: Govt mandates Advance Care Planning Consult. Think Senior Citizens end of life patients.

Page 425 Lines 17-19: Govt will instruct & consult regarding living wills, durable powers of attorney. Mandatory!

Page 425 Lines 22-25, 426 Lines 1-3: Govt provides approved list of end of life resources, guiding you in death. (assisted suicide)

Page 427 Lines 15-24: Govt mandates program for orders for end of life. The Govt has a say in how your life ends.

Page 429 Lines 1-9: An “advanced care planning consultant” will be used frequently as patients health deteriorates.

Page 429 Lines 10-12: “advanced care consultation” may include an ORDER for end of life plans. AN ORDER from GOVT!

Page 429 Lines 13-25: The govt will specify which Doctors can write an end of life order.

Page 430 Lines 11-15: The Govt will decide what level of treatment you will have at end of life!

Page 469: Community Based Home Medical Services = Non profit organizations. Hello, ACORN Medical Services here!!?

Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORIGINATION. 1 monthly payment 2 a community-based organization. Like ACORN?

Page 489 Sec 1308: The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage.

Page 494-498: Govt will cover Mental Health Services including defining, creating, rationing those services.

I guarantee that I personally will do everything possible to inform patients and my fellow physicians about the dangers of the proposed bills you and your colleagues are debating.

Furthermore, If you vote for a bill that enforces socialized medicine on the country and destroys the doctor/patient relationship, I will do everything in my power to make sure you lose your job in the next election.

Respectfully,

Starting in July of 2009 there are brand new Aetna small group insurance plans at very reasonable prices.

Brief:

Humana and Blue Cross Blue Shield are getting together to form what they call a “payer-based health record”. This database is going to be populated with all their claims information and is designed to:

• Help improve patient safety
• Eliminate duplicate medical procedures
• Reduce unnecessary services
• Reduce Fraud

Healthcare professionals will be able to view a statement containing all the patient’s health care services from the various doctors, other medical providers, and other health plans.

The record itself is going to contain:

• Transactional information from the health plans claims record
• Dates of service
• Name of health care provider
• Name of prescription

The record is NOT going to contain results and diagnosis for:

• Psychiatric treatment
• Substance abuse
• HIV related treatments

The information will be held in the patient’s respective health plan and ONLY providers have access to the consolidated medical records.

You can read the complete article
here.

Of course affordable is a relative term and from what I have seen, on their website, these plans are quite expensive for what they offer. So, if you can make it through underwriting for an individual or family plan then these plans are not for you.

You can read the rest of the article here: Cover Florida Health Insurance

The Miami herald also has an article on the Cover Florida Plans.
http://www.miamiherald.com/business/story/808036.html