Posts Tagged ‘government’

Health Care Fraud And You

Monday, February 8th, 2010

Millions of Americans feel the effects of health care fraud without ever being aware of it. This is a growing problem that takes each and every one of us to fight. If you know of anyone who has committed this type of crime then you should report them to the proper authorities immediately. This is a problem that will only grow worse unless we work together to put a stop to it.

Even our insurance premiums may be affected. When someone files a false claim and insurance companies pay out on it then they have to get that money back. They don’t get it from the person who files the claim but from everyone who has insurance with them. No matter who files that claim it is all policy holders who pay in the end.

Government run programs are often the target of fraud. These programs are paid for by each and every one of us through tax dollars. When someone commits fraud it not only costs us but it could mean others are not getting the care they need. It may also mean the programs won’t be around when we need them our selves.

Because of fraud in the health care system, some procedures and medications may not be available to those who need them most. Some of these could be life saving but instead people suffer and possibly die because of those who take advantage of the system or abuse narcotics. No person should have to live in pain because of other peoples addictions.

Health care providers are guilty as well. Every time a bill is padded or they charge for a procedure that wasn’t done this is fraud. Some doctors and hospitals have even invented ghost patients to get more money. Fraud of this type could even be as simple as performing procedures that are not medically necessary.

While you may not be able to prove weather or not a procedure was necessary you can prove weather or not it was preformed. What one doctor considers legitimate another may say was unnecessary. This is a gray area and not all doctors will agree on what is best for a patient. More often than not this is left at the doctor’s discretion.

Another form of medical care fraud is medical identity theft. This occurs when a person uses another’s identity to gains access though their medical coverage or you may find huge medical bills in your name that aren’t yours. They can also use your name to get narcotics due to an addiction. This can affect your medical records and be very dangerous.

The simple fact is that fraud affects each and every one of us. Imagine not being able to get medical coverage for your child because of other peoples fraudulent activities. Worse, imagine your child being given the wrong medication because of medical identity theft.

You can help prevent fraud simply by knowing what is in your medical files. Help insure that all people who need medical coverage can have access to it. Report any suspected fraud to proper authorities.

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The Basics Of Medicare Eligibility And Coverage

Monday, February 1st, 2010

Medicare is a social insurance program administered by the United States government that provides health insurance coverage to people who are aged 65 or older. Another requirement for Medicare eligibility is having paid money or taxes into the Medicare system for at least ten years. Seniors below 65 years old can also avail of Medicare benefits if they have a disability or have been diagnosed with permanent kidney failure.

These benefits include hospital insurance, medical insurance, and prescription drug plans, which are commonly referred to as Medicare Part A, B, and D, respectively. Part C is a recent addition to Medicare, and deals with another type of insurance plan known as the Medicare Advantage plan. The following are some general descriptions of each aspect of Medicare:

Part A: Hospital Insurance. Medicare can help pay for your inpatient costs at a hospital, clinic or ambulatory surgical centers. It can also assist on payments for home health care, skilled nursing service and hospice, provided that you meet additional criteria. This benefit does not require any premium payments since this is already paid for with the Medicare taxes deducted from your paycheck when you were still working.

Part B, or medical insurance, covers outpatient costs, and some services and products not covered by Part A. Examples include professional fees, laboratory, and diagnostic tests, x-rays, blood transfusions, renal dialysis, drugs covered by Medicare and medical equipment such as canes, walkers and wheelchairs. Most people pay monthly premiums for Part B.

Part D helps pay for prescription medicine and other drugs not covered by Part B. It also provides protection from higher expenses related to this in the future. Also approved and regulated by Medicare, prescription plans are actually administered by private companies.

Part C: Medicare Advantage Plan. This is basically another method to get your Medicare benefits. It combines Parts A, B and some aspects of Part D. Private insurance groups endorsed by Medicare administer these plans. The policies cover services that are medically essential and can charge non-standard deductibles, co-payments, or co-insurance for these services.

Some people perceive the fact that Medicare cannot cover all possible medical expenses of its beneficiaries are perceived as a disadvantage. However, of greater concern is the increasing number of beneficiaries versus the working population, which are basically the source of Medicare funds. It may reach the point where the federal government will no longer be able to support the Medicare program. Some people predict that this situation could come as early as 2018.

However, the advantages still outweigh the disadvantages. Beneficiaries should take the time to learn about Medicare eligibility rules and coverage. After all, education is the key in making the most of this program.

There are a variety of Medicare plans to decide on including the Medicare Advantage Plan. When you need coverage research Medicare eligibility to see if you meet the requirements.

Iowa Governor Signs Bill for Children’s Health Insurance

Saturday, May 30th, 2009

Health insurance for children in Iowa has become more available. The Governor, Chet Culver, has signed a new health insurance coverage bill.

The eligibility family income limit for the current childrens health insurance program has been raised. This is the main part of the bill, which allows for more children to qualify for Hawk-i.

An annual income of less than $64,000 now qualifies under the new ruling, reports the Des Moines Register. This is a family income of 300 percent of the federal poverty level, increased by 50% over the old income level.

This new legislation also paves the way for these children to have access to the dental coverage. The hope is that it will urge people to sign up and provide more dental care to more kids.

There are state subsidies available for lower income families to purchase health insurance. This new bill has a portion to it that gives state administrators the power to provide these subsidies for them.

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Republican vs. Democrat The Health Care Debate

Thursday, May 28th, 2009

In Congress the Democrats want to shakeup healthcare delivery and payor system as we know it now. Republicans see the need for change but are wanting to move slower on some of these choices. They are disturbed about cost to the country and limiting choices for some citizens.

A tax credit for Americans that would help pay for costs of individual health insurance plans has been put on the table by the Republican party. This is an effort to go against the Democratic ideal which would have employers pay for health care for all their workers. This doesn’t sit well with Republicans as they view it as a bind on the economy, restricting job growth. The plan is called the Patients Choice Act, as proposed by the Republicans, would eliminate the tax break for employers who do provide health insurance, and provide annual tax credit to each individual.

Congress has been charged by President Obama to create legislation to balance the costs of health care and create a more user friendly system. This plan should cover all the uninsured people in this country and make for a more competitive environment for the private sector insurance companies.

As Congress moves toward a plan there is intense disagreement on some issues, but there are also many issues in common. Both want to create a more transparent shopping environment for health insurance plans which would make it easier on the person purchasing the plan. In addition, both parties would like to see a shift of resources toward the preventable diseases as this would be cheaper than treating something after it intensified.

All ideas will be considered and Congress assures us that the end result will be beneficial to more Americans to have access to health insurance. This plan should be through Congress by the end of the summer.

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President Obama Meets With Healthcare Industry

Thursday, May 14th, 2009

There was a significant meeting between President Obama and healthcare representatives. It was for the President to listen and talk with them regarding health care reform, and it went well.

The meeting was very useful in looking at some issues such as reducing costs in health care nationally and ridding policies of pre-existing conditions. The health care representatives and the President communicated well.

A reduction of health care costs by $2 trillion in the next ten years was pledged by the industry leaders, a promise encouraged by the Obama Administration. The administration is expected to hold them to their quotes.

There is much to be glad about, the Obama Administration is listening to private health industry and the industry is willing to work with the government. The details are still to be determined but it is a good start.

Knowing from the past healthcare solution attempts during President Clinton’s era that lack of cooperation with the healthcare industry doesn’t work. All involved must be part of the process so there are some creative solutions laid out.

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South Carolina Officials Squash Health Care Tax As Wrong Path

Wednesday, May 13th, 2009

After working its way through the legislative process, a bill that would have raised cigarette taxes in South Caroling was blocked by the Senate Minority Leader. The bill would have generated money to assist in covering health care costs.

South Carolina currently has a cigarette tax of 7 cents per pack, a national low. The bill would have increased the state’s tax to 50 cents per pack, which would have generated $145 million in annual revenue. The national average for cigarette taxes is $1.23 per pack.

The majority of the money from the tax would be applied toward a maximum of $3,000 for individual health care plans for low income uninsured residents. Employers who contributed would also receive a credit of 67% for their contributions.

The bill was successfully argued against by Senate Minority Leader John Land. Land claimed that the money could be better spent by going directly into the state’s Medicaid program.

Land said he thought the bill was one of the silliest things he’d seen during his time in South Carolina politics, and that he would not vote for it under any circumstances.

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Rights and Responsibilities of Medical Treatment

Sunday, May 10th, 2009

There are many diseases that cause death in this country. Some of these people would have survived if they were covered with a health insurance plan. All citizens have the right to have health insurance, this should not be a item available only for those with jobs and money.

There are countries within Africa where there is not access to medication and health care such as we have here in our country. So there are lots of preventable deaths there due to this lack of resources.

There is so much medical care in the US that we are casual in regards to our health. Our eating patterns are gradually destroying our bodies. Even as we do this as a wealthy nation, we still don’t have the health industry in such a place that people without health insurance can afford to get life preserving medication.

To begin to rectify such conditions as diabetes, heart attack, stroke and other vascular issues which are mostly brought on ourselves, we have to make better decision about what to eat and how we exercise so we live longer lives instead of shortening them. These types of medical conditions in our society are not like if a society is taken over by the Swine Flu (H1N1) or AIDS.

Essential to our survival is becoming concious of our decisions about how we treat our bodies to stay healthy. Would that come to pass our medical expenses would decrease dramatically as medical care would be only for the occassional disease or illness.

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Legislators in Hawaii Will Attempt to Reopen Keiki Care

Saturday, May 9th, 2009

Hawaii Governor Linda Lingle shut the Keiki Care plan down last year. This was a free health insurance program for the children of Hawaii. Some people have been choosing the free plan over their available individual plans and this caused budget problems according to Governer Lingle.

This plan provided a public subsidy for families who could afford to buy their own health insurance. They were able to access health insurance with no cost, funded by the public, said Linda Smith, the governors senior policy advisor.

Renewing Keiki Care is the plan of Hawaii’s Legislature which is Democrat controlled according to the Associated Press. They are going to add funds through separate spending bills to support the children’s insurance program instead of trying to push through a single bill which the Governor would veto.

The Governor can keep the additional funds held back from these additional bills, and she has continuing opposition to providing free insurance coverage for people who could afford it if they had to purchase insurance.

The ideals within the health insurance struggle continue to conflict.

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Kathleen Sebelius Added to Cabinet

Wednesday, May 6th, 2009

The new Secretary of Health and Human Services is Kathleen Sebelius, a former Kansas Governor. In this position she will oversee the CDC, the Centers for Medicare and Medicaid Services and the FDA.

Secretary Sebelius received approval for her nomination on a 65 to 31 vote, as noted by the Wall Street Journal. The negatives regarding her nomination were that she is pro choice in regards to abortion and has an association with a physician who performs these procedures.

Her five additional approving votes came from a small number of Rebpublicans who supported her. As a Cabinet member now President Obama has a good inside group who will tackle the health care reform and get it right this year.

The newest cabinet member, who is a Democrat, has similar views to President Obama on health care. Secretary Sebelius will produce a similar plate of ideas and plans such as prohibiting pre-existing condition exclusions, individual mandates, and public sponsored individual health insurance plans.

President Obama had some others in mind for his first choice in this post. But Sebelius will be a powerful person in dealing with the health reform issue.

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Public Health and Health Insurance

Thursday, April 30th, 2009

Health care is taking a careful look at the current swine flu issue, while many of us are wondering how to protect ourselves if there is an epidemic or pandemic of this flu. In America, the opinion is we have the most highly functioning health care system anywhere, so that’s where the explanation is as to why Mexico is facing such a huge problem in preserving life for it’s people. Here in the US we have good medical care access and health insurance so are preserved from facing the Mexican issues. But why do we still maintain health better right now than the Mexican people?

Well, it is not that I dont appreciate the health care that we have here in the states, however, the main thing that Americans have that other countries dont is the CDC. This is actually a huge help when dealing with the swine flu or any disease or illness that is easily spread. The CDC works in conjunction with the WHO to help locate, detect and trace cases of spreadable diseases, and help limit them while searching for treatments, cures and vaccines. Although our medical system is more advanced in its reporting than in third world countries.

Other countries have some difficult issues to overcome in order to keep them healthy, safe from something such as the current swine flu. Some of these are poor nutrition, no clean water supplies, communal living, lack of personal hygiene and little to no disease education.

Our country does have it’s own issues within our health care system and insurance system which causes many questions from our citizens. However, our government is involved in our health care in that they provide nutritious foods, clean water and have an agency who monitors disease and informs us to keep us safe.

In the wake of a crisis, as we are currently facing, it is important to remember all the things that the government does do right, even though there are many areas of health care that need to be revamped. Health insurance and medical care coverage are not the only things in place to help keep this nation healthy, there are many other facets of public health to consider. When looking at a crisis like this, you can see that our public health system is working for the greater good of all of our people.

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