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In the news

Beverly Gossage — Wed, 02 Dec 2009 05:30:54 +0000

I was quoted in a few articles recently:

“Health care cards carry same credit risks” by Sally Herigstad (CreditCards.com)

“Utah Overhauls Health Care” by Sarah McIntosh and Joe Emanuel (Health Care News)

“Skepticism of health reform effort crosses industry lines” by Clarissa French (Springfield Business Journal)

Concerns about Health Care Reform Growing

bgossage — Tue, 20 Oct 2009 19:18:56 +0000

Americans are concerned about the growing national budget deficit, and, in particular, how the cost of the pending health care reform legislation will add to the astronomical debt. Clarissa French interviewed Beverly and others about this concern in her article “Skepticism of health reform effort crosses industry lines” in the Springfield Business Journal.

Health insurance denial of claims widely debated

bgossage — Sun, 11 Oct 2009 01:16:30 +0000

We are wondering what Edward S. Kornreich and Herschel Goldfield think now after reading our post “Which health insurance carrier denies the most claims?” You see these gentlemen posted an op ed “Medicare’s lesson for health insurance reform” at The Hill.com in September. Here is a quote from the piece, “ Missing from the healthcare debate is any serious discussion about a critical flaw built into our system: Insurers have an incentive to deny claims, because the more they pay out, the less they profit. Patients and doctors have the opposite incentive…….There is an alternative. In fact, it is already in place for the millions covered by Medicare.”

Kornreich and Goldfield should be pleased. Denials are no longer missing from the debate. You’re welcome.

90-year-old’s Frustration with Medicare Denial

bgossage — Sat, 10 Oct 2009 22:37:53 +0000

Medicare denied coverage for ambulance rides, which had been pre-approved, for a 90-year-old double amputee. After multiple resubmissions of paperwork, trips to the hospital patient services department, and two-hour-long phone calls (reaching different Medicare representatives each time), this elderly man has not been able to resolve his nightmare.

Medicare Wastes Tax Dollars

bgossage — Fri, 09 Oct 2009 16:39:42 +0000

The next time that you hear that National health care would save money because of the bulk buying power, consider this report from Fox News. Medicare overpays for items purchased for the elderly.

Here’s an example:

“– $7,215 to rent an oxygen concentrator, when the purchase price is $600.”

Medicare Denies the Most Claims, Congressman

bgossage — Tue, 06 Oct 2009 21:26:21 +0000

Last month, Congressman Dennis Kucinich grilled private insurance carriers about the insurance claims they denied in an attempt to demonize them. Meanwhile, it turns out that Medicare actually denies a larger percentage of claims than any of the private insurers. See the report here.

AMA Endorses Largest Denier of Health Care Claims

bgossage — Tue, 06 Oct 2009 16:01:00 +0000

Patrick Tuohey of Big Goverment picked up our post about Medicare being the largest denier of insurance claims. They also mentioned our findings on Sean Hannity Discussion, Fox Nation, NewsBusters, the Mark Levin Show, Pirate’s Cove, Conservative Thoughts, Wake Up America, MIHealthfacts, Stoptheaclu, moreaboutpolitics, bizzyblog, Healthcare Horserace, the News Factor, Liberty Republican Forum, Insignificant Thoughts, Beltway Blips, Freedom’s Zone, American Daughter, Scared Monkeys, This Board Rocks,Conservative Black Woman, Qando, Outloud Opinion, pharmphun, Free Republic, Shrinkwrap, No Quarter, Prolifeblogs, News Factor, Missouri Record, Free Public, Canada Free Press, Poynter Online, No Oil for Pacifists, A Disgruntled Republican, Brookfield 7, FullosseousFlap’s Dental Blog, myspace forum, Stupica, CoacheP, WOWOWOW, Jeremiah Films, Collecting my Thoughts, Dana Show, Bellingham Tea Party, Widgetbox, Truckingboard, Live Journal, Argue with Everyone, Liberty’s Army, Google Groups, All Nurses.com, reddit.com, FOX Winknewsradio, Askmen.com, MacDoctor, Community.comcast, insureblog, westandfirm.com, Investors.com, Economistblog, Dailymarkets, Freemarketmojo, mjperry, NCPA, Politics Alabama, 1800blogger, fundmasteryblog, Healthcare Economist, benzinga.com, valuesvoternews, wallstreetblips, Yahoo Answers, prolifeblogs, This Blue Marble, Finheaven.com, Businessweek, topix, 2secondsfaster, macresource, sprintusers, Mrswing,

Some doctors won’t meet with the President

bgossage — Mon, 05 Oct 2009 21:09:07 +0000

Hear from the doctors who chose not to meet with the President even if invited.

Posted by Kathryn Serkes, AAPS at the Association of American Physicians & Surgeons

DOCS AS PROPS

OOPS! President Obama mistakenly invites OPPONENT to stand up for him at White House today

AAPS doctors ask, Is he having trouble finding supporters?

Oct 5, 2009 – WASHINGTON, DC — One of the doctors who will NOT be standing behind the President today is one of his most vocal opponents. But he would have been there if the White House had its way.

Dr. Eric Novack of Phoenix, AZ, was one of the 50 doctors invited to the White House photo op today. But he turned down the invitation, because he has lead the fight to pass state legislation and constitutional amendments to prohibit individual insurance mandates.

“They had 16 hours to Google me, but I guess no one bothered,” Dr. Novack told Kathryn Serkes, Director of Policy and Public Affairs for the Association of American Physicians and Surgeons (AAPS) in a video interview available at Takebackmedicine.

Dr. Novack says that it was very tempting to accept the “once-in-a-lifetime” invitation, but in the end, he had to say no. But it also makes him question whether the doctors who will be there today actually support the President, or even understand all of the details of the bills.

“Are these doctors just star-struck, or do they have real knowledge about what they are supporting?” asked Serkes. “It’s looking like another dog-and-pony-show, and doctors should not be used in this shameful manner. First the President vilifies them, now he wants their help.”

And that’s when he’s not just ignoring them. AAPS and other groups held a rally of 1,000 on Captiol Hill on Sept. 10. “Where was the President then?”

“And at the very least, it makes the White House look like it does some very sloppy work,” added Serkes.

AAPS SURVEYS REBUT WHITE HOUSE CLAIMS

Serkes also rebuts the White House claims that doctors overwhelmingly support the public plan. A recent poll on the AAPS web site, Takebackmedicine shows that 93% of the doctors polled are even more adamantly against the President’s plans after his national address to Congress and the country on Sept. 9.

Further, pre-publication results of an AAPS survey show that about 80% of doctors would refuse to VOLUNTARILY take part in a public plan.

So what will Dr. Novack be doing on Monday instead of standing behind the President? “I’ll be taking care of patients – because that’s what it’s all about.”

Which Health Insurance Carrier Denies the most Claims?

bgossage — Mon, 05 Oct 2009 14:25:38 +0000

According to page 5 of the 2008 Health Insurance Report Card released by the American Medical Association, the “carrier” with the highest percentage of denials is…..Medicare. Does it still sound like we need to put the government in control of (or develop a public option to compete with) health insurance companies to prevent them from denying claims?

DENIALS

Metric 12—Percentages of claim lines (i.e., records) denied Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial is defined as: allowed amount equal to the billed charge and the payment equals $0. Source: NHXS
Payer	Count of records	Denied records	Percent of claim lines denied	Date range
Aetna	637,239	43,317	6.80%	03/01/2007 – 3/10/2008
Anthem	250,070	11,546	4.62%	03/01/2007 – 3/10/2008
CIGNA	263,728	9,060	3.44%	03/01/2007 – 3/10/2008
Coventry	20,487	590	2.88%	03/01/2007 – 3/10/2008
Health Net	4,975	193	3.88%	03/01/2007 – 3/10/2008
Humana	143,026	4,142	2.90%	03/01/2007 – 3/10/2008
Medicare	6,938,431	475,566	6.85%	03/01/2007 – 3/10/2008
UHC	1,127,691	30,177	2.68%	03/01/2007 – 3/10/2008

The truth about COBRA subsidies

bgossage — Thu, 01 Oct 2009 17:08:11 +0000

The eligibility rules for COBRA subsidy say “an employee who is terminated involuntarily (unless for gross misconduct)” is eligible. A client called to inform me that their company had two people who walked off the job who haven’t come back for days. Basically, “take this job and….” My client asked me if the company would have to offer COBRA and if these employees would receive the subsidy. When I called the Department of Labor office today to clarify what they meant by “gross misconduct” and “involuntary,” I was told that an employee would have to commit a felony to be considered gross misconduct and that an employee walking off the job and not coming back for days is not involuntary termination since the employer would have to make the decision to “take him off the books” for this behavior. So our tax payer dollars are going to subsidize COBRA premiums for pretty much everyone, not just those who were laid off due to the economy, as we were told.