Doesn’t surprise me a bit
Today’s Washington Post has a story about how the health insurance companies deciced on how much they would pay policy-holders for visits to out-of-network physicians based in a “customary” charge that was calculated by the insurance industry.
They routinely shortchanged policy-holders by nearly 30 percent, costing consumers billions.
The practice was detailed today in a US Senate Finance Committee report. According to the Post:
” As it turns out, insurers typically used numbers from Ingenix Inc., which was a wholly owned subsidiary of the big insurer UnitedHealth Group. As such, Ingenix had an incentive to produce benchmarks that low-balled usual and customary rates and shifted costs from insurers to their customers, the report said.
“Making matters worse, Ingenix got all of its data from the same insurers that bought its benchmark information, the report said. Insurers that contributed data to Ingenix often “scrubbed” their data to remove high charges, and Ingenix further manipulated the numbers, removing valid high charges from its calculations, the report said. ”
New York Attorney General Andrew Cuomo described it last year as “a scheme by health insurers to defraud consumers by manipulating reimbursement rates.” A dozen insurers have reached settlements with Cuomo agreeing to change their practices.
But, really, we can trust them with our health care system.
Read the entire story here:
Second annual Eat at Mike’s
Reserve now
Life o' Mike sponsors its second annual Eat at Mike's, an evening of good food prepared by local chefs, at Tingles Cafe in downtown Asheville. The event also features silent and live auctions with items from Highlands Brewing, artist Angela C. Alexander and more.
Tickets to the dinner are $25; $20 for children 3-12 and free for children under 3.
To reserve, e-mail lifeomike@gmail.com. For more information, call 828-243-6712.
Patient Pals & Family Friends
Life o' Mike has a new peer support program for people newly diagnosed with chronic or serious illness or with a new disability and their caregivers.
Patient Pals are people who have experience with various illnesses and disabilities, who can help someone newly diagnosed or with a new disability work through the fear, frustration, confusion and grief often experienced in the first few months.
Family Friends are there to help caregivers and other family members grow into their new role.
People with new illness or disability fare better when they have a role model -- someone who can help them negotiate their new path in life.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
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