Family Health Insurance

A health care crime sweep on Thursday revealed that 114 people took part in what could be the largest Medicare scam takedown in U.S. history. The sweep of nine metropolitan areas found that that at least 40 schemes were in play and, as a result, the government was being defrauded of over $240 million.

Plots Involved Doctors and Health Practitioners

An announcement made by Attorney General Eric Holer revealed that the over 40 schemes were mostly being conducted by doctors and health practitioners, the majority of whom were acting along.

After sweeping nine metropolitan areas, which included Los Angeles, Brooklyn, Miami and Detroit, law enforcement discovered that many of these medical professionals were billing for services that didn’t exist.

Among the highest-profile defendants being charged is Aleksandr Kharkover, a Brooklyn physical therapist who is being charged in at least one of three separate rings. S

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Health care reform has many concerned about potential hikes in health insurance premiums over time.  According to the article “States Can Apply For Nearly $200 Million to Help Fight Health Premium Increases” found on MedicalNewsToday.com, The US Department of Health and Human Services is trying to prevent this from happening.

The department announced that about $200 million in new grants are now available to help states start programs that will help increases in health insurance premiums be more transparent.  The money would also give states the power to stop large increases in health insurance premiums from happening.  This funding process builds on the $46 million awarded in 2010 to help states crack down on large spikes in premiums.  This

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Humana Inc. (NYSE: HUM) was informed by the U.S. Department of Defense (DoD) that it has awarded the South Region TRICARE contract to Humana’s wholly owned subsidiary, Humana Military Healthcare Services, Inc. Under terms of the award, Humana Military will continue supporting the DoD’s delivery of health care services to three million active duty and retired service members and their families in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee and most of Texas. Eligible military beneficiaries in the Fort Campbell, Kentucky area will also be served by Humana Military under terms of the award. Read more…

Dr. Rich of The Covert Rationing Blog has done an excellent job with the latest edition of Grand Rounds, and its well worth your time to stop by and check it out.  I found this article by Doug Perednia to be particularly interesting.  Doug looks at a variety of research data regarding pay-for-performance reimbursement systems for physicians, and the results of the various studies indicate that pay-for-performance doesnt seem to have an impact on overall outcomes (or much of anything else for that matter).  

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Humana Inc., a U.S. healthcare group, will partner with Discovery Holdings Ltd., Africa’s largest medical insurance administrator, to offer clients of the U.S. company wellness and loyalty programs.

As part of the plan, Humana, based in Louisville, Kentucky, will set up a new entity in the U.S. in which Discovery will have a 25 percent stake. Humana will also buy 25 percent of The Vitality Group, Discovery’s U.S. subsidiary, the companies said in a statement today. The value of the transaction wasn’t disclosed.

The partnership will give Humana customers access to the wellness and loyalty programs designed by Discovery and provide the Johannesburg-based insurer with the opportunity to sell its incentive plans to Humana’s 10 million medical members, the companies said. Discove Read more…

With unemployment rates staying discouragingly high, many consumers are out and about looking for a new job.  If you are one of the lucky few who have a variety of possible opportunities be sure to look closely at what kind of benefit packages your potential employer offers.

Whether your company has options for a PPO insurance quote or an HMO insurance quote, understand how the differences will affect you.  Health care reform is causing employers to change the way they offer benefits to their employees, and some packages may actually decrease as employers try to save money.  If you can get information as to how health care reform is affecting their packages that would be ideal.  O

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