Changes in Anthem’s Pathway Network Leave Some Ga. Patients Battling For Care Options
People who bought plans during the open enrollment last fall did not know that the insurer's contract with WellStar Health System hospitals was set to expire at the end of February. Now they want to be able to buy new plans. Also, a Kentucky County settles a claim with the federal government about ambulance charges and Tesla comes under scrutiny over its policies on injured workers' care.
Georgia Health News:
Unforeseen Cancer, Unexpected Bills: A Georgian’s Ordeal
Late last year, during Open Enrollment for 2019 insurance plans, the online information for consumers showed WellStar Health System hospitals and doctors as part of Anthem’s Pathway health plan. But enrollees say they didn’t realize during the sign-up period that the Anthem-WellStar contract for that plan was scheduled to end in February. That contract termination – and the ensuing furor over patients having to switch doctors and hospitals — led to recent litigation against Anthem, based in Indianapolis. (Miller, 4/11)
Lexington Herald Leader:
False Ambulance Billing In Kentucky County Topped $500,000
Lee County will pay $253,930 to the federal government to resolve allegations that its ambulance service submitted false bills for transporting patients on medically unnecessary runs, according to the federal prosecutor for the eastern half of Kentucky. With that agreement and others, the government will recoup a total of $515,000 in connection with allegations that the ambulance service submitted false bills to Medicare and Medicaid, U.S. Attorney Robert M. Duncan Jr. said in a news release. (Estep, 4/11)
Reveal:
How Tesla And Its Doctor Made Sure Injured Employees Didn’t Get Workers’ Comp
Inside a medical clinic not far from Tesla’s electric car factory, Yvette Bonnet started noting a troubling pattern. The automaker’s workers’ compensation manager would pressure her boss, Dr. Basil Besh, to make sure Tesla wasn’t on the hook for certain injured workers. ... interviews with former clinic employees and internal clinic communications show how Tesla and Besh coordinated behind the scenes in an arrangement that financially benefited both the carmaker and the doctor, to the detriment of the injured. (Evans, 4/11)
