Matrimonio gana millones a costa de Medicaid
Norma Díaz y su esposo, Joseph García, han dedicado sus carreras a administrar una aseguradora de salud sin fines de lucro que cubre a residentes carenciados de California. Y en el proceso, han ganado millones de dólares.
Couple Makes Millions Off Medicaid Managed Care As Oversight Lags
How a California health plan’s CEO and her husband, an executive consultant, got rich off the taxpayer-funded program for the poor. Critics see a conflict of interest, the plan doesn’t, and the state has no rules either way.
Judge Orders New Olympus Trial Over Superbug Death
The Seattle jurist finds that Olympus Corp. failed to properly disclose evidence that it knew of concerns about cleaning problems with its redesigned medical scopes years before they hit the market and were linked to dozens of deaths. The company maintains the devices were not defective and intends to appeal.
Whistleblower: Medicaid Managed-Care Firm Improperly Denied Care To Thousands
An explosive report prepared by a SynerMed executive alleges the California firm, which oversaw care for 1.2 million patients, fabricated documents and violated state and federal regulations for years. The state says it left low-income patients on Medicaid managed care in “imminent danger.”
Health Giant Sutter Destroys Evidence In Crucial Antitrust Case Over High Prices
“‘Fingers crossed’ that I haven’t authorized something the FTC will hunt me down for,” a staffer wrote after destroying the documents. Sutter, a huge Northern California Health system with 24 hospitals, said it destroyed them by mistake.
Gigante de salud Sutter en demanda crucial por monopolio de sobreprecios
De acuerdo con un juez estatal, Sutter Health, el gigante del sistema de salud que gerencia 24 hospitales en California, abusó de su poder para inflar precios y destruir documentación crítica de sus empleados.
California Fines Anthem $5 Million For Failing to Address Consumer Grievances
The Department of Managed Health Care cited one example in which consumers and advocates had to call the insurer 22 times to contest a decision. Still, the complaint still was not resolved until the department became involved.
California Firm Running Physician Practices Is Closing Down as Scrutiny Ramps Up
State regulators and insurers are looking into SynerMed, which medical groups depend upon to handle their finances and business operations. The groups, serving 1 million patients, fear a messy fallout.
Enriched By The Poor: California Health Insurers Make Billions Through Medicaid
Medicaid is rarely associated with getting rich. But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds their patient care is subpar.
Health Companies Race To Catch UnitedHealth As Amazon Laces Up
UnitedHealth, a health industry goliath, has its hand in doctors’ offices, surgery centers, technology services and prescription drugs. It is the industry model, and CVS and Aetna, says one expert, are ‘wannabes.’
Anthem Eases Up On Premium Hikes After State Scrutiny
After regulators questioned Anthem’s forecast for medical costs, the company agreed to reduce rate hikes on its individual and small-business health plans next year, saving customers an estimated $114 million.
California Slaps Surcharge On ACA Plans As Trump Remains Coy On Subsidies
Covered California authorized a 12.4 percent average surcharge on silver-tier plans, the second-least expensive option sold on the exchange. It brings the total average premium increase on those plans to nearly 25 percent next year.
To Wage War On Superbugs, FDA Clears Way For Scope With A Disposable Piece
Agency says a removable cap will lower the risk of antibiotic resistant infections but some experts see it as a modest step in curbing the sort of deadly outbreaks that occurred a few years ago.
High On Drugs? Anthem Cites Soaring Drug Costs To Justify 35% Rate Hike in California
The company’s drug spending prediction, far above other insurers in the individual market, has experts scratching their heads. Anthem cites market volatility.
Why One California County Went Surgery Shopping
Fed up with high hospital costs and limited competition, Santa Barbara County sends willing employees out of town for better bargains. Local governments are slowly joining private employers in aggressively seeking out the best care for the lowest price.
Why One Insurer’s Collapse Could Whack Insurers, Policyholders Across the Country
Little-known rules require all health insurance companies to help pay claims when any one of them fails. Penn Treaty failed big — and insurers around the country are likely to pass those costs onto policyholders.
Anthem’s Retreat Leaves Californians With Fewer Choices, More Worries
The nation’s second-largest insurer is shrinking its presence on Obamacare exchanges and in the broader individual market in response to prevailing uncertainty. California is just the latest — and the biggest — example.
Scope Maker Olympus Hit With $6.6 Million Verdict In Superbug Outbreak Case
In the first case of its kind in the U.S., the company was ordered to pay damages to the hospital where a patient died of an infection linked to a contaminated scope. But jurors also found the hospital negligent, and it was ordered to pay the patients’ family $1 million.
The failure this week of the U.S. Senate’s ACA repeal effort was one more twist in the ongoing political drama that has complicated routine rate setting for insurers and state officials.
Widow Unleashes Court Fight Against Scope Maker Olympus Over Superbug Outbreak
The Seattle case, the first to reach trial in the U.S., offers possible glimpse into fate of some two dozen lawsuits against manufacturing giant Olympus, accused of failing to address scope contamination linked to numerous deaths. The company faults poor hospital cleaning practices.
