Medicaid Paid $9.6 Million For Dead Patients

From the statement of Seto Bagdoyan, Director, Forensic Audits and Investigative Service (June 2, 2015):

Approximately 8,600 beneficiaries received benefits worth about $18.3 million concurrently in two or more states –- even though federal regulations do not permit beneficiaries to have payments made on their behalf by two or more states concurrently.

…… our work raises concerns about whether payments made on behalf of certain beneficiaries were appropriate, including the following:

Read the entire entry at NCPA's Health Policy Blog.

Many Congressional Republicans Opposing Obamacare Have Conflict of Interest

Many representatives and senators are benefiting from an illegal payment of public monies the administration is using to prop up Obamacare. When the Affordable Care Act was being debated, one sticking point was that politicians were proposing to impose an unpopular health insurance “reform” on vulnerable citizens while leaving their own generous health benefits untouched. Members of Congress and their staff have long been covered by the same health plan that unionized federal public servants enjoy.

So, politicians of both parties collaborated with the administration to “fix” this, and the Office of Personnel Management (which is the federal government’s HR department) unilaterally decided in August 2013 to change the law and pay these subsidies to politicians’ and staffers’ exchange plans. The politicians and staff are then able to get health insurance through a Small Business Health Options Program (SHOP) exchange. Did you catch that? Congress is defined as a “small business” by its own administrative bureaucracy!

Read the entire op-ed at The Hill.

More on Obamacare's Double Digit Rate Hikes

Yesterday, I pointed out that this blog would have room for nothing else if we discussed every local newspaper’s coverage of how Obamacare’s outrageous 2016 rate hikes were going to hit their community. Well, the House Speaker John Boehner’s office collected and summarized many of the articles, from the Wall Street Journal to the Wichita Eagle; from the New York Times to the Fayetteville Observer.

Insurance expert Bob Laszewski corroborates my conclusion from yesterday: It is surprising that insurers are asking for such “eye-popping” premium hikes while they still have taxpayers’ protection from losses via Obamacare’s risk corridors and reinsurance.

Read the entire entry at NCPA's Health Policy Blog.

13 Percent of Obamacare 2015 Sing Ups Dropped Out A Month Later

The Administration released data on the status of enrollees in second open enrollment, which ended on February 22 (give or take a few days, depending on the state):

About 11.7 million Americans selected plans through the Health Insurance Marketplaces as of February 22, the end of the “in-line” special enrollment period for 2015 Open Enrollment for individual market coverage. On March 31, 2015, about 10.2 million consumers had “effectuated” coverage which means those individuals paid for Marketplace coverage and still have an active policy in the applicable month.

That’s a 13 percent drop-out rate within five weeks. Actually, I am happy to see if it those people got employer-based coverage, which has explained most growth in coverage over the last few years.

Read the entire entry at NCPA's Health Policy Blog.

Medicare Accountable Care Organizations Cut Spending Two Thirds of One Percent

The Center for American Progress, a very pro-Obamacare organization, has published a study summarizing results of one of Obamacare’s most hyped tools to wring savings out of Medicare:

We first calculated overall savings by the Pioneer ACOs, finding that they reduced overall spending by 0.67 percent compared with the target amount of spending in the model’s second year.

Underwhelming, to say the least, don’t you agree?

Read the entire entry at NCPA's Health Policy Blog.

Net Neutrality Versus Your Health

(A version of this Health Alert, which is co-authored by Roslyn Layton, was published by iHealthBeat. Roslyn Layton is a PhD fellow at Aalborg University’s Center for Communication, Media & Information Studies and vice president of Strand Consult.)

The Federal Communications Commission’s recent decision to regulate the Internet with the same law that was created for “Ma Bell” before World War II has plenty of implications for the health innovation economy. The era of “permission-less innovation” may be coming to an end as the FCC will scrutinize telemedicine applications and other broadband-enabled health care services because they involve connectivity. If Congress can act quickly to rein in the FCC, a disaster can be averted.

Read the entire Health Alert at NCPA's Health Policy Blog.

Hip Replacements in L.A.: $12,457 to $17,609

A short drive in the Los Angeles area can yield big differences in price for knee or hip replacement surgery. 

New Medicare data show that Inglewood’s Centinela Hospital Medical Center billed the federal program $237,063, on average, for joint replacement surgery in 2013.

That was the highest charge nationwide. And it’s six times what Kaiser Permanente billed Medicare eight miles away at its West L.A. hospital. Kaiser billed $39,059, on average, and Medicare paid $12,457. 

The federal program also paid a fraction of Centinela’s bill — an average of $17,609 for these procedures. (Chad Terhune & Sandra Poindexter, “Price of a common surgery varies from $39,000 to $237,000 in L.A.,” Los Angeles Times, June 2, 2015)

Okay, hospital bills are silly. We already know that. Let me point out two things.

Read the entire entry at NCPA's Health Policy Blog.