Health Insurance

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Former Georgia Insurance Commissioner pleads guilty to health care fraud scheme, USAO says

Former Georgia State Insurance Commissioner John W. Oxendine pleaded guilty to charges of entering a conspiracy to commit healthcare fraud on Friday.

According to the announcement by the US Department of Justice, Oxendine and a co-conspirator referred unnecessary medical tests to a lab company in Texas to enrich themselves through hundreds of thousands of dollars in kickbacks.

US Attorney Ryan K. Buchanan said, as presented in court, Oxendine conspired with Dr. Jeffrey Gallups to submit fraudulent insurance claims for medically unnecessary testing procedures.

In return for directing the tests, Oxendine and Gallups were given a 50% kickback for the net

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by Alisha Putri•
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Medicaid: News for Members | Wisconsin Department of Health Services

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Change Healthcare service outage

Due to a recent cybersecurity issue with a health care information technology company, a system some pharmacies use to process prescriptions is temporarily offline. If you go to one of these pharmacies, you may experience a delay in filling your prescription. Learn more about the outage.

Health care renewals are ongoing

As a BadgerCare Plus or other Wisconsin Medicaid member, you must update your information with the state each year so we can make sure you are still eligible for benefits.

Resources

April health care renewals - Renew by April 17, 2024. Log in at access.wi.gov

Other news

We recently updated the look of our verification checklist and

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by Alisha Putri•
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FTC Sends Nearly $100 Million in Refunds to Consumers Harmed by Benefytt Technologies’ Sham Health Plans

The Federal Trade Commission is sending nearly $100 million in refunds to consumers who were charged for sham health plans marketed by Benefytt Technologies.

According to the FTC’s August 2022 complaint, Benefytt and its third-party partners operated a series of deceptive websites that targeted consumers who were searching for comprehensive health insurance plans qualified under the Affordable Care Act. Sales agents pitched Benefytt’s sham plans even though they were not ACA-qualified health plans and lacked key elements. Consumers were led to believe that they were buying comprehensive health insurance and were then charged hundreds of dollars per month for benefit

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by Alisha Putri•
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I Took A Corporate Job For Health Insurance. It Was Awful.

This story was supported by the journalism non-profit the Economic Hardship Reporting Project.

The breaking point came in a one-on-one. My manager looked distressed. He told me the issues had been building up: I didn’t unmute myself to say “yes” in a Google Meet call but instead nodded; I gave him briefer-than-expected answers during our last conversation; and, perhaps worst of all, he’d noticed I was looking away from my screen too much during meetings.

“If something doesn’t change, we’re going to have to consider a termination,” he told me.

By then, I’d grown weary of the absurdity of

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by Alisha Putri•
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Narayana Health gets Irdai nod to launch health insurance business | Company News

The company runs one of the largest hospital chains under the brand name of Narayana Hospital.

In a press release, IRDAI said, “Insurance Regulatory & Development Authority of India (IRDAI) in its 124th meeting held on December 28, 2023, has granted a Certificate of Registration to a new health insurer namely, Narayana Health Insurance Limited to carry health insurance business in India after a hiatus of 5 years.”

Post the approval, the number of Standalone Health Insurance Companies (SAHI) will rise to 6 from the existing 5.

Recently, at an event organized by the National Insurance Academy (NIA), IRDAI Chairman

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by Alisha Putri•
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Majority of debtors to US hospitals now people with health insurance | US healthcare

People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts.

This marks a sea change from just a few years ago, when people with health insurance represented only about one in 10 hospital bills considered “bad debt”, analysts said.

“We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that has the ability to pay but doesn’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis.

“Now,

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by Alisha Putri•
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California becomes first state to offer health insurance to all undocumented immigrants

California will welcome the new year by becoming the first state to offer health insurance for all undocumented immigrants.

Starting Jan. 1, all undocumented immigrants, regardless of age, will qualify for Medi-Cal, California’s version of the federal Medicaid program for people with low incomes.

Previously, undocumented immigrants were not qualified to receive comprehensive health insurance but were allowed to receive emergency and pregnancy-related services under Medi-Cal as long as they met eligibility requirements, including income limits and California residency in 2014.

In 2015, undocumented children were able to join Medi-Cal under a bill signed by then-Gov. Jerry Brown. In 2019,

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by Alisha Putri•
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Why Long-Term Care Insurance Falls Short for So Many 

For 35 years, Angela Jemmott and her five brothers paid premiums on a long-term care insurance policy for their 91-year-old mother. But the policy does not cover home health aides whose assistance allows her to stay in her Sacramento, California, bungalow, near the friends and neighbors she loves. Her family pays $4,000 a month for that. 

“We want her to stay in her house,” Jemmott said. “That’s what’s probably keeping her alive, because she’s in her element, not in a strange place.” 

The private insurance market has proved wildly inadequate in providing financial security for most of the millions of

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by Alisha Putri•