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  1. #1 Doctors on the hook for patient fraud in Obamacare 
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    December 6, 2013 12:00 AM
    Obamacare Dumps Unpaid Bills on Providers
    Payment grace period opens the system to fraud.
    By Michelle Malkin

    ...Here’s the raw deal: The Affordable Care Act created a 90-day grace period before insurers can drop patients who fall behind on premiums. So, delinquents who obtain tax-subsidized health insurance through an Obamacare health-insurance exchange have three months to settle up their bills prior to their policy’s being canceled. As written, the law puts insurers on the hook for the grace period.

    But the bureaucrats at the Centers for Medicare and Medicaid Services (CMS) decided to issue a rule in March making insurers responsible only for paying claims during the first 30 days of the debtors’ grace period. Who’s on the hook for the other two months? Well, customers are entrusted to foot the bills for additional services. But if they blow off the payments, it’s up to physicians and hospitals to collect.

    In real-world practice, this means providers will be eating untold costs. Several large hospital associations raised red flags over the issue this summer. In August, the Missouri Hospital Association noted that the regulatory shift “unduly burdens physicians, hospitals, and other health-care providers” by making them directly collect payments from patients, which “puts them at an unfair and significant risk for providing uncompensated care to patients.”

    Emilie J DiChristina spelled out the financial risks for clients on the Practicefirst Medical Management Solutions blog: “This leaves providers in a potentially bad place as they have a high potential for accruing bad debt on services provided between 31 and 90 days of the allowed grace period.” Can you spell f-r-a-u-d? People could “go on and off” insurance plans, Tampa Bay health-care lawyer Bruce Lamb told me, and game the system by bailing on payments and exploiting Obamacare protections against denial of coverage.

    Or as Missouri Hospital Association officials put it: “We also are very concerned that some disreputable individuals will learn they can manipulate the system and win a full year’s insurance coverage on only nine months of premiums. Knowing they are entitled to three months of grace-period coverage, dishonest persons could stop paying premiums on the ninth month, enjoy free coverage during the 90-day grace period, have their coverage terminated, and then reenter the exchange market where the Affordable Care Act’s guaranteed-issue mandate would prohibit another plan from denying them coverage.”....
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  2. #2  
    PORCUS MAXIMUS Rockntractor's Avatar
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    If every doctor in America that does not want Obamacare decided to withhold their services tomorrow obama care would fold almost instantly.
    The difference between pigs and people is that when they tell you you're cured it isn't a good thing.
    http://i.imgur.com/FHvkMSE.jpg
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  3. #3  
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    Quote Originally Posted by Rockntractor View Post
    If every doctor in America that does not want Obamacare decided to withhold their services tomorrow obama care would fold almost instantly.
    If only they could afford to.
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  4. #4  
    PORCUS MAXIMUS Rockntractor's Avatar
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    Quote Originally Posted by Elspeth View Post
    If only they could afford to.
    It would not take long.
    The difference between pigs and people is that when they tell you you're cured it isn't a good thing.
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  5. #5  
    Sin City Moderator RobJohnson's Avatar
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    How affordable!


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  6. #6  
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    Quote Originally Posted by Rockntractor View Post
    If every doctor in America that does not want Obamacare decided to withhold their services tomorrow obama care would fold almost instantly.
    Hey Rock, something is happening in California:

    Report: 7 In 10 Doctors Boycotting California’s Obamacare Exchange…

    http://washingtonexaminer.com/doctor...rticle/2540272

    An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said.

    “It doesn’t surprise me that there’s a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association.

    Thorp has been a primary care doctor for 38 years in a small town 90 miles north of Sacramento. The CMA represents 38,000 of the roughly 104,000 doctors in California.

    “We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” he said.

    California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federalMedicare payments. And reimbursement rates for some procedures are even lower.

    In other states, Medicare pays doctors $76 for return-office visits. But in California, Medicare’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

    In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

    Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That's driven many doctors to just say no.

    They're also pointing out that Covered California's website lists many doctors as participants when they aren't....
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    PORCUS MAXIMUS Rockntractor's Avatar
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    Quote Originally Posted by Elspeth View Post
    Hey Rock, something is happening in California:
    I'll be darned, the doctors in the rest of the states need to follow their example.
    The difference between pigs and people is that when they tell you you're cured it isn't a good thing.
    http://i.imgur.com/FHvkMSE.jpg
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  8. #8  
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    Quote Originally Posted by Rockntractor View Post
    I'll be darned, the doctors in the rest of the states need to follow their example.
    The interesting thing is that Covered California (CA Obamacare) is claiming to have the best facilities and 85% of all doctors on their plans. It just doesn't compute. I wonder if Covered CA is covering nurse practitioners and counting them as actual physicians. Remember, we now have a law saying you don't need to have a doctor perform an abortion anymore.
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  9. #9  
    PORCUS MAXIMUS Rockntractor's Avatar
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    Quote Originally Posted by Elspeth View Post
    The interesting thing is that Covered California (CA Obamacare) is claiming to have the best facilities and 85% of all doctors on their plans. It just doesn't compute. I wonder if Covered CA is covering nurse practitioners and counting them as actual physicians. Remember, we now have a law saying you don't need to have a doctor perform an abortion anymore.
    If this keeps up the meat cutter at your local grocery will be allowed to do surgery.
    The difference between pigs and people is that when they tell you you're cured it isn't a good thing.
    http://i.imgur.com/FHvkMSE.jpg
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  10. #10  
    Sin City Moderator RobJohnson's Avatar
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    MedCal (CA Medicaid) only reimburses doctors $24 for a office call.


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