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Fed Up – 1.3 Billion Dollars in US Health Fraud Schemes

US charging 412 in health fraud schemes worth $1.3 billion

In recent news, more than 400 people have found themselves in a narcotic scandal worth over a billion dollars. These people were illegally billing Medicare, Medicaid and health insurance programs that were serving members of the armed forces. In one situation, “A Florida rehab facility is alleged to have recruited addicts with gift cards and visits to strip clubs, leading to $58 million in false treatments and tests.” Absolutely unacceptable.

Jeff Sessions, Attorney General, explains:

“They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves, often at the expense of taxpayers, but also feed addictions and cause addictions to start,” Sessions said.

To put the blame on one aspect of the waste and abuse in the healthcare industry is wrong. The waste and abuse is coming from multiple lines of business. The reoccurring theme for pharmaceuticals, insurance companies, brokers, physicians, etc. is that at some point the leaders of these companies get greedy. We have all heard the same song and dance. Clearly there are a lot of issues in the healthcare industry. The best thing to do in an industry that is wrought with waste and abuse is to be a good person. Do the right thing even when nobody is looking.

Rising Healthcare Costs Hurts Retirement Contributions

Rising Healthcare Costs Hurts Retirement Contributions

Cost sharing efforts from employers are beginning to dig into retirement savings for many employees.

“According to Bank of America Merrill Lynch’s ‘2017 Workplace Benefits Report’ 79% of employees experienced an increase in healthcare costs last year, leading 63% of women and 62% of men to decrease their retirement-savings contributions.”

This article explains in order to make the most of your 401k be sure to roll over your 401k when switching jobs. Naturally, rolling over your 401k is a good option otherwise you miss out on the opportunity for interest to continue to build on itself. However, the article never approached the actual problem of soaring healthcare costs and the continual increased cost sharing to employees which ultimately is the pain for why people are decreasing contributions to their 401k.

So…what can an employer do to control their healthcare spend and prevent cost sharing to employees? Reference based pricing, value based pricing, etc.; whatever you want to call it, it is a unique method to challenge the status quo of traditional network options. When done correctly this puts the employer sponsored plan in the driver’s seat when working with providers and hospital facilities. A collaborative communication process with hospital facilities and providers outlying a healthy payment methodology puts transparency in the employer’s hands.

Find more healthcare news on ClaimDOC’s Industry News Section.