MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'insurance coverage'. Sat, 03 Sep 2011 02:28:10 +0100 http://www.medworm.com/index.php?rid=4828888&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-insurance-coverage-and-leaving-the-hospital-against-medical-advice%2F2011.05.15 There is a huge myth being unknowingly  perpetrated against the general public when it comes to their rights and responsibilities as a patient.  It’s a myth that I can remember hearing as far back as my first few weeks of clinicals during medical school.  It was a constant presence during my residency training and even now, as a private practice hospitalist I hear misinformation being handed down day after day, month after month. This myth is perpetrated by doctors, nurses, and therapists of all kinds.  What is this myth?  That their health insurance company will not pay for the care provided if they want to leave against the medical advice of their physician. Will my insurance company pay if I leave against medical advice (AMA)? Yes.  They will pay.  Medicare and Medicaid pa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828888 Sun, 15 May 2011 19:00:00 +0100 4828888 http://www.medworm.com/index.php?rid=4696959&cid=t_102248_151_f&fid=36896&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSuboxoneTalkZone%2F%7E3%2FuA9yORq3fi8%2F I have written about the sleazy actions of health insurer Humana.  Today I filed a formal complaint with the Wisconsin Commisioner of Insurance regarding their practices.  I’ll copy my letter below, rather than take the time to write everything over again.  If there is an attorney willing to work the case on contingency, please contact me.  Likewise, if other patients or physicians are having similar problems with Humana, send me an e-mail through my website at www.fdlpsych.com. The complaint: My patient, XXXXXX, has been treated for opioid dependence for two years, using maintenance treatment with Suboxone.  He has maintained sobriety from opioids.  He also suffers from panic attacks and takes Effexor daily.  He uses lorazepam, a sedative, several times per month, and takes a... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=4696959 Sun, 10 Apr 2011 01:00:18 +0100 4696959 http://www.medworm.com/index.php?rid=4664176&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbureaucrats-propose-to-discontinue-home-glucose-monitoring-coverage%2F2011.04.01 The larger the bureaucracy the more inefficient a system becomes. Several things can happen in the decision making process. 1. The decision making process can become opaque rather than transparent. 2. Decisions are made by a committee by consensus. 3. Consensus committee decisions might not sharply define the original goals. 4. Blame for errors gets dissipated. 5. Decisions are only as good as the information that is gathered. 6. Changing a wrong decision can be difficult and costly. President Obama’s healthcare reform law is creating 256 new agencies to gather information and recommend decisions for other agencies to write regulations. The following decision is being made by an agency in Washington state. It is not only the wrong decision, but is a decision that will set back the care o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4664176 Fri, 01 Apr 2011 11:00:24 +0100 4664176 http://www.medworm.com/index.php?rid=4411730&cid=t_102248_151_f&fid=36896&url=http%3A%2F%2Fsuboxonetalkzone.com%2Fbupe.pain.pdf Humana Health Insurance recently revised their guidelines to ultimately reduce the number of scripts for Suboxone that they will cover.  I am in the process of writing the Humana Grievance Department a letter to regain coverage for a patient who was doing very well on the medication.  To provide context, last week I learned of a former patient who had stopped buprenorphine for his own reasons, who passed away a few months later from on overdose of heroin.  And then this morning a patient told me about her nephew, who at the age of 16 is in a coma after an overdose yesterday. Buprenorphine has the power to prevent these and other deaths from opioid dependence.  But patients must have access to the medication.  Many barriers exist;  doctors are reluctant to prescribe, afraid of their p... Suboxone Talk Zone blogs http://www.medworm.com/rss/comments.php?id=4411730 Thu, 27 Jan 2011 09:35:23 +0100 4411730 http://www.medworm.com/index.php?rid=4225251&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpregnancy-as-a-pre-existing-condition%2F2010.12.03 Women who own individual healthcare policies, please take note. Should you become pregnant in the future, your individual healthcare policy might not cover your pregnancy. A recent article in the Los Angeles Times by Michelle Andrews was revealing. Andrews described the plight of a North Carolina biology teacher who subsequently left teaching after the birth of her twins. She became a small business owner and was covered under individual health insurance policies. However, when she became pregnant again, she had a rude awakening. Despite paying an insurance premium of $400 per month, her pregnancy wasn’t covered unless she had paid for a special rider, prior to becoming pregnant. Since half of all pregnancies are “unplanned” how can you pay for coverage six months in advance of an u... Better Health blogs http://www.medworm.com/rss/comments.php?id=4225251 Fri, 03 Dec 2010 13:00:20 +0100 4225251 http://www.medworm.com/index.php?rid=4190150&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-rationing-of-healthcare%2F2010.11.22 Do you recall the severe rationing of food and water the Chilean miners had to endure to survive? The rationing was done to stretch their limited resources. I would argue the state of Arizona’s new policy to not cover organ transplants for patients on Arizona Health Care Cost Containment System (AHCCCS) or their version of Medicaid is a similar form of rationing. AHCCCS, as many Medicaid programs, is underfunded. They are trying to operate on a limited budget. Something has to give. Sadly in this case, many (NPR reports 98) had already been granted approval for organ transplants which they may not receive. Francisco Felix, 32, who due to hepatitis-C needs a liver transplant, is reported to have made it to the operating room, prepped and ready for his life-saving liver transplant when d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190150 Mon, 22 Nov 2010 21:00:00 +0100 4190150 http://www.medworm.com/index.php?rid=4074062&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fun-insurance-reform%2F2010.10.15 Who doesn’t need insurance reform? Why, the insurers like Aetna, Cigna, and BCS Insurance, that’s who! From Emergency Physicians Monthly: By threatening to raise health care premiums by 200 percent or threatening to drop coverage altogether, the companies got the Department of Health and Human Services to cave. Now the companies have our government’s blessing to continue offering “insurance” to their employees that is capped at a few thousand dollars per year instead of the $750,000 required in the health care law. Perhaps GruntDoc said it best: “I am not an Obamacare fan, and would like it repealed, with smaller, more focused Bipartisan fixes, but if the government is going to pass something then roll over this easily to special interests… it’s already worse th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4074062 Fri, 15 Oct 2010 19:00:00 +0100 4074062 http://www.medworm.com/index.php?rid=4053289&cid=t_102248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-pick-good-health-insurance%2F2010.10.10 Unless your doctor is a policy expert, in healthcare administration, a researcher, an author or blogger, I seriously doubt he will be reviewing an important report card that helps you pick the best health insurance plan that keeps you healthy. Published annually by the National Committee for Quality Assurance (NCQA), this year’s report card ranks 227 health plans across the country on their ability to keep you healthy and well, treat you quickly, and how patients feel about their insurance coverage. Because unlike banking or airlines where there is not much difference in ATM machines or planes, there is a big difference in whether a health insurance plan helps in keeping its enrollees healthy. Do children get their vaccinations? Do healthy mothers get screened for breast cancer or ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4053289 Sun, 10 Oct 2010 14:00:00 +0100 4053289 http://www.medworm.com/index.php?rid=3757852&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FsaYXyH9Fags%2F By Michael F. CannonChristopher Weaver of Kaiser Health News has an excellent article in today’s Washington Post on the various government agencies that will now be deciding what health insurance coverage you must purchase, and how many of those decisions will ultimately fall to lobbyists and politicians: For years, an obscure federal task force sifted through medical literature on colonoscopies, prostate-cancer screening and fluoride treatments, ferreting out the best evidence for doctors to use in caring for their patients. But now its recommendations have financial implications, raising the stakes for patients, doctors and others in the health-care industry. Under the new health-care overhaul law, health insurers will be required to pay fully for services that get an A or B recomm... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3757852 Thu, 15 Jul 2010 15:32:20 +0100 3757852 http://www.medworm.com/index.php?rid=3467839&cid=t_102248_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FcvHo0cow9go%2F GUEST POST BY ANDREW WOLFE, LMP, MMs “Medical Massage Therapy and Insurance Coverage.”  By Andrew Wolfe, LMP, MMs. Medical massage therapy is recognized as a health care provision under rehabilitation outpatient coverage under most major medical plans.  Specific plan coverage’s vary according to the benefit package your plan and/or employer offer.  Medical massage therapy definition is the ability to heal, restore and improve function which was otherwise compromised due to illness, injury, disease or surgery.  It must be a part of a treatment plan your primary care provider recommends as medically necessary to restore lost function. Provisions are also given towards motor vehicle accident (PIP) and worker’s compensation-labor and industry (L&I), job injury reco... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3467839 Wed, 14 Apr 2010 13:28:37 +0100 3467839 http://www.medworm.com/index.php?rid=3378449&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FD8FXSTYtAVk%2F By Michael F. CannonHouse Democrats claim that a not-yet-released Congressional Budget Office report puts the cost of their revised health care overhaul at $940 billion over the next 10 years. Though I have yet to see the CBO score, I’ll bet anyone a fancy lunch that it does not claim the legislation would cost the federal government just $940 billion from 2010 through 2019. As former Congressional Budget Office director Donald Marron has explained over and over, the figure that Democrats consistently cite for the cost of their bills is only the CBO’s estimate of the cost of federal spending related to the expansion of health insurance coverage.  It is not the full cost to the federal government, because each bill also spends taxpayer dollars on other items. Marron examined th... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3378449 Thu, 18 Mar 2010 15:26:23 +0100 3378449 http://www.medworm.com/index.php?rid=3197609&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FFuq8gN2Wdcw%2F By Chris MoodyYesterday, Cato released a new study, “The Massachusetts Health Plan: Much Pain, Little Gain,” which showed that official estimates overstate the gains in health insurance coverage resulting from a 2006 Massachusetts law by at least 45 percent.  The study also finds: supporters understate the law’s cost by nearly 60 percent; government programs are crowding out private insurance; self-reported health improved for some but fell for others; and young adults are responding to the law by avoiding Massachusetts. Given that the Massachusetts health plan bears a “remarkable resemblance” to the Obama plan, the study should serve as a warning sign to members of Congress, says Michael Cannon, director of health policy studies. The study has received coverage in Investor&#821... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3197609 Thu, 21 Jan 2010 21:52:45 +0100 3197609 http://www.medworm.com/index.php?rid=3039784&cid=t_102248_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FQNfh6N-gAw4%2F In the face of acute primary care physician shortages and steady reductions in the number of physicians who are willing to accept Medicaid and Medicare, it is unclear whether our existing primary care system will be able to meet the needs of a universally-insured nation, as President Obama has expressed as a priority for his Administration. Health care delivery is strained under tremendous pressure from the demands of chronic health issues, downward trends in third party payments, and while insurance coverage will address some of these issues, many of these problems may persist even if universal insurance coverage is achieved in the United States. So what else needs to happen to make healthcare reform a success? In recent years, a series of “disruptive innovations” in the health care s... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3039784 Mon, 30 Nov 2009 14:35:11 +0100 3039784 http://www.medworm.com/index.php?rid=2886415&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FhFjLimHBpTU%2F The problem that Democrats have faced from Day One is finally coming to a head. The Left and the health care industry both want universal health insurance coverage.  The industry, because universal coverage means massive new government subsidies. The Left, because that’s their religion. But universal coverage is so expensive that Congress can’t get there without taxing Democrats. Sen. Jay Rockefeller (D-WV) is the biggest opponent of Sen. Max Baucus’ (D-MT) tax on expensive health plans because that tax would hit West Virginia coal miners. Unions vigorously oppose that tax because it would hit their members. Moderate Democrats in the House oppose Rep. Charlie Rangel’s (D-NY) supposed “millionaires surtax” because they know it would hit small businesses in their di... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2886415 Mon, 12 Oct 2009 21:45:50 +0100 2886415 http://www.medworm.com/index.php?rid=2803887&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FUJEALC3pR_E%2F In their attempt to defeat Obamacare, Republicans have focused their criticism on the public option, painting it as the most objectionable feature of existing proposals. Senator Max Baucus, (D-Mont.), has now proposed a plan without the public option. This leaves the Republicans in an awkward position, especially since Baucus’s plan is projected to cost less than earlier proposals. If Republicans oppose the Baucus plan, they surely risk the ire of voters who will be told during the mid-term elections, “The Republicans blocked a plan that would have covered the uninsured and reduced the deficit.” The problem is, the public option was never the crucial issue; instead, it was the mandate to purchase insurance. Once government mandates insurance coverage, it gets to define wh... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2803887 Thu, 17 Sep 2009 15:26:45 +0100 2803887 http://www.medworm.com/index.php?rid=2477542&cid=t_102248_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fcy8wOcJPGRw%2F Columnist Robert J. Samuelson, writing in this morning’s Washington Post: It’s hard to know whether President Obama’s health-care “reform” is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it’s imperative to control runaway health spending. He’s right. The trouble is that what’s being promoted as health-care “reform” almost certainly won’t suppress spending and, quite probably, will do the opposite… The president summoned the heads of major health-care groups representing doctors, hospitals, drug companies and medical device firms to the White House. All pledged to bend the curve. This is mostly public relations. Does anyone believe the American Medical Association can control t... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2477542 Mon, 15 Jun 2009 15:02:54 +0100 2477542