Thread: UnitedHealth drops thousands of doctors from insurance plans: WSJ

UnitedHealth drops thousands of doctors from insurance plans: WSJ

November 15, 2013 10:00 PM










(Reuters) - UnitedHealth Group dropped thousands of doctors from its networks in recent weeks, leaving many elderly patients unsure whether they need to switch plans to continue seeing their doctors, the Wall Street Journal reported on Friday.


The insurer said in October that underfunding of Medicare Advantage plans for the elderly could not be fully offset by the company's other healthcare business. The company also reported spending more healthcare premiums on medical claims in the third quarter, due mainly to government cuts to payments for Medicare Advantage services.


The Journal report said that doctors in at least 10 states were notified of being laid off the plans, some citing "significant changes and pressures in the healthcare environment." According to the notices, the terminations can be appealed within 30 days.


Tyler Mason, a UnitedHealth spokesperson, was not immediately available for comment when reached by Reuters.
The insurer told the WSJ that its provider networks were always changing and that it expected its Medicare Advantage network to be 85 percent to 90 percent of its current size by the end of 2014.


UnitedHealth is participating in about a dozen new state insurance markets that launched on October 1 to offer subsidized health coverage under President Barack Obama's healthcare overhaul.


The insurer said previously it planned to withdraw from some markets in 2014 because of the government funding cuts.
Another top health insurer, Aetna Inc , also warned in October that it expected slowing growth in 2014 in its Medicare Advantage plans.

(Reporting by Zeba Siddiqui in Bangalore; Editing by Peter Cooney)

http://news.yahoo.com/unitedhealth-d...--finance.html



All this just at the time the medicare plans that are up for their yearly renewal are almost over...

WSJ: Warning To Seniors: Obamacare Creating Fraud Opportunities

inShar

By Anne Tergesen

November 17, 2013
“During the past year, scams tied to Medicare have risen sharply as con artists have sought to exploit confusion among older individuals about the Affordable Care Act, commonly known as Obamacare.
Now, with Medicare’s open-enrollment season in full swing, consumer advocates say beneficiaries—and the adult children who advise them—should be on guard for swindles and steer clear of unsolicited requests for personal financial information.
In the months preceding the Oct. 1 opening of the state-based health-insurance exchanges, consumer complaints about Medicare—many alleging fraud—soared. In September alone, consumers filed almost 2,000 such complaints with the Federal Trade Commission, up from 57 in January 2012. An additional 58 complaints filed this year have mentioned the ACA, up from two in 2012.
The trend has prompted the FTC and nonprofit organizations—including the National Consumers League, the Better Business Bureau and the Coalition Against Insurance Fraud—to issue warnings in recent months about health-care scams that target the elderly.

Lois Greisman, associate director of the FTC’s Division of Marketing Practices, says the recent wave of publicity over changes in the health-care system and confusion among consumers over the ACA may be contributing factors. “With confusion comes opportunity for fraudsters,” she says.”
Read More
http://conservative50plus.com/blog/w...opportunities/

Fraudsters Are Exploiting New Health Law

One Con: Telling Medicare Beneficiaries They Must Choose New Plans

By Anne Tergesen


November 17, 2013
During the past year, scams tied to Medicare have risen sharply as con artists have sought to exploit confusion among older individuals about the Affordable Care Act, commonly known as Obamacare.
Now, with Medicare's open-enrollment season in full swing, consumer advocates say beneficiaries—and the adult children who advise them—should be on guard for swindles and steer clear of unsolicited requests for personal financial information.


In the months preceding the Oct. 1 opening of the state-based health-insurance exchanges, consumer complaints about Medicare—many alleging fraud—soared. In September alone, consumers filed almost 2,000 such complaints with the Federal Trade Commission, up from 57 in January 2012. An additional 58 complaints filed this year have mentioned the ACA, up from two in 2012.
The trend has prompted the FTC and nonprofit organizations—including the National Consumers League, the Better Business Bureau and the Coalition Against Insurance Fraud—to issue warnings in recent months about health-care scams that target the elderly.
Lois Greisman, associate director of the FTC's Division of Marketing Practices, says the recent wave of publicity over changes in the health-care system and confusion among consumers over the ACA may be contributing factors. "With confusion comes opportunity for fraudsters," she says.
According to a recent survey of 1,101 people by Express Scripts, a St. Louis-based pharmacy-benefits management company, a significant portion of Medicare recipients has misconceptions about the ACA. While there have been no changes to Medicare's annual open-enrollment procedures, 20% of Americans age 65 and over incorrectly believe they can enroll in Medicare through one of the new state-based health-insurance exchanges, which actually cater to individuals under 65. Seventeen percent believe exchange-based policies are replacing Medicare, according to the survey.
Among the survey's respondents, 10% say they or someone they know has been the victim of a health-care fraud. Ms. Greisman says in many instances, con artists claim—falsely—that the ACA requires Medicare beneficiaries to buy a new policy or Medicare card. Often, they pose as a representative of Medicare or an insurer and ask for personal financial information, such as a Social Security or bank-account number.
David Lipschutz, a policy attorney at the nonprofit Center for Medicare Advocacy, says Medicare employees "as a rule" don't contact beneficiaries. He says Medicare rules prohibit most insurers, brokers and agents from initiating contact with Medicare beneficiaries.
Advocates say consumers shouldn't divulge any information to unsolicited callers or visitors and should be skeptical of Caller ID, which can be manipulated. Those who are approached should file complaints with the FTC (ftc.gov/ftc/contact.shtm), local law enforcement, and their state's attorney general and insurance department, says John Breyault, a vice president of public policy at the National Consumers League. They can also call the U.S. Senate Special Committee on Aging's new fraud hotline at 855-303-9470.
During Medicare's annual open-enrollment period, which started on Oct. 15 and ends on Dec. 7, beneficiaries can make changes to their coverage. Those who wish to enroll in or switch plans can go to medicare.gov or call 1-800-633-4227. Free counseling is available through the nonprofit State Health Insurance Assistance Program (SHIPtalk.org).

http://online.wsj.com/news/articles/...93720742106130