Health cost fraud: The Most Wanted

Filed Under: Costs, Health plans

Health cost fraud: The Most Wanted

This is for real: a Web site from the Health and Human Services Department showing the most wanted fugitives committing Medicare and Medicaid fraud. For example: “Carlos, Luis, and Jose Benitez, commonly referred to as the Benitez brothers, allegedly schemed to submit false and fraudulent claims to Medicare, pocketing approximately $110 million from Medicare, according […]

Test charges: $401 = $24.80

Filed Under: Costs, Health plans, Patients

Test charges: $401 = $24.80

It’s not the first time medical bills in my family have seemed really confusing. Take a look at these two bills, for the same procedure, performed not long ago. The top one is from the provider for the actual test, a blood test at a lab. The charge was $401, the mysterious “adjustment” $376.20, leaving […]

Aetna sues in New Jersey, Pt. 2

Aetna sues in New Jersey, Pt. 2

The Aetna lawsuit in New Jersey seemed so puzzling that we continued reporting on it, following links. Why would Aetna pay such ridiculous rates, including a payment of $56,980 for a bedside consultation and “$59,490 for an ultrasound that typically costs $74”? That just seems absurd; we have a hard time getting $23.40 out of […]

An ultrasound: $74 or $59,490?

An ultrasound: $74 or $59,490?

Aetna is unhappy: it received high bills from providers and paid them, and now it’s suing. “Aetna Inc. (AET) is suing six New Jersey doctors over medical bills it calls ‘unconscionable,’ including $56,980 for a bedside consultation and $59,490 for an ultrasound that typically costs $74,” Peter Waldman wrote on Bloomberg News on March 24. […]