We’re ClearHealthCosts — telling people what stuff costs in healthcare and helping them navigate this messy and complicated world. Welcome to our industry newsletter!
New whistleblower program offers big rewards to those who expose fraud and corruption
A new federal whistleblower program went into effect Aug. 1, offering rewards to people who expose financial fraud and corporate corruption. The government has for many years paid rewards under the existing whistleblower program, the False Claims Act, which is limited to civil cases involving abuse of the government’s huge federal contracting system, and also in a few areas of thhe financial and commodity industry. The new program encompasses enforcement areas outside of the government, including corporations, healthcare, financial institutions and foreign and domestic corruption.
Tax-exempt hospitals under increasing fire for not giving community benefits
Tax-exempt hospitals are increasingly coming under fire for failing to deliver contributions to the community that are supposed to offset those tax breaks. A Washington state nonprofit hospital, PeaceHealth, was ordered to return up to $13.4 million to patients who should have received financial assistance by the Washington Attorney General late last year. In Connecticut, a coalition of groups is trying to pass a measure in the legislature to make it easier for people to get financial aid from hospitals. Why is this happening now? With health costs rising, higher insurance deductibles and the specter of medical debt threatening many Americans, the problem has gained more attention. The kind of financial aid known as “charity care” is granted based on income and household size. But sometimes it’s not given easily.
TikTok childbirth and less personal access to doctors: Dr. X talks (Part 2 of a series)
What’s it like to be a doctor these days? And what might patients want to know about that? I met a doctor and we struck up a conversation. Her views were so interesting that I asked her to join me in a series of conversations for ClearHealthCosts. She is a D.O. (Doctor of Osteopathic Medicine) in private practice who also has a leadership role in obstetrics and gynecology at a Midwestern hospital system. In our second conversation, I asked her about things that had changed in labor and childbirth since she started practicing 30 years ago.
She said: “Sometimes, you’ll have a bunch of patients that will ask you the same thing. I’m like, this has got to be a TikTok thing.
“Like curb-walking to start your labor. You do curb-walking, which is — you have one foot on the curb and one foot on the street and kind of go up and down, up and down. And that’s got to be a TikTok thing.
“Dates, you know, people eat a lot of dates to bring them into labor. And I’m like ‘I don’t know if it brings you into labor. I don’t think it really does. But it’s really, really good fiber. So you’re not gonna be constipated.”
Employee health plans: A new option for employers
Employer health insurance has long been a challenge, and is particularly difficult for small businesses. Now some things in the market are changing, with the rising cost of care for employers and employees being a strong catalyst for new approaches. One of the rising recent trends is Individual Coverage Health Reimbursement Arrangements or ICHRA — employers, instead of buying health insurance for employees, give them a chunk of money and let them buy their own insurance. Health insurance premiums are an ever-growing headache for businesses. More than 150 million workers get health insurance from employers, but the costs are always rising.
What we’re reading
Nearly half of insured Americans get surprise expenses in medical bills, survey finds. USA Today.
The one-hour nurse visits that let insurers collect $15 billion from Medicare. The Wall Street Journal.
Nearly half of online pharmacies selling weight loss drugs are operating illegally, study finds. NBC News.
While Cigna saddles patients with increasing out-of-pocket requirements, the company bought back $5 billion of its own stock. Wendell Potter, Health Care Un-Covered.
The class action lawsuits against Multiplan alleging price-fixing are being rolled up into one case. U.S. Judicial Panel on Multidistrict Litigation.
We are getting a lot of traffic from an aggregator website called NewsBreak, apparently posting our headlines and liinks. No idea how they found us. Here’s a little bit about them. Reuters.
Zombie pharmacies are holding back New York City retail: Why massive amounts of chain drugstore space are standing empty. The New York Times. (gift link)
The New York Times is doing some seriously good reporting on PBM’s, though some of this might be known to you healthcare aficionados. So here’s a gift link to the kickoff piece; more are probably on the way. The New York Times. (gift link)
