Healthcare overhaul bills working their way through Congress could jeopardize laws in California and other states that require insurers to pay for treatments such as AIDS testing, second surgical opinions, and reconstructive surgery for breast cancer patients, the Los Angeles Times reports. The federal legislation could also make it virtually impossible for states to enforce other consumer protection laws, such as the right to appeal if an insurer denies coverage for a particular treatment.
The government has paid more than $47 billion in questionable Medicare claims including medical treatment showing little relation to a patient's condition. Excerpts of a new federal report show a dramatic increase in improper payments in the $440 billion Medicare program that government auditors have cited as a high risk for fraud and waste for 20 years. Much of the increase in the past year is attributed to a change in the Department of Health and Human Services' methodology that imposes stricter documentation requirements and includes more improper payments.
The health bills passed through Senate committees would extend insurance to fewer people than the final bill passed through the House last week, and Senate leaders have been refining their bill to increase that number. Hospitals and insurance companies warn that if the final Senate bill doesn't cover more people than its earlier drafts, insurance prices will increase and industry pledges to cut costs could fall apart, the Wall Street Journal reports.
UnitedHealth Group, the nation's largest health insurance carrier, is urging its employees to lobby the Senate against reform proposals that would hurt the firm's bottom line. Minnesota-based UnitedHealth Group e-mailed its 75,000 employees asking them to write their senators and local newspapers in opposition to a public insurance option, alleging that "government-run healthcare" will force "millions of Americans" to drop their current coverage. Proposed form letters from the company also lay out opposition to cuts in the Medicare Advantage program and advocate higher financial penalties for individuals who do not buy health insurance. Consumer Watchdog, a California-based advocacy group, says the campaign amounts to intimidation of employees of UnitedHealth Group and its main operating division, UnitedHealthcare.
Democrats heralded a report from the Business Roundtable on healthcare costs, saying it showed their legislative efforts would reduce employers' costs in coming years. The Business Roundtable, which represents the chief executives of major U.S. companies, released a report that stated that without changes to the current U.S. healthcare system, costs would rise to $28,530 per employee. But the "right legislative reforms" would reduce those costs by more than $3,000 per employee, according to the report.
Kaiser Permanente's Oregon-based unit has agreed to pay $1.8 million to settle charges of false billing brought by the federal Medicare program. The U.S. Justice Department said Kaiser's hospice program billed for services without obtaining written certifications of terminal illness required by federal regulations. Kaiser Permanente officials said Kaiser voluntarily disclosed the billing errors to the government in 2005, when the company discovered the errors during an internal review.