Author Archives: Joseph Burns

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Lawsuit claims UnitedHealthcare concealed Medicare Advantage enrollment fraud complaints

Credit: Kaiser Family Foundation
UnitedHealthcare has 4.6 million Medicare Advantage members, 24 percent of the U.S. Medicare Advantage market.

A recently unsealed whistleblower lawsuit claims that UnitedHealthcare concealed from federal officials hundreds of complaints of enrollment fraud and other misconduct in its Medicare Advantage program.

Brought by two UnitedHealthcare sales professionals in Wisconsin, this suit is worth watching because it is the third in recent months that whistleblowers have brought using knowledge they gained while working for Minnetonka, Minn.-based health insurance giant. Continue reading

Report on Cruz amendment shows how one option would affect insurance market

Photo: Matt Johnson via Flickr

With efforts to repeal and replace the Affordable Care Act sidelined, for now, it may be a good time take a closer look at a Sen. Ted Cruz (R-Texas) proposal in case similar attempts to change insurance market regulation resurface when Congress returns from its August break.

Vox’s Dylan Scott has written that any significant reforms to Obamacare will not come until September at the very earliest, although some bipartisan discussion of ways to stabilize the individual market exchanges has begun. My AHCJ colleague Joanne Kenen in a recent blog post outlined various options going forward. Continue reading

For N.C. reporter, news brief led to series on solitary confinement, mental illness

Photo: Thomas Hawk via Flickr

In most states, care for those with behavioral health problems is so poor that the nation’s prisons have become the default treatment centers for many of the most vulnerable mental health patients. As Congress wrestles with plans to cut funding for Medicaid, many observers are calling for more coverage.

For an example of a mental health system that relies on state prisons, see the work of Taylor Knopf, a reporter for North Carolina Health News. In the spring of 2015, Knopf was working for the Raleigh News & Observer when an editor asked her to write a news brief about an effort to improve the state’s use of solitary confinement. Seeing an opportunity, Knopf made a few calls and did more than write a brief: Over the next year, she turned that assignment into a two-part series on how the prison system used solitary confinement to discipline inmates for even minor infractions.

In a new “How I Did It” article, Knopf writes about the series and how her reporting focused on one inmate’s struggle to adjust to life outside of prison after being held in solitary confinement for almost three years. Continue reading

Opposition forces GOP senators to delay ACA repeal-and-replace vote

Photo by Sean Stayte via flickr.

Senate GOP leaders today scrapped this week’s planned vote on their version of Obamacare repeal-and-replace legislation, with plans for a quick turnaround on the bill faltering in the face of fierce opposition from voters and a wide variety of interest groups.

After the Congressional Budget Office reported Monday that the Better Care Reconciliation Act would cause 22 million Americans to lose their health insurance, organizations representing physicians, hospitals, small businesses and Medicare patients and other interest groups said the BRCA would have a devastating effect on the health insurance system. Continue reading

Health plan execs fear Senate version of AHCA would gut Medicaid

Photo: Tax Credits via Flickr

The Better Care Reconciliation Act (BCRA), the Senate Obamacare repeal-and-replace bill unveiled Thursday, would do little to promote better care via Medicaid, the federal-state partnership program that insures 75 million primarily low-income Americans that include children, the disabled and certain seniors, according to some insurers that specialize in Medicaid coverage. Continue reading