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
If you’ve ever wondered what it would be like to face a lawsuit over a story you’ve written, you’ll want to read how Ron Shinkman responded when a source threatened to sue.
The editor and publisher of Payers & Providers, a newsletter in Los Angeles, Shinkman got the phone call we all dread. On the line that day in March 2012 was Jeannette Martello, MD.., a plastic surgeon Shinkman had covered when the California Department of Managed Health Care enjoined her from balance billing her patients.
As Shinkman writes in a new How I did It, the article was a just-the-facts brief based on a report the insurance regulator issued. Continue reading
There’s a lot of speculation about what outgoing House Speaker John Boehner may or may not accomplish in his last weeks in office.
Ending the acrimony about the Affordable Care Act is not one of them.
Not only is the House now rapidly moving ahead with another attempt to gut key sections of the law through a budget tool known as reconciliation (which President Obama would veto), Boehner has another ACA legacy. He was pivotal in filing the House of Representatives lawsuit charging that President Obama and his administration overstepped their authority in implementing the health law. Continue reading
In January 2012, EMTs took Ignacio Alaniz by helicopter to Memorial Hermann Hospital, one of the largest nonprofit medical centers in Texas. Alaniz had been working underneath his Buick Century, trying to get it started. When it rolled over him, he suffered a punctured lung, nine fractured ribs and a broken arm.
“By the time the helicopter landed, he was already $12,196.37 in debt,” wrote Dianna Wray, a staff writer for the Houston Press. Her article about Alaniz, “Getting Stuck: Uninsured Patients Slammed with Lawsuits by Not-for-Profit Hospital,” was recognized as one of the best examples of health journalism in the business (small) category in AHCJ’s Awards for Excellence in Health Care Journalism. In a new “How I did it” article, Wray explains how her reporting led her to many more cases of patients being sued for medical debt and some of the reaction the story generated. Continue reading
A class-action lawsuit, accusing one of America’s largest corporate dental chains of illegally owning dental practices and of deceiving patients, has been filed.
The Center for Public Integrity’s David Heath reported on the suitas part of his continuing coverage of Aspen Dental.
Mary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.
If you have questions or suggestions for future resources on the topic, please send them to firstname.lastname@example.org.
In June, “Dollars and Dentists,” a joint investigation led by CPI and PBS Frontline took a long look at rapidly expanding corporate dental chains, and probed the question of whether the profit motive built into their business model leads to overtreatment of patients.
The program joined a growing body of related inquiries, by the press and state and federal agencies and legislators. In May, Sydney Freedberg of Bloomberg took a detailed look at the model under the headline “Dental Abuse Seen Driven By Public Investments.”
Months of coverage by Dallas-Fort Worth television station WFAA into questionable Medicaid billing at corporate-owned All Smiles Dental Centers helped spur lawsuits by the state attorney general. Continue reading