Hospitals to Medicare Advantage - Take a Walk
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Hospitals Fed Up with Medicare Advantage
Medicare Advantage provides health coverage to more than half of the nation's seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping some or all contracts with the private plans altogether.
Remember that this is private insurance NOT traditional Medicare.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.
According to San Diego, California based Scripps Health, it is a game of delay, deny and then don’t pay. They’ve had enough and want nothing to do with Medicare Advantage plans. Their decision affected 30,000 patients and 1,000 doctors.
Here is a link to a Becker’s Hospital Review article from November 2023 that lists 13 instances of hospitals dropping Medicare Advantage.
You have insurance and no place to use it to get the healthcare you need. This is not what you signed up for. I fear that this is the just the start.
ACTION
Let’s remind our legislators in Congress that healthcare needs reform. Universal Healthcare would fix the problems we described. You can find their contact info in the Resources section. Or use RESISTBOT and text SIGN PZVFOJ to 50409 to send the message below.
“I am your constituent and I want you to know that there are major hospital systems refusing to do business with Medicare Advantage commercial insurance plans. The report was written in Beckers’ Hospital Review. Here is a link so you can read it. https://www.beckershospitalreview.com/finance/hospitals-are-dropping-medicare-advantage-left-and-right.html.
This leaves hundreds of thousands of seniors in the lurch.
The problem is that commercial insurance practices Delay, Deny, then Don’t Pay enough of the time so hospitals can’t afford to continue with them. Of course, these same companies sell health insurance to all of us Medicare or not and so this problem will only grow.
Universal Healthcare fixes this by paying fair amounts to every provider using global budgets. Everyone in, no one out, cradle to grave for hundreds of billions of dollars less EVERY YEAR according to the Congressional Budget Office
I encourage you to read the text of HR 3421, the vastly improved Medicare for All Act. Then pass it. Thank you.”
IVF Halted in Alabama
Recall that the Alabama Supreme Court declared that frozen embryos are to be accorded the same rights as children and destruction of unneeded embryos would be a crime.
From Axios, the University of Alabama at Birmingham paused in vitro fertilization (IVF)treatments, citing "the potential that our patients and our physicians could be prosecuted criminally or face punitive damages for following the standard of care." Medical professionals throughout the state are questioning whether they'll need to overhaul their approach to IVF, most likely in ways that could make it riskier, more expensive and more painful for women trying to conceive.
Nationwide IVF accounts for about 2% of births (reference). According to UNICEF, 3,745,361 babies were born in the United States in 2023. That comes to 74,907 babies.
Smartwatches and Blood Sugar - Not Ready for Prime Time
Smartwatches and rings that claim to measure blood sugar levels for medical purposes without piercing the skin could be dangerous and should be avoided, the U.S. Food and Drug Administration warned Wednesday.
The caution applies to any watch or ring, regardless of brand, that claims to measure blood glucose levels in a noninvasive way, the agency said. The FDA said it has not authorized any such device.
The agency’s notice doesn’t apply to smartwatch apps linked to sensors, such as continuous glucose monitoring systems that measure blood sugar directly.
Using the unapproved smartwatch and smart ring devices could result in inaccurate blood sugar measurements, with “potentially devastating” consequences, said Dr. Robert Gabbay, of the American Diabetes Association. That could cause patients to take the wrong doses of medication, leading to dangerous levels of blood sugar and possibly mental confusion, coma or even death.
FDA approved monitors are available at pretty much any pharmacy and are low risk. I have a friend who uses one and is super pleased with the results. He’s now able to keep his blood sugar in check. (AP)
Women’s Health Research
The Biden administration pledged to invest $100 million for women's health research, First Lady Jill Biden announced Wednesday. The investment is part of federal efforts to close gender gaps in research, which supporters say have led to insufficient funding for endometriosis, MS and other conditions that disproportionately affect women.
It’s a start. More would be more better.
Extra Credit Action
We can thank the President for a start and ask that they continue this focus and effort.
Here is their contact info https://www.whitehouse.gov/contact/ and here is my message.
“Thank you for investing $100 million in research focused on the medical issues faced by women. I’m glad you’ve taken this important step and we look forward to better healthcare for women as a result. Please make sure it continues. Again, thank you.”
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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