Seven busted in $375 million healthcare fraud
Dr. Roy's scam came to the attention of authorities after an analysis by the Texas Medicaid Fraud Control Unit revealed that Dr. Roy approved 5,000 home healthcare patients in one year, which is more than 50 times the number of patients approved by the average doctor.
The scam is estimated to have led to at least $24 million in fraudulent Medicaid claims in 2011, and as much as $375 million in improper claims over a five-year period.
Shocking Numbers from the Kaiser 2011 Employer Health Benefits Survey
The survey also reports that the number of employers offering health insurance decreased a whopping 9% from 2010 to 2011.
To read the full survey, click here
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The high cost of health insurance fraud
A common tactic for health insurance scammers is to obtain medical records for Medicare or Medicaid patients. The criminals then file false claims and funnel the payments through fake medical clinics. Often, the thieves obtain medical records by purchasing them on the black market from individuals with access to the records -- medical administrators and other healthcare professionals. This method is estimated to cost American taxpayers as much as $47 billion every year, again according to the NHCAA.
Medical-related insurance fraud extends beyond health insurance and Medicare/Medicaid. Allstate recently brought a $4 million lawsuit against 20 doctors and business owners, alleging fraudulent personal injury claims related to auto accidents. Allstate alleges that the defendants created medical offices whose primary purpose was filing fraudulent claims in connection with auto accidents.
Special Report on Medical Benefits
Read the HTML version of the Bureau of Labor and Statistics report Selected Medical Benefits: A Report from the Department of Labor to the Department of Health and Human Services
Quick Statistics on Health Insurance in the United States
The number of uninsured in the United States has increased drastically in the past decade. More people are foregoing health insurance because they can't afford it, or in some cases because they choose not to get it. In 2014, health insurance will be required for all U.S. citizens, and medical care will be provided for those who can't afford insurance.1 Those who fail to carry health insurance, despite being able to afford it, will be subject to fines and other penalties.
Those near the poverty line are often most likely to be uninsured. These individuals do not have insurance through an employer, do not qualify for government medical assistance, and usually cannot afford their own private insurance. As people face economic hardship, many have no choice but to let their health insurance lapse. This chart from the National Centers for Disease Control shows the number of uninsured among those near the poverty line, from 1997 through 2009:
Here are a few key statistics on the rising number of uninsured, and subsequent effects on the economy:
- In 2001, the U.S. Census Bureau reported that 41.2 million citizens, 14.6% of the population, lacked health insurance.
- In 2002, this number rose to 15.2% - 43.6 million individuals.2
- In 2002, 20% of families with children include at least one family member who is uninsured.3
- Americans often have gaps in their insurance coverage. In 2002-2003, 82 million Americans under age 65 - 33% of the under-65 population - did not have health insurance coverage for at least one month.4
- By 2006, 46.6 million Americans lacked health insurance.5
- In 2010, 50 million Americans were uninsured. Among those under age 65, 20% of the population had no medical insurance - 33% of 19 to 29 year olds.6
- How much does all of this cost? According to a study by Families USA and reported on FOXNews.com, the typical American family's health insurance premium, and other costs, are increased by $1,000 every year in "hidden expenses" directly tied to medical expenses for the uninsured. The typical person with an individual health insurance plan pays an additional $370 annually.7
1How Much Health Insurance Will I Need in 2014? (2010).
2Number of americans without health insurance rose in 2002. (2003, October 8). Center on Budget and Policy Priorities.
3Health insurance is a family matter. (2002). Board of Health Care Services of the National Academy of Sciences.
4Study finds 82 million lacked health insurance in past two years. (2004, June 16). PBS NewsHour.
5Aston, Geri. (2006, September 18). Uninsured climb to 46.6 million. American Medical News.
6The uninsured: a primer. (2010, December 22). The Kaiser Commission on Medicaid and the Uninsured.
7Study: average family pays $1g a year to cover the uninsured. (2009, May 28). Associated Press.
How Much Is Dental Insurance Per Month?
Remember that health insurance doesn't cover dental work, although it may cover the basic cleaning and checkup (but not usually). Expect to pay between $125 and $170 per year for dental coverage, and know that no dental insurance plan will cover every expense -- you might have to cover a large portion of expensive dental work like bridges, crowns, or dentures. To know the exact answer to the question "how much is dental insurance per month", the best thing to do is use an online insurance quote finder and calculate your cost. Good luck!
Why Cheap Health Insurance Is Rare - Health Insurance Demographics
Will National Health Care Be Repealed?
At this time, the future of health care remains very murky and unclear. Will you have to get health insurance even if you don't want it? Will you be rejected for pre-existing conditions? Still, some questions will remain even after the legal future of Obamacare is cleared up. you'll always have to ask: What's the co-pay, deductible, and cost for prescriptions? What's covered? What doctors or hospitals can I visit, and what will I pay for an emergency room trip? Either way, the smart thing to do is to have health insurance. Young families can get policies that end up saving over the long haul, and individuals can get coverage that provides financial back-up in the event of a major health care emergency.