Medical Loss Ratios (MLR’s) are designed to lower healthcare costs. Here is how they work. In a recent Federal Court ruling, a Court found that physician settlement payments may be included in the MLR for the carrier. CMS Page on Medical Loss Rule (MLR)
CBO Estimate on House Healthcare Bill Report on Numbers in CBO Report on AHCA
$33M J&J Settlement with State Attorneys Over Drug Fraud
Depakote and Birth Injuries
AAJ: Women Disproportionally Affected by Dangerous Drugs, Devices
Quality Fraud drives medical costs. DOJ Stressing Healthcare Fraud
On April 4, 1997, Charles Blair wrote a letter for the Joint Commission for the Accreditation of Hospitals Organization (JCAHO) to a Hospital Administrator. The JCAHO letter describes a “sentinel event” that occurred in March, during which a patient died in the Hospital Recovery Room from an overdose of concentrated medicine given by her healthcare providers […]
Dartmouth study on reigning in healthcare costs This chart on the left (in the article linked above) was originally created by the Kaiser Foundation and is now outdated (as shown in the chart on the right) – largely because the cost of drugs, medical devices and hospitalizations has skyrocketed. As a percentage, the amount we spend on primary […]
It’s Not Just Profit Wrecking America’s Healthcare System Dartmouth University Researchers recommend following the money to capture efficiencies.
Systemic Quality Fraud: Medicare Advantage Bilked by Carriers Gaming Billing Process. NYT Article on United Health Whistleblower
