According to the New York Times, the curtain is expected to come down next week on a monopoly for the anti-inflammatory medication, Humira, that has generated $114 billion in revenue for AbbVie just since the end of 2016. Questions: Source: Robbins, R. (2023). How a Drug Company Made $114 Billion by Gaming the U.S. Patent… Read more »
Posts Tagged: Medicare
Under-capitalization costs lives
According to the Washington Post, investigations show that Life Care Centers of America, one of the largest chains in the industry, violated federal standards meant to stop the spread of infections and communicable diseases even after outbreaks and deaths from COVID-19 began to sweep its facilities from the Pacific Northwest to New England. Questions What… Read more »
Don’t Delay Reporting to Federal Officials
According to the Washington Post, The Life Care Center of Kirkland in Washington State failed to report an outbreak of respiratory illness to local authorities for two weeks as required by law under Medicare and Medicaid, which led to 40 COVID-19 deaths at the nursing home. Questions: How much is the per-day civil penalty levied… Read more »
Now you See it, Now you don’t.
The Federal Trade Commission has issued a warning to consumers that criminals are posing as government officials and asking people to use a gift card to pay a bogus tax bill or get a new Medicare card. Questions: 1. How much money was lost to this scam in 2015? 2. How much money was lost… Read more »
New Study on Hospital Costs
Twenty of the 50 U.S. hospitals that charge the most for their services are located in Florida — and all but one of them are for-profit, according to a study released Monday. Questions: 1. Which facility is at the top of the list for charging the most and how many times more do uninsured patients… Read more »
Don’t Pay that Medical Bill: The Truth about Balance Billing
As health-care costs continue to soar, millions of confused consumers are paying medical bills they don’t actually owe. Typically this occurs when an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid. The health-care provider demands the balance from the patient. Questions: 1. Explain why balance billing is… Read more »
Rip Off: We Work Hard for the Money!
Although Guadalupe Rangel worked nearly 70 hours per week, he never saw any overtime pay at the Schneider warehouse in Mira Loma, California. As a result he joined a lawsuit involving hundreds of warehouse workers where he will likely receive more than $20,000 in back pay as part of the recent $21 million legal settlement… Read more »
Fraudsters are always looking for a way to rip off the Government
This article details a wheelchair scam that was designed to exploit blind spots in Medicare, which often pays insurance claims without checking them first. The fraud begins with criminals disguised as medical-supply companies. Questions: 1. Based on the article, which major internal control allowed this fraud to happen? 2. What type of control slowed down… Read more »
Nothing’s sacred!
Over the past decade, the number of “hospice survivors” in the United States has risen dramatically. According to the Washington Post, this is, in part, because hospice companies earn more by recruiting patients who aren’t actually dying. Healthier patients are more profitable because they require fewer visits and stay enrolled longer. Questions: 1. How large… Read more »
Is it fair that some hospitals are charging 400% above their costs to deliver services?
According to government data, hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure. This raises questions about how hospitals determine prices and why they differ so widely. Questions: 1. Discuss the data set and what was included. 2. According to the article, who… Read more »
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