Anthem: Rash? Don’t Go To The ER
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According to the St. Louis Post Dispatch, in a recent letter to policy holders in Missouri, Anthem advised that: “Should members choose to receive non-emergency care in the ED [emergency department], they will be responsible for the charges incurred,” and that … Continue reading

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Overtesting: Where Do We Go From Here?
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I heard recently about a case of over-testing that seems so typical nowadays that it makes me wonder not just how we got here, but how we go back.   A 9-year-old child comes to the ED with abdominal pain and … Continue reading

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Hospital Charges: Should Physicians Care ?
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Recently my primary care physician ordered some screening lab tests for me, some of which may not be covered by Medicare. Since he has long been associated with one of the local hospitals (he was recently Chief of the Medical … Continue reading

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The Biggest Mistake in the ACA
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It was interesting to hear Hillary Clinton, on the stump at the last Democratic Town Hall, bemoan the fact that not-for-profit health plans were not participating more in the exchanges. Blue Cross and Blue Shield, she pointed out, used to … Continue reading

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Does New York Have the Answer to Balance Billing?
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New York State has enacted legislation that purports to solve the issue of patients being caught in the middle of disputes between commercial health plans and physicians over the reasonable value of out-of-network services. Several other states, including most recently … Continue reading

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