Anthem said sales of Obamacare plans have been disappointing to date, and the company could pull back its business in those plans in 2018. The Anti-Kickback statute is not only a criminal prohibition against payments made purposefully to induce or reward the referral or generation of Federal health care business, it also addresses the offer or payment of anything of value in return for purchasing, leasing, ordering of any item or service reimbursable in whole or part by a Federal health care program.
But the trend toward reducing benefits and dropping health insurance altogether was in full swing before the act kicked in this year, according to a recent analysis by the University of Minnesota’s State Health Access Data Assistance Center and the Robert Wood Johnson Foundation.
Where a doctor had a small staff helping with the back office to bill insurers and where the health care information systems vendors were in high demand you will now have the nexus of targets that cyberspace criminals will be focused on. Like the consumer retailers who rely on third party credit card processing companies to take care of the millions of annual point-of-sale transactions, so too will the consumers of health care services at the retail level.
The feds also released totals for the states using and major cities within those markets ( read that report here ). We don’t yet have a breakdown of new plans vs. renewals for the states, though Counihan said about 8.6 million of the 11.4 million nationwide, or 75 percent, were renewals.
Perusing the list of the members of the board reveals two people with pharmaceutical connections that could be conflicts of interest, a few people with health care affiliations, but no obvious affinity for the patients and public in New Jersey whom the new hospital system is supposed to serve, and many lawyers and business people with no obvious affinity for the values of health care professionals.