Humana Inc., one of the nation’s largest managed-care companies, was accused in a Federal lawsuit yesterday of misleading health plan members by failing to disclose financial incentives to doctors and case reviewers intended to keep down costs by limiting or denying care.The suit, filed on behalf of workers in Florida and Texas, asked a United States District Court in Miami to certify a class action on behalf of more than six million customers of Humana health plans nationwide. The suit seeks triple damages under the Federal anti-racketeering law. No amounts were specified.
The plaintiffs say they did not get the health coverage that they thought they were selecting because the company did not disclose incentives to doctors to deny care.
Joseph Sellers, a Washington lawyer who represents the plaintiffs in Miami, said the suit did not question whether managed care was a good idea or whether cost should be a factor. Instead, the suit contends that there was a ”breach of trust” because plan members thought that medical guidelines would solely determine their treatment.
Source:
Humana Sued in Federal Court Over Incentives for Doctors
11 comments:
Taking advantage of a Veteran is the worst of the worst.
People need to know in order to protect themselves!
Beware of elder abuse in the hospitals eyes wide open on the SOCIAL WORKERS CASE MANAGERS working in concert with insurance companies particularly MEDICARE ADVANTAGE PLANS promoted and advertised as being better than ORIGINAL MEDICARE.
Insurance company is the GATEKEEPER to your Medicare benefits if you select Medicare Part C - ADVANTAGE PLAN.
It's all about the profits what better way than to TERMINATE and DENY coverage for 'medically necessary' treatment and care including needed REHABILITATION Physical & Occupational therapy to recover from CVA (stroke) or other incidences from an accident, broken hip, bones etc.
Be prepared to pay for needed rehab out of YOUR pocket OR to best protect yourselves over the age of 65 is to select: ORIGINAL MEDICARE with a supplement.
On May 30, 1996, Linda Peeno, who was contracted to work for Humana for nine months, testified before Congress as to the downside of managed care.[14]
“ I wish to begin by making a public confession: In the spring of 1987, as a physician, I caused the death of a man.
Although this was known to many people, I have not been taken before any court of law or called to account for this in any professional or public forum.
In fact, just the opposite occurred: I was "rewarded" for this. It bought me an improved reputation in my job, and contributed to my advancement afterwards.
Not only did I demonstrate I could indeed do what was expected of me, I exemplified the "good" company doctor: I saved a half million dollars. ”
“ I contend that "managed care," as we currently know it, is inherently unethical in its organization and operation. Furthermore, I maintain that we have an industry which can exist only through flagrant ethical violations against individuals and the public.
There are so many angles being worked to steal or deprive. The treatment of the elderly in the USA is tragic. The treatment of veterans is unconscionable. We should get Operation Stand Down involved. They work with veterans. I'll point my friend who works for OSD to this issue.
Just today, I saw Humana doing an infomercial on their "Advantage Plan" and so I'm very glad to see this new website.
Beware of Humana Advantage Plans!
Shocking now badly Veterans are treated when we're not watching.
Shame on them.
well here we go another veteran who got the shaft this is disgusting and a scam its all about the profits and who is profiting and where the money goes to which legislators campaign war chests and lobbyists to buy legislation in their favor on the federal level its all there if you look follow the money trail we the people are sold out be informed to make an informed decision advantage plans must be abolished til then make your decisions wisely once in there is no way out til open enrollment getting out of advantage plans is not easy
Thank you, NASGA, for your continued efforts to protect our disabled, our elderly, and our veterans!!!
Veterans first - warning to all military personnel ~~~ in reality aging sets you up for easy target for elder abuse in the hospital where you are alone and vulnerable - bring your family members with you glued to your side do not trust hospital Social Workers and Case Mangers who work in concert with insurance companies including Medicare and the most dangerous of all are: MEDICARE ADVANTAGE PLANS DisAdvantage to the enrollees $$$$ Advantage to the insurance companies follow the $.
Thank you Anon for your valuable information with more information at:
http://thecommonsenseshow.com/2013/07/16/a-whistleblowers-profile-in-courage/
A Breach of Trust will have this information in the very near future.
Post a Comment