Tenn Care Blue Care vs Tenn Care Amer...

Tenn Care Blue Care vs Tenn Care Ameri choice.

Posted in the Dyersburg Forum

GSS

Jackson, TN

#1 Oct 30, 2009
Which is better?
moneypenny

Sioux City, IA

#2 Nov 2, 2009
Bluecare more drs accept it
whipped

AOL

#3 Nov 2, 2009
not true..depends on your area. CAll your dr's office, and ask what plan they are on, as most only take one plan
AmeriChoice Health

Berlin, NJ

#4 Sep 6, 2010
Among its provisions, the anti-kickback statute penalizes anyone who knowingly and willfully solicits, receives, offers or pays remuneration in cash or in kind to induce, or in return for: A. Referring an individual to a person for the furnishing, or arranging for the furnishing, of any item or service payable under the Medicare or Medicaid program; or B. Purchasing, leasing or ordering , or arranging for or recommending purchasing, leasing or ordering, any goods, facility, service or item payable under the Medicare or Medicaid program. Violators are subject to criminal penalties, or exclusion from participation in the Medicare and Medicaid rograms, or both. A violation of the anti-kickback law is a felony offense that carries criminal fines of up to $25,000 per violation, imprisonment for up to five years and exclusion from government health care programs.The federal anti-kickback statute, 42 U.S.C.§ 1320a-7b(b), prohibits individuals or entities from knowingly and willfully offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid or any other federally funded program.

If this were any one person they would be in jail now, if the FBI were called in on this matter they would be in jail now, if the IRS were notified they would be in jail now.Since all Ameri-Choice checks come from the United Health's home office they should be held equally responsible for any bribes, kickbacks, Stark, Fraud and inducements violations that have occured. Federal and State Governments have developed such a depended position with this company that laws and rules no longer apply for them.This role is nothing new for the AmeriChoice people and its been going on for years, look at some of the prior news articles that date back for years only now they can afford to hire the best of Law firms and give the most for Political contributations all on the back of the taxpayer.The Laws have become tighter for sure but they can still dance away their problems.
Chicken Gate

Berlin, NJ

#5 Sep 11, 2010
The 101 Dumbest Moments In Business 2003 EDITION Whiffed pitch No. 6: blatant stereotyping. By Mark Athitakis April 1, 2003 (Business 2.0)– GRAND PRIZE WINNER, DUMBEST MOMENT OF 2002 Which leads to the question, Who is Chicken Man? & Why were whole fried chickens selected?

In September, insurance company AmeriChoice brings trucks to blighted neighborhoods in New York City and gives away coupons for "free chickens" as an incentive for the underprivileged to switch their Medicare coverage. New York state senator Carl Kruger files a complaint with the state attorney general. The 101 Dumbest Moments In Business 2003 EDITION - April 1, 2003 Apr 1, 2003 ... Just don't tell him about the "Chinese health balls." ..... In September, insurance company AmeriChoice brings trucks to blighted ... New York state senator Carl Kruger files a complaint with the state attorney general..... Falling on his sword, Welch announces he'll give up most of the perks,...2009 and 2010 $120,000 from your tax dollars.

Philadelphia PA Mayor Nutter received two years in a row $60,000 checks to help keep open and operate the city swimming pools. These checks came from AmeriChoice Health and on the surface seems like fine gifts. Yet, they are Bribes non the less, these checks come from a company who receives all its money from the Federal Government as a vendor for Medicare Medicaid services is not allowed to offer bribes kickbacks and money gifts of any kind in order to promote its share or induce its share of the market place. This is not allowed as a use of your taxpayers dollars, yet it happens.What does it really cost the City of Philadelphia to receive this money? Americhoice Health has a long history of corruption over the years yet seems to be protected by those who are responsible to over see their actions why is that? PS... Did the Mayor send for Chicken Man or was he approched by Chicken Man? The Mystery Widens! Can Chicken Man save the Liabraries?
CEO of AmeriChoice Health Bolts.. Was that Chicken Man? John J. Kirchner - Director, Operations John Kirchner joined Healthfirst in May 2010 with over 25 years experience in health care management. Mr. Kirchner’s background includes responsibility for health plan P&L, strategic planning and operations, and government and regulatory affairs. Mr. Kirchner will be responsible for supporting all aspects of NJ health plan operations. Prior to joining Healthfirst, Mr. Kirchner held a variety of positions at AmeriChoice of New Jersey serving as President from 2007 through 2009.

Will this mystery man or woman or chicken ever be caught? Will the "secret eggs" given out to housing authority officers Clinics, Doctors and whoever, make it into through that crispy crust prepared by their Home Office Line Chefs?. Will the Doctors who collected all those extra eggs for sharing thier patients recipes with the Home Office Line Chefs ever really be rewarded? Will the Great Head Chef Chicken Man or whomever that directed and approved all to avoid, overlook the rules, laws and regulations Menu, ever be really compensated for their true worth or will Salmonella remain the dish served for Medicare and Mediciad Industry.

PS Is the Chicken Man a Blues Brothers Wanna B???
AmeriChoice Health

Berlin, NJ

#6 Sep 16, 2010
Recirculate Your Tax Dollars only as the tax payor you receives no write off...or choice.
Medicare.gov as well as other Federal agency's encourage you to report any fraudulent activities, yet,the same government agencys were notified the way this company does business yet did nothing.
Three years ago they were reported to these same Federal agency's and as of todays date not only were they allowed to continue doing business but were never charged once. Protected vendor status sure, politics sure,limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat existed. Even with the vast changes in the laws and budgets,a hands off policy remains, you tell me what's wrong with this picture? The Government created this monster and now they don't know what to do about it, like shooting yourself in your own foot etc. Tons of money to advance their national growth, its market positions, tons of money for political donations, tons of money to send 75 millon back to its home office from New York state alone, tons of money to suppot National TV shows, tons of money to pay hugh State fines, tons of money to hire the very best law firms, tons of money to pay for bribes and kickbacks, tons of money for hugh salarys and bonuses, all done on the back of the American taxpayor, you see this company receives all its money from the Federal government. Should your tax dollars be held to a higher standard? Should the government agencys responsible for there review be held to that same standard?Should the IRS audit their corruption? Why has this company not been charged? How long can the buck be passed here in more ways then one? Hey, it's your tax dollars don't complain now.. then don't complain later on...
Lawsuit

Berlin, NJ

#8 Sep 25, 2010
Doctors Group Sues AmeriChoice TOM WILEMON | The Daily News

Mid-South Imaging & Therapeutics PA, a hospital-based group of more than 30 radiologists, has filed suit against AmeriChoice, accusing the insurance company of “unfair and deceptive trade practices.” The complaint, filed last week in Shelby County Chancery Court, according to The Daily News online, www.memphisdailynews.com , alleges the insurance company made a “phantom offer” to the state in regard to doing business with Mid-South Imaging.

“Because AmeriChoice has not had an opportunity to review Mid-South’s lawsuit and its allegations, we are not in a position to comment at this time,” said Roger Rollman, a spokesman for AmeriChoice. AmeriChoice is one of two companies the state is contracted with to provide TennCare coverage in West Tennessee. The doctors from Mid-South Imaging provide radiology services to patients of Baptist Memorial Health Care Corp.

The lawsuit comes after back-and-forth negotiations between the physicians group, the state and the insurance company, which is a division of United Healthcare of Tennessee. The insurance companies are owned by parent company United Health Group Inc. The complaint alleges that AmeriChoice is paying only 50 percent to 55 percent of the lowest rate paid by any other “equivalent network provider,” which in this case is Medicare. Daniel Van Horn, the lawyer representing Mid-South Imaging (MSIT), wrote about the negotiations in the complaint.“Beginning in January 2009, MSIT complained to the state about AmeriChoice’s failure to make any serious offer,” Van Horn stated.“The state responded to the MSIT complaint by talking with AmeriChoice. AmeriChoice falsely told the state that it had made an offer to MSIT in the range of 78 percent of Medicare – a phantom offer that was significantly higher than the 50 percent to 55 percent offer that it actually made.

“Upon learning of the alleged significantly higher offer as reported to the state by AmeriChoice, MSIT wrote AmeriChoice a letter dated June 11, 2009, offering to enter into a contract with MSIT at the originally offered shockingly low 50 percent to 55 percent reimbursement rate.” The physicians group cannot refuse to take AmeriChoice because it provides radiology services to a hospital, according to the complaint. MSIT is seeking compensatory damages, a declaratory judgment that AmeriChoice’s actions constitute “unfair or deceptive trade practice” and an injunction against the insurance company in relation to its reimbursement rates.
Lawsuit

Berlin, NJ

#9 Sep 25, 2010
Full Name: Wayne Berman Title: Vice-Chair; Finance Co-Chair; Adviser
Over the course of three years, Berman’s lobbying firm was paid $660,000 to lobby on behalf of UnitedHealth subsidiary Americhoice, a managed care HMO providing health insurance to Medicaid, Medicare, and SCHIP recipients. Specifically, according to the lobbying report, they lobbied on Medicaid issues in the Deficit Reduction Act of 2005.[Americhoice Lobbying Reports 2004 – 2007; Americhoice.com ] Berman Also Lobbied For “Absurdly Low” Rates for Medicaid Managed Care Companies to Pay Out of Network Hospitals. Also included in the DRA, and mentioned as a lobbying issue on Berman’s Americhoice lobbying report, was a provision setting rates managed care companies must pay to out-of-network providers -- mainly hospital emergency rooms -- for care received by Medicaid beneficiaries. Rather than forcing managed care companies to reimburse out-of-network hospitals an amount comparable to network providers, the legislation set the default amount to the state’s “fee-for-service rate,” which often is “absurdly low.” The provision thereby shifted financial responsibility for services to Medicaid beneficiaries from the managed care companies to the hospitals themselves, permitting managed care companies to rake in huge profits, while hospitals incurred added losses.[Modern Healthcare, 1/29/07; Text of S. 1932] To Save Money, Bill Cut Services to Medicaid Beneficiaries, But Left Managed Care Providers Untouched. Under the final budget package, substantial Medicaid spending cuts were achieved by imposing new premiums and increased co-payments on Medicaid beneficiaries; some costs were also shifted to the states, who in return were awarded new powers to drop coverage or reduce benefits to certain beneficiaries. In a letter to Senate Majority Leader Bill Frist, the AARP CEO decried the final bill, saying it “protects the pharmaceutical industry, the managed-care industry and other providers at the expense of low-income Medicaid beneficiaries.”[Inside CMS, 12/29/05; Los Angeles Times, 12/22/05; World Markets Analysis, 12/21/05; The Hill, 12/20/05]
Danielle

Maryville, TN

#11 Mar 20, 2013
GSS wrote:
Which is better?
I work for a PCP in Blount County, TN and there are NO doctors in our area or the nearest county that accepts BlueCare.

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