100 years old, and no place to go

100 years old, and no place to go

There are 27 comments on the www.lohud.com story from Nov 1, 2008, titled 100 years old, and no place to go. In it, www.lohud.com reports that:

Neita Allen, who turns 100 today, charms nearly everyone who meets her with her songs, her tales of Jamaica, and her good cheer despite adversity.

Join the discussion below, or Read more at www.lohud.com.

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PSL

Boca Raton, FL

#22 Nov 4, 2008
Biker Mom wrote:
I also think that prices are jacked for medicaid because they pay SO LITTLE to the doctor.
I know several doctors who had to stop seeing medicaid patients because they were lucky of they got $3 -$10 dollars depending on what was done. When you look at how much a doctor has to pay for insurance premiums and such (not saying there are not a hell of a lot of wealthy docs but that is not always the correct image of docs as a whole), and then how much they are reimbused from medicaid.
The Doc who used to own the PT clinic I go to had a check taped to the receptionist's desk with a note that this was how much medicaid was paying him. And out of that he had to pay staff, rent, etc. I know where he lives - nice area but far from Potomac, MD rich... Guess who pays the rest? Yup... The check was for $3.00 and he had to suck up the rest of the PT and such his staff provided for care. Each appt of mine is about $100 depending on what is done. I pay $30 and my insurance pays the balance. The clinic gets it's $100. Does not work that way for medicaid according to them.
I worked at a hospital that closed in part due to late medicaid payments, they could not make their bills, etc.
Now combine this with illegals being able to come in and demand emergency room treatment to the tune of thousands even for non emergency things...
Ugh...
I did billing for 3 hopitals and 3 doctors and we NEVER changed prices. However, and this used to really bug me, a person paying cash had to pay, say, 100.00 for their first consult where a medicaid paid out 20.00. Since the Medicaid patient never
had to pay any additional in reality the cash patient was paying 5 times more. And even the Group Ins. patients were paying far more than Medicaid. And Medicare wasn't much better although most people don't mind helping the elderly.
Here's another example that we are paying for baby machines and loosers that just don't want to work.

Since: Jun 08

Woodbridge, VA

#23 Nov 4, 2008
Sunlight wrote:
<quoted text>I am writing this down, M e r c k, thanks for the tip. Be sure to let me know if a specific division is responsible for that special pill, will you?
I wonder what the doctor will get? Do you know that doctors are wined, dined, given trips and that the pharmaceutical companies know what prescriptions they write? They actually track the doctors.
Not as much as any more. My husband is in a medically related field, works with doctors, drug and media reps (not new media but lab supply media) and the image of the wining and dining is not as accurate anymore as it used to be.

Since: Jun 08

Woodbridge, VA

#24 Nov 4, 2008
PSL wrote:
<quoted text>
I did billing for 3 hopitals and 3 doctors and we NEVER changed prices. However, and this used to really bug me, a person paying cash had to pay, say, 100.00 for their first consult where a medicaid paid out 20.00. Since the Medicaid patient never
had to pay any additional in reality the cash patient was paying 5 times more. And even the Group Ins. patients were paying far more than Medicaid. And Medicare wasn't much better although most people don't mind helping the elderly.
Here's another example that we are paying for baby machines and loosers that just don't want to work.
My mother in law is a benefits admin (retired) and my husband deals with billing from a clinical/lab standpoint all the time.

Just because your places did not do it - does not mean it does not happen. That is the last I will say on that...:)
PSL

Boca Raton, FL

#25 Nov 4, 2008
Biker Mom wrote:
<quoted text>
My mother in law is a benefits admin (retired) and my husband deals with billing from a clinical/lab standpoint all the time.
Just because your places did not do it - does not mean it does not happen. That is the last I will say on that...:)
Got ya!!

Since: Jun 08

Woodbridge, VA

#26 Nov 4, 2008
No, my husband has never doctored books - he does nto do the billing himself but trust me, it is amazing what gets coded differently, etc. He just has to deal with billing to make sure things are coded correctly, make sure that the billing crew knows what each insurance will and will not cover as well as make sure that the billing dept bills on time and collects. Sadly, this is not part of his job but someone has to make sure things are being done correctly.

I do not want anyone thinking any of us have been involved in questionable stuff by any means. But it does happen. There are places that charge differently based on insurance, ability to pay, etc. Not all places are honest.

My MIL worked for a church conference handling the benefits for staff in the regional conference. My husband's field does not take Medicaid generally and a lot of insurances do not cover it or only covers certain parts so many clients are self pay to varying degrees.

There are a lot of rules and regs to Medicaid and they are confusing. Basically, if I understand it right, a participating provider has to accept as payment in full whatever Medicaid pays and not send the balance of the bill to collections.
42 CFR 447.15: Acceptance of State payment as payment in full

But then there is something regarding cost sharing and inability to pay cannot limit the liability for the individual's cost sharing.

Now each state has different regulations as well.

This is also kind of an intersting law suit: http://www.nsclc.org/areas/federal-rights/are...

Now Merck pharmaceuticals settled a lawsuit regarding overcharging Medicaid for Vioxx and Zocor earlier this year. This also went along with the issues of Merck wining and dining to get docs to push their drugs.

Now in Virginia, two teaching hospitals came under fire by overcharging Medicaid to the tune of over $10M in 1997 according to Kaisernetwork.org - Medicaid | Two Virginia Teaching Hospitals Overcharged Government for Indigent Care, Audit Says
[May 16, 2003]

Now in TX, a Medicaid contractor overcharged by millions - Medicaid | Texas Attorney General Report Finds Medicaid Contractor Overcharged State by 'Millions of Dollars'
[Jul 18, 2002]

Now some doctors just do not recommend some tests and procedures that they may to an insured patient. http://www.washingtonpost.com/wp-dyn/content/...
what

Somerset, KY

#27 Nov 6, 2008
Indyeast wrote:
<quoted text>
Look,you said the guy got a $2000 pill.
Give us the name,it's beginning to sound like a fabrication without the name.
I still didn't get the name. I don't exactly talk to this guy on a regular basis, just what I was told.
In any event, however, they sent him home and put him on something else as Medicaid told them to go get f*cked in regards to paying for that.
Can't say I blame them.
May not even be the actual cost of the pill, just inflated.
Kind of like charging 129.00 bucks for a 'mucus collecting receptacle.' Which you can readily get at the grocery store for around 2 bucks or so. It's called, Kleenex.
http://moneycentral.msn.com/content/Insurance...
Rendezvous

Hicksville, NY

#28 Nov 16, 2008
100 yrs old? Come'on , let's have mercy on this poor lady ! What.. She is gonna be lay to die just like that? I do believe it is inhumane - lacking and reflecting lack of pity or compassion. I do believe we have govertment and all but this act is way out of proportion especially when this person is 100 yrs old..

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