IT giant CSC coughs up $2m after helping New York City bill Medicaid for child therapy rather than insurance cos An IT provider has settled with the US government regarding a row over medical billing in New York City. Computer Sciences Corporation (CSC) agreed to a deal [PDF] that ends legal action over its role in a major Medicaid healthcare-billing case that dates back to the late 2000s and early 2010s. CSC, now part of DXC, was at the …
we have a system of medical freedom here in the good old USA. I speak for all Americans in our gratitude for not living in a socialist hell such as Norway or Sweden. The free market will adjust and coffin production will create new millionaires supporting generations to come. Freedom is glorious.
"Wait, this is the tyranny that was paying for the treatment, despite people having insurance for it?"
Think of the US health insurance industry as a middleman that takes a very large cut out of any health transaction. For every $1m billed directly to MedicAid, claiming the same via insurance would have likely required an addition 10-20% for hospital administration, 40%-60% for insurance company fees and administration and anyone without the necessary insurance to be denied treatment. And if there are any medical supplies or medicines required, the costs spike considerably higher. I believe this case focussed on Speech and Language Therapy - private therapy costs for NYC and London are similar but the costs for those services on insurance are approximately 5-6 times higher.
Insurance companies may have missed out on additional revenue, but the rest of the US healthcare is so broken BY THE INSURANCE INDUSTRY that it needs significant reform.
Think of the US health insurance industry as a middleman that takes a very large cut out of any health transaction. For every $1m billed directly to MedicAid, claiming the same via insurance would have likely required an addition 10-20% for hospital administration, 40%-60% for insurance company fees and administration and anyone without the necessary insurance to be denied treatment.
I've never understood the US health industry.. Other than it's a massive cash cow for many of the players involved. I once saw a doc with a doc demonstrating the costs for a typical procedure. They whipped out various bits of plumbing and said stuff like tubes for intubation 'cost' $8,000.. And me thinking it's a bit of plastic tubing, and does it bollocks. Ok, so it needs to be tested/approved/sterilised but shouldn't cost that much. But I think rather than cost, it was really the maximum RRP the plumbing could be billed for.
Which also made some sense given overhead costs need to get paid, but things like B&B are also charged ending up with a parts & labour bill that'd make a BMW dealership green with envy. And then I saw something that suggested a 2-tier price list. So one bill if it was heading for an insurer, another much lower bill if the patient was going to pay themselves. But overall, margins seemed grossly inflated, inflating the cost of US medical care in general. And being a business, hospitals 'controlling costs' by squeezing staff pay & conditions. And if that results in malpractice claims, well, those can be against the physician's insurance, not the hospital. Assuming the physician can afford that insurance. If they can't, well, they can't practice. Which was the subject of another article pointing out a shortage of neurosurgeons due to the stonkingly high cost of insurance.
You're totally misunderstanding the situation. The kids got the therapy whatever happens: CSC was employed to act as NYC's claims agent make sure that private insurers paid the cost if the kid was covered by private insurance. If there wasn't a private insurance policy, then CSC was supposed to bill Medicaid (taxpayers).
However instead of doing what they were supposed to do (hassle insurance companies to get them to pay up and save taxpayers money), CSC decided it would be much easier if they didn't bother themselves too much and billed the lot to the government. Bunch of spankers.
A couple of points:
- do the kids get the therapy if they don't have insurance? Or do they not even inquire when the medical institutions are geared towards requiring insurance?
- the amount of money involved is a rounding error for large military projects. Ignoring cases like this where the amount of tax payer money saved after prosecution and investigation costs is likely to be zero and going after the wastage within large military contracts or prosecuting telecoms/drug companies that are profiteering would likely yield actual savings for taxpayers.
- CSC doesn't appear to profit from claims going to Medicaid or Insurance companies so was it an error translating requirements or a misunderstanding? You say that the Medicaid option was easier for CSC to pursue - surely an efficient corporation (i.e. the insurer) would be the easy option rather than the inefficient bureaucracy?
If they won't pay up within 90 days, then end them and move their customers to a state-run insurance scheme under the same terms.
You'll only have to terminate one or two insurers before the rest play ball. And if they don't, well, it won't be long before you've got a single-payer system and bingo, problem solved.
Richard 12,
I sort of agree with your comment !!!
The major problem is the Insurers have too much power, money and influence in the US of A.
Your politics if solely driven by money and lobbying so neither party is able (or willing) to challenge the *big* payers/supporters as the potential loss of funds directly impacts number of votes.
Even worse the expectation from your voters is that is how it works, so few will risk voting for any other party than the *big Two as it is seen as a wasted vote.
Hence the reducing voter numbers .... (also impacted by, the people who would gain most are the *most* likely to be the target of voter 'restrictions' and gerrymandering !!!)
I thought the UK was bad enough *but* US of A is getting worse !!!
"Even worse the expectation from your voters is that is how it works, so few will risk voting for any other party than the *big Two as it is seen as a wasted vote."
Don't forget the gerrymandering that actually causes votes to be wasted if you don't vote for the incumbent.
I do wonder if Trump may be the bitter pill that causes the US electorate to demand meaningful change. While the Democrats aren't the answer, getting rid of some of the toxic incumbents might shake up state and national government enough to actually alter the power of lobbyists and allow something different.
Have always wondered why medical cover is such a contentious issue is the USA and 'freedom' must be built into the market when you don't take the same approach for Defence, Policing, Government, Education, etc. Why is medicine treated so differently?
Medicine in the USA costs more then all developed countries but with the same / worse outcomes and is twice the global average.
https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-start
Someone is ripping off 'The People' and not adding value.
{Quote} "We are proud to have partnered with the City of New York on this very worthwhile early intervention program from 2008 to 2014," a DXC spokesperson said of the settlement. "There were no allegations that CSC improperly received any amounts from Medicaid or that any services or payments to providers were inappropriate. {/Quote}
If there were "...no allegations […] any services or payments to providers were inappropriate" then what were CSC in trouble for exactly?
I understand they're saying 2 different things in that statement:
1: CSC themselves have not been accused profiting from monies recieved from medicaid.
2. there has been no accusation that NYC received money they weren't entitled to.
my reading is that the only thing CSC did wrong was to wrongly bill mediaid, when in fact the money should have come from insurance companies.
That's correct. The CSC is saying things that didn't happen...that no-one claimed happen. It is muddying that waters
"I am happy that the court confirmed that CSC did not commit genocide, smuggle rare birds across borders, or double park on crosswalks".
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