6 insidious ways you’re getting ripped off

6 insidious ways you’re getting ripped off

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 The out-of-network doctor trap
The rip-off: You need medical treatment. You dutifully check the listings from your insurance provider to choose an in-network doctor or hospital. After your treatment, you receive a surprise in your mailbox—a giant bill, perhaps for many thousands, or even tens of thousands of dollars. Why? A person involved in your treatment, unbeknownst to you, is considered out-of-network. This is the out-of-network doctor trap, a.k.a. the surprise billing scam.

This can happen in a doctor’s office for a simple scheduled procedure or in a hospital for an emergency. Sometimes it’s the assistant surgeon. Others times it’s the radiologist, pathologist or anethesiologist. In a practice called “balance billing,” you get billed the difference between what your insurance chooses to reimburse and what the provider chooses to charge. You may think that your insurer is supposed to reimburse you for 70 percent of out-of-network costs, but that really means only 70 percent of what the insurer determines is “usual, customary and reasonable.”

And what does reasonable mean? Whatever the insurer says it means, which is often far less than what the out-of-network doctor charges. Insurers often manipulate claims and data just to screw you: In 2009,UnitedHealth had to pay a big settlement for this type of fraud when then-New York Attorney General Andrew Cuomo investigated and sued. But fines don’t stop these big insurers – the money they make from scamming is too good.

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Leo W. Gerard: West Blast Obliterates Safety Lie

Leo W. Gerard: West Blast Obliterates Safety Lie:

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Either way, the owner of the West fertilizer plant never reported to Homeland Security that it routinely stored 540,000 pounds of ammonium nitrate next to a school, playground, apartment building and nursing home in the town of 2,800. So, of course, Homeland Security didn't know.

Long before 9-11 or Oklahoma City, long before the current owner bought the fertilizer plant, OSHA inspected it in 1985. OSHA didn't return in the ensuing 28 years. But that's not surprising considering OSHA has so few inspectors that it would take 131 years for it to examine every American workplace one time.

The West plant did submit a risk management plan to the EPA because it kept 54,000 pounds of another hazardous fertilizer, anhydrous ammonia, which could kill large numbers of people if leaked. In its most recent plan, the plant reported no risk of fire or explosion, saying the most serious threat was a 10-minute release of anhydrous ammonia.

The underfunded and overworked CSB, which has only 20 investigators nationwide, recommended in 2002 that the EPA require reporting of hazardous materials like ammonium nitrate. But agriculture and fertilizer lobbyists opposed that, and the anti-regulation Bush administration took no action.

Over the years, the plant in West vented anhydrous ammonia in violation of its permits and moved tanks without informing authorities as required, but encountered only finger wagging and minor sanctions from state regulators in Texas which boasts of its anti-regulatory regime.

Corporations aren't moral entities. They won't follow safety rules unless forced.

Workers Memorial Day Reminds Us of Safety Risks, Hazards, Atrocities and Death

Workers Memorial Day Reminds Us of Safety Risks, Hazards, Atrocities and Death:

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Progressive talk show host Leslie Marshall and USW International Vice President of Human Affairs Fred Redmond discuss Workers Memorial Day and the recent events in Texas and Bangladesh remind us that safeguards are necessary to protect employees in the workplace. In addition, lack of regulation and compliance also puts communities at-risk as well.

•    14 people killed in a devastating explosion at a fertilizer plant in West, Texas.

•    340 people dead after Bangladesh building collapse.

•    13 Americans killed every day which translates into 4,000 workers killed each year.

•    Millions at risk of a hydrofluoric  acid (HF) release

The President Leo Gerard’s Blog addresses these issues:  West Blast O

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