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Update

Article

Professional and financial news you can use.

DEBT

Which is harder, losing weight or losing debt?

MANAGED CARE

Doctors hit another HMO with racketeering charges

Thousands of doctors in Pennsylvania may be eligible to join a class-action suit against Keystone Health Plan Central, an HMO, and its former owners, Capital Blue Cross and Highmark. The original suit, filed in October 2001, alleges that the defendants together operated as an entity to defraud physicians through a variety of methods. For example, the complaint alleges that, when contracting with physicians, Keystone intentionally misrepresented, and failed to disclose, internal HMO policies and practices that were designed to systematically reduce, deny, and delay reimbursement. Now a US District Court has okayed class-action status for two racketeering claims and one alleging payment delays. However, the court denied class-action status on the claim that Keystone breached its contracts with both primary care providers and specialists. Although the HMO did so in the same general way, the court said, it used means that are best adjudicated separately.

INSURANCE

These health plans aren't very popular

Consumer-driven and high-deductible health plans, which offer lower premiums but greater out-of-pocket costs, attracted only 8 percent of privately insured adults in 2006, a rate virtually unchanged from the year before. Those with the relatively new plans aren't terribly happy with them either, says the study released by the Employee Benefit Research Institute and The Commonwealth Fund. Only 36 percent of those in high-deductible plans say they would stay with their plan if they had a choice, compared with 63 percent who have comprehensive coverage. (High-deductible plans have deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage.)

IDENTITY THEFT

Even kids aren't safe

The percentage of identity theft victims under the age of 18 crept up to 5 percent at the end of 2005, according to the most recent data available from the FTC. That represents 500,000 children, says the Identity Theft Resource Center, a nonprofit group offering victim assistance. Those whose IDs were stolen during childhood often don't learn of the crime until they try to open a bank account or get a driver's license. To protect your children's identity, be very stingy about handing out their personal information.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health