Imagine planning to undergo surgery thinking you are well protected by your health insurance only to find out, just one day before you go under the knife, your coverage was dropped. That’s just what happened to a Dearborn man, and it’s a practice that needs to end here in Michigan now.
Blue Cross Blue Shield of Michigan never drops people from coverage when they become sick – a much-maligned practice called rescission – except in cases of fraud or intentional material misrepresentation.
This is yet another example of how the Blues stand as a model for health reform.
A dark side of health care fraud will be revealed tonight on CNBC’s “American Greed” when the program reports on a Michigan doctor who bilked insurers, Medicare and patients out of at least $1.9 million.
The program profiles Dr. Robert Stokes, who ran a thriving dermatology practice in East Grand Rapids. Dr. Stokes had a dark secret. He was stealing patients’ money. He reused medical supplies and endangered patients.
Blues Vice President Greg Anderson (left), a former detective sergeant with the Michigan State Police, describes to an “American Greed” reporter how the Blues work with law enforcement agencies to fight health care fraud.
The program includes an interview with Greg Anderson, vice president of Blue Cross Blue Shield of Michigan’s Corporate and Financial Investigations unit, who explains how the Blues’ investigative team worked with law enforcement agencies to convict Stokes of health care fraud.
Stokes, who bilked the Blues out of more than $600,000, is serving a 10½-year sentence in a federal prison.
“American Greed” is narrated by award-winning actor Stacy Keach. The program airs tonight on CNBC at 9 p.m., 10 p.m., 12 a.m. and 1 a.m.
For a preview of tonight’s episode, go to “American Greed” online. Or check out a preview of the episode in this trailer below.
The Michigan Blues will participate in National Walk @ Lunch Day on April 30th. This event, championed by the Blue Cross and Blue Shield Association, encourages people to take steps toward better health—even in the midst of a busy work day.
Thirty Blues plans across the U.S. will celebrate National Walk @ Lunch Day this year. Participants are invited to extend their lunch break and walk for 30 minutes. The truth is, walking away from work—for at least a few minutes—has the potential to re-energize employees and increase productivity. Walking also keeps the heart healthy, burns calories and increases energy levels.
The Blues have a long history of encouraging people to walk. With the formation of WalkingWorks, the Blues have spread the word that walking provides significant health benefits. This Walking Works web site encourages people to begin a walking regimen and offers the tools necessary to make it happen. People can log their steps online, purchase pedometers, find health tips, and more.
So, grab your co-workers, friends and/or family members and take a walk during lunch on April 30th. And then, keep it going! Find the time to walk as much as possible. Your body and mind will thank you for it.
Beginning May 1, smoking won’t be allowed in most public places in Michigan. What does this mean for Michigan residents? The Dr. Ron Davis Smoke Free Air Law prohibits smoking in public places such as businesses, restaurants, bars, shopping malls, bowling alleys, concert halls, arenas, museums, mechanic shops, health facilities, nursing homes, education facilities and child care centers.
For non-smokers, it’s good news. It means enjoying dinner at a favorite restaurant or bowling with the family without being exposed to secondhand tobacco smoke. For smokers, the news may be a little irritating for those who enjoy smoking a cigarette while watching the big game at a bar or while spending an evening at a night club.
Whatever the case, non-smoker or smoker, everyone should agree that smoke-free air is cleaner air, and clean air is fundamental to good health. So, why not use this as an opportunity to stop smoking altogether? Easier said than done, right?
Kicking the habit is not easy but, a Blue Cross Blue Shield of Michigan program called Quit the Nic can help.Quit the Nic matches Blues members with registered nurse health coaches to help them develop action plans to quit smoking.
Interested in Quit the Nic? Blue Cross Blue Shield of Michigan members call
1-800-775-BLUE (2583). Blue Care Network members call 1-800-811-1764.
Michigan Blue Cross is hosting a free seminar about how to apply for free or low-cost medical insurance programs such as MIChild, Healthy Kids and Medicaid for adults today. Blue Cross Blue Shield of Michigan and Blue Care Network are committed to ensuring access to quality health care coverage to all ages. The expo is being held at Cobo Arena in Detroit.
Expo attendees can also receive the following for free:
·Health screenings
·H1N1 vaccinations
·HIV/AIDS and STD testing
·Screenings for diabetes and dental care
·Mental health services
·MIChild, Healthy Kids and Medicaid enrollment
·Information about Head Start
The event runs from 8 a.m. to 5 p.m. today, Friday, April 23, 2010, in the Ambassador Room at Cobo Hall in Detroit. Parking is free. Click here for more information.
Our customer service representatives at Blue Cross Blue Shield of Michigan are getting lots of questions from members who buy individual plan coverage asking about changes in store from health care reform.
We take a look at some of those changes as we conclude our week-long series exploring what reform means to you.
The new health care reform law targets the “donut hole” in Medicare Part D prescription drug coverage and provides community living assistance for people with disabilities. We explore the measures here as part of our series on what reform means to you.
One notable feature of the Patient Protection and Affordable Care Act of 2010 – better known as health care reform – is the extension of coverage to high-risk individuals with costly medical conditions through the creation of insurance pools.
The program is designed to help individuals whose pre-existing chronic or other conditions have made it difficult for them to afford or find insurance. As we’ve noted before, Blue Cross Blue Shield of Michigan is unique among insurers in that we never deny anyone coverage based on their medical history. Many other insurers, both non-profit and for-profit deem these people too costly to insure.
As part of our ongoing series of what health care reform means to you, here’s a look at how the new high-risk pool program will impact people with pre-existing conditions.
One of the central talking points for health care reform during the long and heated push for its enactment was that if you currently receive health insurance from your employer, and you like your plan, you get to keep it.
But health care reform does make a few important changes to benefit-rich “Cadillac” group plans, and it will incentivize small business owners to begin offering health insurance for workers by providing tax credits.
As part of our weeklong series exploring what the changes mean for Michigan Blues members, we delve into some of your most commonly asked questions. You can also check out yesterday’s post about individual-market policy impacts, or our earlier post outlining the changes more broadly.
And as always, we welcome your comments and questions.
All this week in this space, we’ll be sharing our responses to many of the most commonly asked questions posed by Blues customers who wonder how health care reform will affect their policies and families.
The series is meant as a deeper dive into changes we first discussed in a previous blog post. While many of the provisions cannot be explained in further detail until we get guidance from the federal government, we’ll share with you what we know now.
We’ll start with changes that will affect customers who get their coverage from one of our individual plans.
Imagine you’re the third parent to call in to the pediatrician’s office one morning, to make an appointment for your child, and being told you had to wait 60 days to get your child in to see a doctor. Or, imagine your doctor tells you that your screening mammogram looked suspicious and you need some follow up tests, but you can’t have those tests for about 20 days.
Unacceptable, right? That’s what the doctors and staff at Borgess Ambulatory Care thought too. This Kalamazoo-area organization applied to take part in a Lean Collaboration offered through Blue Cross Blue Shield of Michigan. The Lean process improvement method, first used in the manufacturing industry, is a systematic way to analyze an organization’s processes and procedures, and find more efficient ways of doing them.
It is a long, complicated process that requires entire staffs to break down their typical processes into a series of individual steps. Once these processes are mapped out, the staff finds ways to reduce steps, reduce variation, and create efficiencies.
One contest. Nine Mid-Michigan communities. Over 1000 participants. The goal? To stay active—even when Michigan’s winter weather makes us want to curl up on the couch.
This fitness contest is known as the Community Partners in Health Winter Warm-Up and it included a challenge for Mid-Michigan area mayors to get their communities walking and moving. All participating communities received grant money—courtesy of the Blues—to put toward a program that will bring the community to a healthier future.
This year, the contest ran from January 23rd through March 27th and within this time frame, the participants were encouraged to walk each Saturday at the Lansing mall. They used pedometers to count their steps and they logged their totals online using the free WalkingWorks tool. The community that logged the most steps online won first place.
The embattled city of Detroit received good news this week with the announcement that Henry Ford Health System plans to invest $500 million in its NewCenter hospital campus.
The move is part of a nearly $1 billion proposal to establish a “CommunityHealthPark” of retail, housing and medical office development immediately south of the hospital. The plan would create 250 high-paying jobs, Henry Ford officials say, but the project is also intended to lure other businesses, including medical device manufacturers and suppliers.
What if there was a plan that made health care more affordable for those who actually set and achieve healthy goals? Well now there is…
We’re proud to announce the launch of Healthy Blue Outcomes, a groundbreaking outcome-based health care plan. Healthy Blue Outcomes is a new, innovative PPO that is part of the Blues’ Healthy Blue ChoicesSM suite of products, services and resources designed to promote personal wellness and member accountability. Learn more at bcbsm.com/outcomes.
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