Tag: President Obama

Healthcare Law Means Changes for Nurse Management Jobs

Would it surprise you to know that President Obama’s health care law goes well beyond simply providing insurance to those who don’t have it? Indeed, the Affordable Care Act (affectionately known as ObamaCare) contains an entire litany of new regulations that will affect everything from who receives care to how services are bought and paid for.

A good example of the burdensome regulations applies directly to nurse management jobs. There is a provision in the law requiring medical facilities to allow breaks for employees who are also nursing mothers, in order to allow them time to express milk. For a nurse manager this presents a whole new set of problems.

For instance, the law states breaks must be “reasonable” in terms of length. But who decides what “reasonable” is? If one nursing mother can express her milk in 15 minutes while another takes 30, there will be questions about fairness and equal time. Then there’s the question of workers who have babies brought to the workplace to nurse rather than expressing milk and putting it in the refrigerator.

Just this one little regulation is already causing a lot of headaches for nurse managers. It provides further evidence that the health care overhaul is not all it’s cracked up to be.

Nurse Management Jobs Still Worthwhile

Despite the changes in the healthcare regulations, don’t be discouraged if you want to get into the healthcare field. Nurse management jobs are still very attractive for a variety of reasons. They offer excellent pay, a good working environment, and room for professional advancement.

Furthermore, working as a nurse manager brings with it a measure of personal satisfaction by being able to help make the lives of patients better. By your willingness to put your best foot forward your nursing staff will be encouraged to do the same and your patients will benefit.

You and Your Staff

To excel as a nurse manager requires a way of thinking that’s slightly different from what you did as an active floor nurse. In other words, before moving into management your primary focus was your patients. As a nurse manager you’re still focused on patient care, but you’re more focused on your staff as the vehicle to provide that care.

Nurse management jobs are therefore more about encouraging the success of your staff. When you’re nurses are doing well, so will your patients. When your nurses are not performing up to standards patient care will suffer.

Nurse Managers also have the added responsibility of representing their staff before upper management and other members of the healthcare team. This requires a certain amount advocacy which some nurse managers find difficult. Nonetheless, it’s part of building a solid team.

In the United States there is currently a significant shortage of nurses and nurse managers. There are nurse management jobs available in big cities, small towns, and through temporary staffing agencies. If you’re qualified and want to work, it’s out there for the taking.

Medicare Fraud and Abuse The Most Profitable Healthcare Crime in the U.S.

Medicare fraud and abuse cost taxpayers approximately $60 billion a year. Its one of the fastest and most profitable crimes in the U.S. The government health insurance program that covers 46 million elderly and disabled Americans is being hijacked by opportunists preying on patients, doctors, suppliers, and lack of oversight of the system itself.

According to President Obama, Medicare fraud and abuse is fueling enormous federal budget deficits. He recently explained that we could pay for healthcare reform if we could eliminate Medicare fraud, abuse, and waste altogether.

Although completely eliminating Medicare fraud isnt entirely realistic, curbing the growing crimes could provide healthcare to many more Americans and stop lining the pockets of the individuals, crime rings, and corrupt healthcare providers that steal a huge amount of the half trillion dollars in Medicare benefits each year.

The instances of Medicare fraud and abuse are as diverse as they are widespread. One recent high-profile case involved an Armenian-American crime syndicate that stole patient and doctor identities to setup dozens of fake clinics. The operation, which is one of the largest Medicare fraud schemes in U.S. history, resulted in over $35 million in illegal billings.

In another Medicare fraud and abuse case, nine hospitals in seven states were ordered to pay $9.4 million in fines for keeping patients overnight after undergoing what is typically an outpatient back procedure. The hospitals fraudulently billed Medicare for the unnecessary services. In still another case, eight nurses in Florida carried out an $18.7 million Medicare fraud scam in which they forged patient files to make it appear that they required home health care services that they didnt need or receive.

Although these are just a few of the many types of Medicare fraud and abuse scams occurring each year, they show the urgent need to be vigilant about preventing Medicare scams. From charging for durable medical equipment (DME) never received to using a deceased doctors information to continue to bill patients, common Medicare fraud and abuse schemes include:

* Advertising “free” consultations to patients with Medicare, and then recording and using their private information for monetary gain

* Offering healthcare services or DME for free in return for a persons Medicare number for “record keeping”

* Setting up fictitious clinics with people impersonating doctors to steal private information and commit medical identity theft is another common Medicare fraud and abuse tactic

* Using real patients data, but without their knowledge, to steal their identities

* Not adhering to the FTC Red Flag Rules that alert the carriers paying the bills

* Fraudulent billing for a wheelchair, specialized hospital bed, or other DME is also a form of Medicare fraud and abuse

* Falsifying claims for expensive procedures is another common tactic, such as the $5.8 million fraudulent HIV infusion scheme in Miami in which a husband and wife team defrauded Medicare by submitting unnecessary HIV injection and infusion claims

Remember that when fraud happens to Medicare, it happens to all of us. Dont let your organization become a victim. Put your employees on the front line to spot Medicare fraud by hiring a healthcare fraud and abuse expert that provides “Lunch and Learn” presentations to help avoid, recognize, and respond to Medicare fraud. Visit www.TheIdentityAdvocate.com. or call 310.831.4400 to learn how to prevent Medicare fraud and medical identity theft.

More People in the USA without Health Insurance

As the United States Supreme Court continues to debate Obamacare, President Obama’s historic health care reform bill that still continues to sit in limbo during an election year, a study by the Commonwealth Fund was released recently which showed that one in four people living in America lived without health insurance like Colorado individual plans in 2011 and many of them still continue to remain without health insurance in 2012 due to issues like unemployment, job changes or health insurance being too expensive for the average individual.

An Alarming Trend

The study of 2,100 working class individuals, between the ages of 19 and 65 showed an alarming trend that 26% of adults over the age of 65 are currently living without health insurance plans like Colorado individual and this amounts to over 40 million people when the study was compared to recent U.S. Census data.

Of the individuals that were surveyed, the majority of individuals said that they were going without health insurance because; most of the health insurance plans on the market today were not affordable for them.

What are consumers supposed to do without health insurance plans for individuals? The average working class consumer will avoid regular check-ups and potential problems that can be resolved early will go unchecked for years until they turn into a -time bomb- waiting to go off.

What’s The Solution to the Problem?

With high unemployment rates, unaffordable coverage and uncertainty about President Obama’s health care reform package, nobody really knows what the future holds for individual health insurance plans in the United States. The study also found that over 40% of the individuals who were surveyed lost their health insurance, when they lost their jobs, 18% were dropped from Medicaid and over 27% were never insured altogether.

Some states are considering alternative health insurance options, in Virginia, Bedford County is considering an insurance plan that would be self-funded and insure that workers take home pay wouldn’t be decreased or increased due to the raises in premiums. Employees would pay their monthly premiums to the county and the county would use the funds to cover administrative costs etc.

Other states are considering forcing health insurers to pay for contraception measures and this is expected to raise the costs that people who are insured can expect to pay. One thing is for certain, serious changes will be coming in the health insurance world in the coming months, regardless if Obamacare is accepted or rejected and everyone who lives in the U.S. should be ready for those changes.

Will The President’s Job Bill Hurt Healthcare Jobs

In light of President Obama’s recent speech outlining his plan to create jobs, critics on both sides of the isle question whether or not his plan will be helpful or harmful. Even in unlikely sectors like health care, there is speculation that the Obama bill could be a job killing one. According to industry experts, health care is one of the few sectors that have continued to add jobs despite a persistent economic downturn – about 74,000 in 2010. The problem with the Obama bill is its effect on Medicare and Medicaid.

Impact of Cuts on Healthcare Jobs

Of the previously mentioned is 74,000 healthcare jobs added last year, almost 40% were in the field of assisted living. It is a field which accounts for a fair amount of growth in the overall industry as the American population continues to age. Unfortunately, the vast majority of patients who utilize assisted living do so on Medicare and Medicaid dollars. If the President’s plan is successful in cutting spending for Medicare and Medicaid programs, it could jeopardize the health of many assisted living facilities to the point that they will be forced to close.

Causing further concern is the implementation of universal healthcare beginning in 2014. That law, which was signed back in 2010, may also result in drastic cuts in government medical spending. Hospitals all over the country that depend on government funding for a variety of purposes will have to realign their budgets, forcing them to reduce their workforces. It seems as though a perfect storm may be on the horizon that could spell disaster for the healthcare industry.

The Other Side of the Story

On the other hand, some healthcare industry officials don’t believe the jobs bill will have an effect on healthcare jobs – even if Medicare and Medicaid are cut drastically. They cite the fact that people still need healthcare services, whether or not the government helps them pay for them. Resourceful Americans will find a way to get their healthcare and to make sure it’s paid for. And even in cases when that’s not possible, we are not a nation that allows our people to suffer unnecessarily. As long as there are people, there will be healthcare jobs.

Those who take this view point to countries like Germany and France where governments have realized they need to stop spending so much on healthcare. As a result, private enterprises have begun to spring up to fill in the gaps. And they are hiring.

Despite the potentially bumpy road ahead, health care facilities are continuing to add jobs. As mentioned previously, healthcare is one of the few industries that have continued to grow over the last couple of years, and statistics from the federal labor department indicate that the need for workers will only continue to grow over the next 5 to 10 years. Healthcare jobs will always be available; the only question is what types of jobs they will be. Only time will tell.

Some Myths about Federal Health Care Reform or Obamacare.

When the Patient Protection and Affordable Care Act (PPACA, aka ACA) became federal law in March of 2010, there were many assumptions about what the law would and would not do. As everyone knows, it has become known simply as “Obamacare,” because President Obama was the one who wanted health care reform. Here are some misconceptions about health care reform.

One of the first statements made was that the new law was tantamount to “a government takeover of healthcare.” For this to be true, the government would need to inform every citizen that they were being enrolled in a federal healthcare program, sort of like Medicare, which is a federal health care program for any qualifying citizen or permanent resident over the age of 65. In fact, there is no federal alternative to private health insurance today. Since most if not all health insurance companies that were doing business in 2010 are still insuring millions of policyholders today, it is safe to say that there has not been a government takeover of healthcare. It is also true however, that many people would like to see that happen. They would love to see Medicare expanded to include everyone; but that is very unlikely for many years to come, if ever.

“Medicare benefits will be reduced.” Actually the opposite has happened. Medicare now covers annual physical exams and colonoscopies in addition to the quite comprehensive benefits they have long provided. It is true that premium costs to Medicare beneficiaries will go up in future years, but medical costs and premiums have been rising steadily for decades, and seniors do use more medical services than people under 65.

There will be government “death panels” that will make end-of-life decisions for people on Medicare. This idea was borne out of a well-intended provision in the health care bill that would have helped pay for the end-of-life planning discussion cost that the elderly already have with their physicians and caregivers. So a good thing became a bad thing. Now there can be no provisions in Medicare for this benefit which, ironically, hurts seniors and can actually adds to the cost of health care.

Illegal immigrants will now be covered. The ACA specifically prohibits undocumented immigrants from receiving coverage.

What is not known is the true long-term cost of this legislation. There are many people on both sides of the argument, time will tell what the real cost will be, and there are many components of this program still to be implemented. The truth about health care is that it is expensive no matter where you are. Canada, England, France, Switzerland, Italy, China.

All of these countries have some form of government provided health care and while it is less expensive per-capita than in the United States, it is expensive nonetheless. The common element of all health care programs is that every citizen or legal permanent resident is covered. The cost of care per person is far lower when everyone is covered.
What needs to be understood about health care is that every person at some point will seek it out when they need it. Whether or not they have health insurance is not a factor when there is a need for treatment. If a person cannot afford car insurance they have the option of not driving, and few people drive without car insurance. Not so with health insurance, and the situation is made worse by the fact that uninsured people often ignore minor medical issues because of the cost. Unfortunately those minor medical issues have a way of becoming serious, and that is when the uninsured seek care. And where do they go to get treatment then? The emergency room, which happens to be the most expensive entry point into the entire health care system in the U.S. They go there because federal law prohibits hospitals from turning away anyone during a medical emergency.

This is a huge factor in the cost of health insurance, and a major reason why health insurance premiums have risen far in excess of the CPI over the past 30 years. Until that part of the health insurance equation is resolved the cost of insurance will continue to be out of reach for millions of Americans.

In summary, the cost of delivering health care in the U.S. is not going to go away as an issue. The debate over the number of uninsured and whether or not they should be covered, public vs. private insurance, and who pays for all of this will go on until our politicians realize that there is no one best solution. All sides will have to agree that there will always be some elements of a common health care system that not everyone will like. There are many elements of the Affordable Care Act which work, and those elements need to be preserved. Many insurers who initially opposed the Act have since re-tooled their benefit and pricing models to reflect the major objectives of the program. The irony here is that abolishing the ACA would actually increase the cost of coverage as insurers once again had to redesign their policies and coverage. What is needed most of all is a system that works reasonably well and covers everyone or nearly everyone. In the long run, the cost of excluding millions of uninsured will cost more than covering them.

Some Myths about Federal Health Care Reform or Obamacare.

When the Patient Protection and Affordable Care Act (PPACA, aka ACA) became federal law in March of 2010, there were many assumptions about what the law would and would not do. As everyone knows, it has become known simply as “Obamacare,” because President Obama was the one who wanted health care reform. Here are some misconceptions about health care reform.

One of the first statements made was that the new law was tantamount to “a government takeover of healthcare.” For this to be true, the government would need to inform every citizen that they were being enrolled in a federal healthcare program, sort of like Medicare, which is a federal health care program for any qualifying citizen or permanent resident over the age of 65. In fact, there is no federal alternative to private health insurance today. Since most if not all health insurance companies that were doing business in 2010 are still insuring millions of policyholders today, it is safe to say that there has not been a government takeover of healthcare. It is also true however, that many people would like to see that happen. They would love to see Medicare expanded to include everyone; but that is very unlikely for many years to come, if ever.

“Medicare benefits will be reduced.” Actually the opposite has happened. Medicare now covers annual physical exams and colonoscopies in addition to the quite comprehensive benefits they have long provided. It is true that premium costs to Medicare beneficiaries will go up in future years, but medical costs and premiums have been rising steadily for decades, and seniors do use more medical services than people under 65.

There will be government “death panels” that will make end-of-life decisions for people on Medicare. This idea was borne out of a well-intended provision in the health care bill that would have helped pay for the end-of-life planning discussion cost that the elderly already have with their physicians and caregivers. So a good thing became a bad thing. Now there can be no provisions in Medicare for this benefit which, ironically, hurts seniors and can actually adds to the cost of health care.

Illegal immigrants will now be covered. The ACA specifically prohibits undocumented immigrants from receiving coverage.

What is not known is the true long-term cost of this legislation. There are many people on both sides of the argument, time will tell what the real cost will be, and there are many components of this program still to be implemented. The truth about health care is that it is expensive no matter where you are. Canada, England, France, Switzerland, Italy, China.

All of these countries have some form of government provided health care and while it is less expensive per-capita than in the United States, it is expensive nonetheless. The common element of all health care programs is that every citizen or legal permanent resident is covered. The cost of care per person is far lower when everyone is covered.
What needs to be understood about health care is that every person at some point will seek it out when they need it. Whether or not they have health insurance is not a factor when there is a need for treatment. If a person cannot afford car insurance they have the option of not driving, and few people drive without car insurance. Not so with health insurance, and the situation is made worse by the fact that uninsured people often ignore minor medical issues because of the cost. Unfortunately those minor medical issues have a way of becoming serious, and that is when the uninsured seek care. And where do they go to get treatment then? The emergency room, which happens to be the most expensive entry point into the entire health care system in the U.S. They go there because federal law prohibits hospitals from turning away anyone during a medical emergency.

This is a huge factor in the cost of health insurance, and a major reason why health insurance premiums have risen far in excess of the CPI over the past 30 years. Until that part of the health insurance equation is resolved the cost of insurance will continue to be out of reach for millions of Americans.

In summary, the cost of delivering health care in the U.S. is not going to go away as an issue. The debate over the number of uninsured and whether or not they should be covered, public vs. private insurance, and who pays for all of this will go on until our politicians realize that there is no one best solution. All sides will have to agree that there will always be some elements of a common health care system that not everyone will like. There are many elements of the Affordable Care Act which work, and those elements need to be preserved. Many insurers who initially opposed the Act have since re-tooled their benefit and pricing models to reflect the major objectives of the program. The irony here is that abolishing the ACA would actually increase the cost of coverage as insurers once again had to redesign their policies and coverage. What is needed most of all is a system that works reasonably well and covers everyone or nearly everyone. In the long run, the cost of excluding millions of uninsured will cost more than covering them.