Morning Briefing
Summaries of health policy coverage from major news organizations
Changes in Anthem's Pathway Network Leave Some Ga. Patients Battling For Care Options
Late last year, during Open Enrollment for 2019 insurance plans, the online information for consumers showed WellStar Health System hospitals and doctors as part of Anthem’s Pathway health plan. But enrollees say they didn’t realize during the sign-up period that the Anthem-WellStar contract for that plan was scheduled to end in February. That contract termination – and the ensuing furor over patients having to switch doctors and hospitals — led to recent litigation against Anthem, based in Indianapolis. (Miller, 4/11)
Lee County will pay $253,930 to the federal government to resolve allegations that its ambulance service submitted false bills for transporting patients on medically unnecessary runs, according to the federal prosecutor for the eastern half of Kentucky. With that agreement and others, the government will recoup a total of $515,000 in connection with allegations that the ambulance service submitted false bills to Medicare and Medicaid, U.S. Attorney Robert M. Duncan Jr. said in a news release. (Estep, 4/11)
Inside a medical clinic not far from Tesla’s electric car factory, Yvette Bonnet started noting a troubling pattern. The automaker’s workers’ compensation manager would pressure her boss, Dr. Basil Besh, to make sure Tesla wasn’t on the hook for certain injured workers. ... interviews with former clinic employees and internal clinic communications show how Tesla and Besh coordinated behind the scenes in an arrangement that financially benefited both the carmaker and the doctor, to the detriment of the injured. (Evans, 4/11)