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vanessa_ca

(70 posts)
47. So much criminality is exposed in McNaughton's case.
Sun Dec 15, 2024, 10:48 AM
Dec 15
McNaughton said one motivation for his lawsuit was to expose how insurers like United make decisions about what care they will pay for and what they will not. The case remains pending, a court docket shows.

This part really warmed my heart:
"He has been accepted to Penn State’s law school. He hopes to become a health care lawyer working for patients who find themselves in situations similar to his."

I hope his first targets are the Healthcare-sharing ministries that were exempted from regulation in the Affordable Health Care Act thanks to the work of a lobbyist for the industry. This case was just as disgusting:

A Christian Health Nonprofit Saddled Thousands With Debt as It Built a Family Empire Including a Pot Farm, a Bank and an Airline

Despite a history of fraud, one family has thrived in the regulatory no man’s land of health care sharing ministries, where insurance commissioners can’t investigate, federal agencies turn a blind eye and prosecutors reach paltry settlements.

-snip-

Luckily, or so Martin thought, she had placed her trust — and her money — in Liberty HealthShare. Liberty is what’s known as a health care sharing ministry, a nonprofit alternative to medical insurance rooted in Christian principles. Hundreds of thousands of people rely on such organizations for basic health coverage. They promise no red tape, lower costs and compassion for the sick. Although Martin wasn’t religious, she found comfort in Liberty’s pledge to “carry one another’s burdens.”

-snip-

For generations, members of the Beers family of Canton, Ohio, have used Christian faith to sell health coverage to more than a hundred thousand people like Martin. Instead they delivered pain, debt and financial ruin, according to an investigation by ProPublica based on leaked internal documents, land records, court files and interviews. They have done this not once but twice and have faced few consequences.

-snip-

Four years after its launch in 2014, the ministry enrolled members in almost every state and collected $300 million in annual revenue. Liberty used the money to pay at least $140 million to businesses owned and operated by Beers family members and friends over a seven-year period, the investigation found. The family then funneled the money through a network of shell companies to buy a private airline in Ohio, more than $20 million in real estate holdings and scores of other businesses, including a winery in Oregon that they turned into a marijuana farm. The family calls this collection of enterprises “the conglomerate.”

-snip-

Despite abundant evidence of fraud, much of it detailed in court records and law enforcement files obtained by ProPublica, members of the Beers family have flourished in the health care industry and have never been prevented from running a nonprofit. Instead, the family’s long and lucrative history illustrates how health care sharing ministries thrive in a regulatory no man’s land where state insurance commissioners are barred from investigating, federal agencies turn a blind eye and law enforcement settles for paltry civil settlements.

-snip-

Recommendations

2 members have recommended this reply (displayed in chronological order):

Medicare would have denied $40k balloon dilation procedure too. It's a 15 minutes procedure Silent Type Dec 14 #1
She tried that. MrsCoffee Dec 14 #2
She tried that and it was painful. So let's spend $35k more because it's uncomfortable for a few minutes. Silent Type Dec 14 #4
I'm sorry but this is peripherally personal. JMCKUSICK Dec 14 #8
My life from the time I was about 12 moniss Dec 15 #53
You are a walking, talking example of insidious discrimination JMCKUSICK Dec 15 #54
Thank you. I can remember moniss Dec 15 #55
Are you fucking kidding me?! Arazi Dec 14 #15
Nope, not one of those because they aren't of questionable clinical value and government plans Silent Type Dec 14 #24
You. Are. Not. A. Medical. Expert. Arazi Dec 15 #26
Well, then, you won't like MFA because any government plan is likely going to do Silent Type Dec 15 #30
She was suicidal and needed medical care Arazi Dec 15 #39
Your lack of empathy is noted. choie Dec 15 #27
Empathy yes. Spending considerably more without looking to see if Medicare/caid guidelines Silent Type Dec 15 #32
You are not in a position to judge someone's pain tolerance Keepthesoulalive Dec 15 #35
I think I'll stick with the judgement of the attending physician.... paleotn Dec 14 #3
You mean the ones who order millions of quack treatments and tests a year to pad their bank account. Silent Type Dec 14 #5
Ah yes. ALL physicians are crooks. Is that what you're saying? paleotn Dec 14 #9
And I told you I'm not. I do work with doctors, and yes many cheat. Shouldn't be surprising Silent Type Dec 14 #11
So answer my question, do people have to die just so we ensure no grifting? paleotn Dec 14 #12
Got citations of people dying because of denials? There are plenty of cases where docs Silent Type Dec 14 #14
Hard to believe I'm having to defend this..... paleotn Dec 14 #17
Looked at Buzzfeed link, Silent Type Dec 14 #20
Words wasted on the wrong people. paleotn Dec 15 #40
Do you have a connection to the for-profit private health insurance industry? (no, not being a customer) Celerity Dec 15 #45
Bullshit choie Dec 15 #28
I work with many doctors Horse with no Name Dec 15 #44
Message auto-removed Name removed Dec 14 #16
I agree with your assessment. choie Dec 15 #29
Medicare would have paid the negotiated rate, not denied the care. Ms. Toad Dec 14 #23
American Academy of Otolarngology differs with your perception of need. Silent Type Dec 15 #50
I'm astounded you're continuing this Arazi Dec 15 #52
First - this has nothing to do with my perception of need. It was her doctor who made that assessment - the doctor Ms. Toad Dec 15 #56
So much effort to explain UHC, amazing. Passages Dec 15 #41
So much criminality is exposed in McNaughton's case. vanessa_ca Dec 15 #47
Absolutely. Passages Dec 15 #48
I just noticed your signature line. I love you lol. eom vanessa_ca Dec 15 #49
This is so painful to read that it leaves me with one question JMCKUSICK Dec 14 #6
As long as healthcare is a profit motivated "industry", the answer is to your question is yes. paleotn Dec 14 #10
Every component of our so-called health system takes a big cut. Heck, UHG donated significantly more to Dems Silent Type Dec 14 #13
As usual JMCKUSICK Dec 14 #18
Once again government failed us. While a big friggin deal, ACA is based totally upon private insurers. Why? Silent Type Dec 14 #22
Because Dems don't fight, they negotiate...with our lives JMCKUSICK Dec 15 #33
That's what I'm saying, Congress has failed us. Silent Type Dec 15 #51
"a million medical victim march on Washington" vanessa_ca Dec 15 #25
I'm sorry I can't hear you. I'm... lame54 Dec 14 #7
I hope she eventually got the surgery Meowmee Dec 14 #19
I wish they would showcase these stories Skittles Dec 14 #21
The Daily Mail? sheshe2 Dec 15 #31
Yes. I have better sources from independent outlets like ProPublica, however vanessa_ca Dec 15 #36
You don't need three OPs. sheshe2 Dec 15 #37
Because I am familiar with those three stories vanessa_ca Dec 15 #38
Since when were doctors not the authority on "medically necessary"? ColinC Dec 15 #34
Since when? Ask a woman who needs an abortion and can't get one. Autumn Dec 15 #42
Yeah, I have an old high school acquaintance, an MD who treats the LGBTQ community primarily Nittersing Dec 15 #43
Ask Greg Abbott, Ken Paxton and a host of other mostly male, GOP officials who are now overlords of the uterus. Vinca Dec 15 #46
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