Free Republic

Medicare Advantage provides health coverage to more than half of the nation's seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping some or all contracts with the private plans altogether. Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates. "It's become a game of delay, deny and not pay,'' Chris Van Gorder, president and CEO of...

Note: this article has been updated to include a response from WellSpan. A Philadelphia law firm said Thursday it filed a lawsuit on behalf of a 72-year-old man who died after staff apparently lost track of him in the emergency room at WellSpan York Hospital. Terry Lynn Odoms, who arrived by ambulance and was put in a wheelchair, was a Marine Corps and Vietnam veteran, according to lawyer Matt Casey, who is representing Odoms’ family. “A decorated veteran who fought for our country was abandoned and left to suffer and die by a health system that knew it wasn’t adequately...

A local hospital is closing its doors. Wellmont Health System is citing unprecedented changes in health care as the reason for closing Lee Regional Medical Center. Company officials say three reasons led to the decision reimbursement cuts associated with the Affordable Care Act, extremely low community use of the hospital and a lack of consistent physician coverage.(snip) Wellmont says the closure is to major cuts in Medicare reimbursements by the federal government associated with the Affordable Care Act and a lack of Medicaid expansion by the Commonwealth of Virginia.