Health Insurance for Young Adults
253 weeks ago
As we grow older, our responsibilities add up. Having a health insurance should be one of the priorities that we should think of. By the time you are old enough to fend for yourself, you are then required to get an insurance. However, many young adults are still confused on its importance.
1. It may be Illegal
When you are living in the United States, Affordable Care Act (ACA) compels you to purchase insurance. Going without insurance for three months would force you to pay a penalty of $325 or 2% of your monthly income, whichever is higher. In developing countries, uninsured individuals have the option to purchase from private companies but laws are already drafted for completion. In cities like Jakarta, Indonesia and Bangkok, Thailand, more than half of their unemployed population goes uninsured.
2. If you are a full-time employee, your employer should provide you with insurance
Most companies require employees work for set period before benefits can be provided. It usually takes 3-6 months in a probationary period before regularization, by which insurance is given. It is in any law in any states and government to mandate to every employer to provide employee benefits.
3. Your parents may still be able to cover you
Individuals under the age of 26 can still be listed under their parents’ coverage. They can still cover even a modest premium cost.
4. You can do it alone
If you are not insured under your parents’ plan or purchasing insurance under your employer is not an option, you have the choice to purchase your own insurance from trusted private companies. If you are buying online, just make sure you are dealing with a legitimate company as there are a lot of scammers operating in the net. If you are looking for a sound advice, you can ask from consulting companies. Westhill Insurance Consulting is one of the longest running catalysts in insurance consulting and the staff can definitely guide you in buying from the best.
5. Know the Difference between HMO and PPO
Health Maintenance Organizations (HMO) and Preferred Provider Organization (PPO) are two different typed of health insurance. HMOs have lower premiums than PPO as its coverage is more limited. Doctors in HMO have to be in-network while in PPO, in-networks are more flexible and you have the option to see doctors outside of your coverage with extra coverage. Review the type you are insured into and make sure you know your coverage.
Medical Insurance for Expatriates
255 weeks ago
Expatriates may find it hard to avail of health insurance when they are in a foreign place. The system varies from that of your own nation and customs of availing is a far cry especially in developing nations.
Luckily, developing countries like Indonesia and Thailand are starting to expand its insurance’s scope to a more international level, catering to both local and foreign individuals.
Companies operating in Jakarta, Indonesia, for instance, realize the importance of a comprehensive medical plan to cover sickness and accidents that happen to the staff that they hire.
Westhill Insurance Consulting is also aware of the struggles faced by expatriates when it comes to getting insurance. What preparations do you do then?
1. Find out before you come
The company who hired you and the person you are working for should provide medical insurance for you and your family members just as they do with local folks. Ask for details from your employer to ensure that your policy will adequate cover your family members for sickness, accidents or emergencies, on home leave and when you are visiting other countries for work-related purposes.
If you are joining a new company, remember that they may never love you more than when you first join. Do not rely on promises that medical insurance coverage will be sorted out when you arrive. It could be the case that what the company considers ideal coverage may not meet your expectations. Be sure before you arrive that you understand what medical coverage your company provides for regular medical concerns, major medical situations such as surgery or deliveries, and medical evacuation both inter- and internationally.
A little warning, if you are in a country like Indonesia, for instance, being a foreigner is more likely to be scammed than locals since your lack of knowledge of the customs would be obvious. Make sure you don’t fall into fraudulent acts.
2. Know if there are Medical Evacuations
Medical evacuations are a big factor in medical coverage, as the quality of medical service available in outlying areas in Indonesia will be quite poor. In such areas, emergency medical evacuation (medevac) to a large city or a neighboring country is considered essential.
3. Options in medical insurance coverage
As an example, international medical insurance plans from the U.K. include emergency medical evacuation with the possible addition of major outpatient services to cover everything but minor outpatient claims, which are often excluded to keep costs down. Therefore, outpatient claims are typically subject to a deductible related to the illness.
A patient may have several doctor and specialist visits plus prescribed medicine for one particular bout of sickness and still be subject to only one deductible amount. A point worth noting is that a person could be undergoing outpatient treatment related to a very serious illness, which would not be covered under a local clinic scheme.
Expansion of Health Insurance to Developing Nations
256 weeks ago
With the challenge of today’s generation, health risk is greatly increasing. Today’s citizens have greatly recognized the danger of going out every day. Health insurance is also in demand in the market and is considered as one of the most necessary insurance to have.
Developing nations are already increasing its insurance economy and even building its own campaign towards the totality of health insurance patrons.
According to a report released by Westhill Insurance Consulting, health insurance has already been accepted as a necessary part of each household.
Indonesia is one of developing nations who has proven to slowly adapt health insurance in its system. With over 200 million citizens flocking on the national health insurance registration in Jakarta, Bali, Sumatra and major places in the country, the government has been proud to predict that it may be possible to see all of the archipelago’s population already avail of health insurance.
To cater to rural areas of developing nations on the other hand, reliable, always‐on broadband wireless connectivity makes a new health care model possible: instead of asking the patient to go to the nearest clinic or hospital, the mobile health care worker reaches out to the patients where they live and when they need care, bringing access to a broad set of medical resources through voice, data, and video applications.
The only challenge in pursuing health care insurance in developing nations is the fraudulent deeds happening among their people because of the lack of security and loose protection from the authorities.
To prevent these scams from happening and keeping more victims from losing their hard-earned money for a non-existent medical assistance, many companies and non-profit organizations are continuously seeking reforms. Universal Health Coverage (UHC) initiatives have sought to create awareness in and provide guidance to countries on how to improve the design and functioning of their health systems based on evidence of what works for achieving the goal of universal coverage. Meeting this goal is, however, challenging, because the available evidence rarely explores the causal link between the design features of these UHC schemes and the outcomes observed, and substantial heterogeneity exists regarding the robustness of the available evidence.
UHC reviews and indicates possible intervention to both low and middle-income countries for improvement. Affordability is currently the main concern for the organization to both solve the problem of the small number of health care insurance holders and keep scams from happening.
Hopefully, more solution can be presented as we look forward for a healthier life in the near future.
Clinical Trials Supported by Insurance
263 weeks ago
Trials involving human patients are crucial to the advancement of clinical science. But they’re not without risk. Fortunately, insurers are willing to cover them.
Westhill Insurance Consulting, one of the most trusted on-line insurance consultant that offer consumer information on reasonably priced health and medical coverage has these following things to review if you are planning to take part in a clinical test.
Here are the conditions the federal law requires for a health insurance to cover:
• You must be eligible for the trial
• The trial must be an approved clinical trial
• The trial does not involve out-of-network doctors or hospitals, if out-of-network care is not part of your plan
• Also, if you do join an approved clinical trial, most health plans cannot refuse to let you take part or limit your benefits.
Approved clinical trials are research studies that:
• Test ways to prevent, detect, or treat cancer or other life-threatening diseases.
• Are funded or approved by the federal government, have submitted an IND application to the FDA , or are exempt from the IND requirements. IND stands for Investigational New Drug. In most cases, a new drug must have an IND application submitted to the FDA in order to be given to people in a clinical trial.
Health plans are not required to cover the research costs of a clinical trial. Examples of these costs include extra blood tests or scans that are done purely for the sake of the clinical trial. Often, the research sponsor will cover such costs. Warnings must be posted days before the outcome to prevent further complaints from both the sponsor and the insurance company.
Plans are also not required to cover the costs of out-of-network doctors or hospitals, if the plan does not usually do so. But if your plan does cover out-of-network doctors or hospitals, they are required to cover these costs if you take part in a clinical trial.
Clinical tests which are made in a different city such as those in Tokyo, Japan, Jakarta, Indonesia and Kuala Lumpur, Malaysia may not be included in the coverage as well.
One challenge for underwriters is the relatively small premium base measured against a trend for higher [insured] limits to be requested.
Clinical trials policies normally have “claims made” wordings which means that insurance coverage does not automatically extend beyond the trial dates. The potential gap is where you arrange insurance, let the policy end and have no insurance for an event which may occur sometime in the future that can be attached to the clinical trial.
Serious problems in clinical trials are rare, as Rossano points out. “But what I would say is that clinical trials are not without risk. The risk of a clinical trial is that the human body is very complex and in rare cases there can be unforeseen outcomes, as happened in cases like TeGenaro.”
HMO vs PPO
265 weeks ago
Most of us who are employed know that we have corresponding health insurance. For others who choose their own insurance, agents might have explained what should be provided and covered for our policies. One of the things that we should be aware of is the type of a managed care plan we need: either an HMO or PPO to avoid complaints, frustrations and disappointments added to our consultation to the doctor. If this is the first time you are hearing this, then, you are not alone. Some insurance are already fixed that agents do not care to mention it anymore.
Westhill Insurance Consulting took the liberty to differentiate each one from the other.
HMO actually stands for Health Maintenance Organization while PPO is an abbreviation of Preferred Provider Organization. Less common are point-of-service (POS) plans that combine the features of an HMO and a PPO. In developing cities like Singapore, Kuala Lumpur, Malaysia, Jakarta, Indonesia and Beijing China, HMO is mostly used by employers for their health care insurance.
To put into an outline, here are the facts that are needed to be reviewed and considered between the two:
Do I need to choose doctors, hospitals and other providers?
• HMO: you must choose doctors, hospitals and other providers
• PPO: you can choose doctors, hospitals and other providers.
Do I need to have a Primary Care Physician (PCP)?
• HMO: Yes, your HMO will not provide coverage if you do not have a PCP.
• PPO: No, you can receive care from any doctor you choose. But remember, you will pay more if the doctors you choose are not "preferred" providers.
How do I see a specialist?
• HMO: Referral is needed from your PCP to see a specialist or if you have to undergo other special test exams such as x-rays, except in emergency situations. Your PCP also must refer you to a specialist who is in the HMO network.
• PPO: You do not need a referral to see a specialist. However, some specialists will only see patients who are referred to them by a primary care doctor. And, some PPOs require that you get a prior approval for certain expensive services, such as MRIs.
Do I have to file any insurance claims?
• HMO: All of the providers in the HMO network are required to file a claim to get paid. You do not have to file a claim, and your provider may not charge you directly or send you a bill.
• PPO: If you get your healthcare from a network provider you usually do not need to file a claim. However, if you go out of network for services you may have to pay the provider in full and then file a claim with the PPO to get reimbursed. The money you receive from the PPO will most likely be only part of the bill. You are responsible for any part of the doctor's fee that the PPO does not pay.
266 weeks ago
Finding Private Health Insurance
Many of us have to rely on the company’s health care insurance provider. Lucky for those people who can stay in one job for years. How about those people who jumps from one venture to the other? Westhill Insurance Consulting has faced queries on the best alternative whenever unemployment comes near. Private health insurance is the main source of health coverage for the majority of people in the United States alone. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover.
If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance. In developing cities like Tokyo, Japan, Seoul, South Korea, Jakarta, Indonesia and Singapore, millions of people have found themselves with no health cover at all. Reviews show that uninsured people reaches up to 46 million. Tens of millions more have inadequate insurance.
Best ways to find the best suitable private insurance for you are:
• One plan or separate plans - adding a spouse or offspring to a plan may be ideal, but not always so. In some cases, shoppers may find better deals by checking what is around first. It is important to balance to benefits offered against the amount that has to be paid out in premiums, in every case.
• Is your doctor included? - if you are considering an interesting plan, make sure your doctor or clinic is listed in their network of healthcare professionals. Otherwise, you may either have to change doctors, or pay out-of-pocket for the one you prefer.
• Only choose relevant options - do not choose a plan with options you do not need, in order to keep your premium costs to a minimum. If the purchaser or spouse is a female over 45, it is unlikely maternity coverage is a top priority. Even prescription plan coverage most likely will not cover all drugs, especially the newer, more expensive ones.
• Big premiums today, or in the future? - if you have little disposable income and enjoy good health, you might find it more convenient to opt for a high-deductible plan to start with, that has progressively lower monthly premiums with the passing of time. If your health care requirements are high now, a low-deductible plan to start with may be a better choice.
The Best Fit in Healthcare Insurance
269 weeks ago
With the widespread of insurance nowadays, people are confused which one is legit and which one is a fraud; which can offer better and which one cost less. Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, you need to consider new provisions in the law that have recently kicked in and could impact your coverage for the coming year. Westhill Insurance Consulting can help you clear away any confusion, doubts and complaints.
Health insurance should cover any medical need you may have, now or in the future.
Buying insurance on your own used to be riskier because many plans didn’t cover important things such as prescription drugs or mental health care. Every kind of health insurance must now cover preventive care, with no deductibles, co-pays, or other types of out-of-pocket expenses. That includes Pap and cholesterol tests, mammograms, immunizations, and colonoscopies when age- and condition-appropriate.
But even though you no longer have to worry about your basic health care needs being covered, you’ll still have to navigate lots of other confusing choices. That’s true even if you get coverage through a job, because more than half of workers have a choice of two or more types of health plans.
1. Do you want to pay for care now or later?
All health plans have to come up with enough money to pay for the medical expenses of their members.
You can choose to collect most of the money up front in the form of premiums. If you have a high premium, you’ll pay a smaller share out of your own pocket, in the form of deductibles, co-insurance, and co-pays. Or plans can go the other way, charging smaller premiums but asking you to pay a bigger share on your own.
2. Are you OK with a small network of docs?
Doctors and hospitals accept lower fees from insurers if they know they’ll be part of a small, or “narrow,” network, because that guarantees them a bigger share of the plan’s business. There’s no evidence that you’ll get worse care in narrow networks. And they can save you about 20 percent over larger networks. But make sure that the plan has enough choice of doctors and hospitals in your area—a particular consideration if you live in a rural area. In Singapore and Jakarta, Indonesia and other developing nation, seldom can you choose this kind of benefit. You might as well review and check with your insurance provider for assurance.
Lapses in Insurance Coverage
270 weeks ago
Insurance has been around since people have realized it should be. Yet sometimes, we cannot avoid not paying for our premiums especially when we encounter financial instability. These are called lapses. Westhill Insurance Consulting gives you the outlines of what you should review once you missed paying your premiums.
Grace Period Must Happen Before Lapse
To prevent a life insurance policy from lapsing each and every time a premium payment is slightly late, every state in the country requires that a life insurance policy first go through what is known as a grace period after a payment is missed. This is a period of time (usually 30 days) where despite the missed payment; the insurance policy will still provide coverage and make a full payout if the insured dies.
Only after the grace period has passed without receiving the due premiums can the life insurance company consider the policy to be lapsed. Once a life insurance policy lapses the life insurance company is not under any legal obligation to pay the beneficiaries if an insured person passes away.
Most Policies Can Be Reinstated After Lapsing
After a policy first lapses, the owner may have the option to reinstate the policy. You want to make sure that you reinstate your policy as quickly as possible after a lapse. Different companies have different rules for reinstatement so you shouldn’t file a complaint or burst into frustrations when your insurance company refuses to reinstate your policy as it should already be stated when you were reading the terms before you signed for the coverage.
Importance of Reinstatement Period Lapse
The reinstatement period is very important to policy owners and insured persons for a couple of reasons. The first reason is as discussed, the insured person may not need to go through the underwriting process. If a person has had a major health change, he/she may not necessarily be aware of the change. The underwriting process may uncover more about a person’s health than they ever knew, for better and worse. Avoiding underwriting when possible almost always leads to lower insurance premiums.
The second reason the reinstatement period is very important is that even with the same health rating, a new life insurance policy will always be more expensive than an old policy, because the insured person has aged. The older the insured person, the higher the rates will be, all else being equal. The bottom line is: Reinstating a life insurance policy rather than taking out a new policy will save money.
Reinstatement Will Cost More than One Month Premium
After a policy has lapsed, a larger payment must be made to reinstate the policy. It is in the best interest of a policy holder never to let a policy lapse. Developing cities like Bangkok, Thailand, Jakarta, Indonesia and Kuala Lumpur, Malaysia are strict in reinstatement and its cost as personal insurance are rare.
The 5 Best Money Lessons We Learned Last Year
284 weeks ago
1. It’s Smart to Prepare for a Breach
How many data breaches from 2014 can you name? The freshest one in your mind is probably the Sony hack, but there were also attacks on Home Depot, Staples, Dairy Queen, P.F. Chang’s the list goes on. Credit.com Co-Founder and Chairman Adam Levin recently wrote about the most important lessons you can learn from the Sony hack, encouraging consumers and companies to prioritize data security and behave with the knowledge that your personal information and correspondence could be exposed at any time.
Prepare for the possibility of fraud by monitoring your credit, regularly reviewing account activity and knowing what to do if your personal information has been stolen. Do what you can to strengthen your data security, but know that so much of it is beyond your control, so the best thing you can do is know how to react to a breach.
2. Communication Is Crucial to Getting Debt-Free as a Couple
We published several success stories about getting out of debt, but some of the most memorable involved couples working together to conquer their finances. The stories had similar themes: Ellie Kay married her husband without knowing about his $40,000 of consumer debt, and Ja’Net Adams was unaware her husband took out student loans to pay for college. Both families eventually hit breaking points where they realized debt was holding them back, and they needed to make drastic changes to get rid of it.
Getting out of debt is never easy, and the more people who are involved, the more complicated it can be. At the same time, having someone to work through the challenges with you can be extremely helpful. Adams’ and Kay’s stories highlight two crucial elements of getting debt free: staying committed to a plan and remaining open and honest about the process’ progress and challenges. Those lessons apply to any personal finance goal, whether you’re planning with a family or on your own.
3. Staying Up to Date on Your Credit Is Easier Than Ever
There’s really no excuse these days for not knowing what’s going on with your credit. You can get two of your credit scores for free every 30 days on Credit.com, and you probably have access to other free credit score tools, too. FICO rolled out a program called FICO Open Access, which allows consumers with certain financial products (including Discover credit cards and some Sallie Mae student loans) to review their FICO scores for free. In the past year, many more of these programs have become available to consumers, free of charge, because there’s a strong belief that an informed consumer makes better financial decisions.
Looking at the same credit score periodically helps you understand how your behavior, like credit card use and loan repayment, affects your credit. It can also help you spot and stop fraud and identity theft.
4. Paying for Health Services Is Harder Than It Should Be
In September, Credit.com Director of Consumer Education Gerri Detweiler broke her hand, resulting in a trip to the ER and a messy experience with medical bills.
“Our medical billing system is far too complicated and convoluted,” Detweiler wrote in a December post for Credit.com. “For all the talk of putting patients more in charge of their care, there is little opportunity to make informed decisions. One of the main things that irked me was my complete inability to confirm whether I received the services my insurance company and I paid for.”
This is coming from a woman whose first question upon arriving at the emergency room was whether the provider was in her insurance network. Detweiler’s experience shows you have to be exceptionally persistent in gathering information about your medical bills, otherwise you’ll easily lose track of something and possibly receive a collection notice about it. Even with her diligent record-keeping and frequent efforts to communicate with billing departments, Detweiler still doesn’t have all the answers she wants about her brief emergency room visit.
5. More Education on Student Loan Debt Is Needed
In December, the Brookings Institution released a report saying about half of students polled in a nationally representative survey didn’t know how much they borrowed for their education. That’s absurd. How can people prepare to repay debt if they have no idea how much of it they have?
Add this to the general consensus that borrowers aren’t well enough aware of their student loan repayment options, and the high default rate among student loan borrowers makes a lot of sense. Granted, the share of borrowers who defaulted within three years of entering repayment declined this year, from 14.7% to 13.7%, but that’s still a huge default rate. Considering it takes months of missed payments to default in the first place, there are millions of borrowers who are having serious trouble repaying their education debt who haven’t yet hit the dreaded point of default.
Not only do students need to have a better idea of what they’re getting themselves into when they take out student loans, they need to be well versed in their repayment options, should they find themselves unable to make the payments.
A lot happened in the personal finance world in 2014, and 2015 is sure to be similarly eventful. If these stories are any indication, the best thing you can do to ensure a productive financial year is to make sure you’re informed about your financial situation, credit standing and options for getting out or staying out of debt.
Data breach trends for 2015: Credit cards, healthcare records will be vulnerable
288 weeks ago
The data breaches of 2014 have yet to fade into memory, and we already have 2015 looming. Experian's 2015 Data Breach Industry Forecast gives us much to anticipate, and I've asked security experts to weigh in with their thoughts for the coming year as well.
Experian highlights a number of key factors that will drive or contribute to data breaches in 2015. A few of them aren't surprising: Organizations are focusing too much on external attacks when insiders are a significantly bigger threat, and attackers are likely to go after cloud-based services and data. A few new factors, however, merit your attention.
First, there is a looming deadline of October, 2015 for retailers to upgrade to point-of-sale systems capable of processing chip-and-PIN credit cards. As banks and credit card issuers adopt more secure chip-and-PIN cards, and more consumers have them in hand, it will be significantly more difficult to clone cards or perpetrate credit card fraud. That’s why Experian expects cybercriminals to increase the volume of attacks early in 2015, to compromise as much as possible while they still can.
The third thing that stands out in the Experian report is an increased focus on healthcare breaches. Electronic medical records and the explosion of health or fitness-related wearable devices make sensitive personal health information more vulnerable than ever to being compromised or exposed.
The risk of health related data being breached is also a concern voiced by Ken Westin, security analyst with Tripwire. He pointed out that part of the reason that retail breaches have escalated is because cybercriminals have developed the technologies and market for monetizing that data. “The bad news is that other industries can easily become targets once a market develops for the type of data they have. I am particularly concerned about health insurance fraud—its driving increasing demand for health care records and most healthcare organizations are not prepared for the level of sophistication and persistence we have seen from attackers in the retail segment.”
“There will absolutely be more breaches in 2015—possibly even more than we saw in 2014 due to the booming underground market for hackers and cybercriminals around both credit card data and identity theft,” warned Kevin Routhier, founder and CEO of Core Telligent. “This growing market, coupled with readily available and productized rootkits, malware and other tools will continue to drive more data breaches in the coming years as this is a lucrative practice for enterprising criminals.”
The rise in data breach headlines, however, may not necessarily suggest an increase in actual data breaches. It’s possible that organizations are just getting better at discovering that they’ve been breached, so it gets more attention than it would have in previous years.
Tim Erlin, director of IT risk and security strategy for Tripwire, echoed that sentiment. “The plethora of announced breaches in the news this year is, by definition, a trailing indicator of actual breach activity. You can only discover breaches that have happened, and there’s no indication that we’re at the end of the road with existing breach activity. Because we expect organizations to improve their ability to detect the breaches, we’ll see the pattern of announcements continue through 2015.”
The combination of a rise in actual data breach attacks and an increase in the ability to discover them will make 2015 a busy year for data breaches. Whether we’re defending against new attacks, or just detecting existing breaches that have already compromised organizations, there will be no shortage of data breach headlines in 2015.
Medicare Overbilling Probes Run Into Political Pressure
289 weeks ago
When investigators suspected that Houston’s Riverside General Hospital had filed Medicare claims for patients who weren’t treated, they moved to block all payments to the facility. Then politics intervened.
Rep. Sheila Jackson Lee, a Texas Democrat, contacted the federal official who oversees Medicare, Marilyn Tavenner, asking her to back down, according to documents reviewed by The Wall Street Journal. In a June 2012 letter to Ms. Tavenner, Rep. Jackson Lee said blocking payments had put the hospital at financial risk and “jeopardized” patients needing Medicare.
Weeks later, Ms. Tavenner, administrator of the Centers for Medicare and Medicaid Services, instructed deputies to restore most payments to the hospital even as the agency was cooperating in a criminal investigation of the facility, according to former investigators and documents. “These changes are at the direction of the Administrator and have the highest priority,” a Medicare official wrote to investigators.
About two months after that order, Riverside’s top executive was indicted in a $158 million fraud scheme. The hospital was barred from Medicare this May, and the CEO was convicted in October.
What happened at Riverside General Hospital shows how political pressure from medical providers and elected officials can collide with efforts to rein in waste and abuse in the nearly $600 billion, taxpayer-funded Medicare system. More than a dozen former investigators and CMS officials said in interviews that they faced questions from members of Congress about policy changes or punitive action affecting providers or individual doctors.
Ricky Sluder, a former senior investigator for a Medicare contractor who oversaw part of the Riverside investigation, said “it was extremely frustrating to stall an investigation to give some explanation to a lawmaker. It’s providers’ way of using political power.”
In an emailed statement, Medicare administrator Ms. Tavenner said the Riverside episode “reflected the tension between fraud prevention and access to care.” She said she wasn’t aware of the pending indictments and that her job required her to “balance two important policy goals” — saving taxpayer money and protecting Medicare’s beneficiaries.
A spokesman for Rep. Jackson Lee declined to comment.
Medicare has reported that during the 2013 fiscal year, waste, fraud and abuse accounted for an estimated $34.6 billion in improper payments to medical providers. CMS says it clawed back about $9 billion that year through audits and investigations.
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