Governor’s budget plan cracks down on insurance companies and prescription price gouging, lowers out-of-pocket healthcare costs, aims to reduce appointment wait times and enable Wisconsinites to get
Make the punishments hurt enough so that it doesn't make financial sense to improperly decline claims. It's the only way to get health insurance companies to behave, since we're dead set on keeping it a private industry apparently.
Can’t do something reasonable like not make a profit moving money around a private bureaucracy, increasing medical expenses so those rent-seekers can get their cut.
To all those in Wisconsin, reminder there's an election coming up that will determine which side controls the state supreme court. If you like policies like this one and also having fair elections, don't let the Republicans win.
Specifically in a few months on April 1, 2025. This will determine if Wisconsin keeps their 4-3 liberal-conservative split. The races are technically non-partisan but one candidate is an insane republican-endorsed figure. The other, Susan Crawford is already on the court and she has previously ruled to do things like stop gerrymandering in Wisconsin and helped give them fair maps
Make sure you are registered to vote - especially if you want a mail ballot! The deadline to register online is March 12th. Wisconsin also has same in-person registration available through election day via same day voter registration (not all state have this)
You could probably make a big enough threat to the companies just by saying, "If our audit finds you are, in fact, sending meritless denials to try and pad your bottom line, you need to reach out to all those impacted and inform them that the denied services will be covered 100%, along with any follow-up care needed as a result from the treatment you denied. And the fine is 150% of the cost of all claims you denied."
Shareholders ultimately don't care about the CEO, they can get another one. Hit their bottom line hard enough, and they'll take note, though.
I don't feel like the insurance companies should have any say in denying claims at all beyond obvious coverage/non-coverage. And choosing the incorrect code is not grounds for a flat denial. They are not doctors. They should have no say in how long surgeries take whether patients need to stay extra days in-patient, etc.
Christ, remember when Leftists like AOC suggested COVID be an opportunity to advocate for universal healthcare and got screamed out of the room for being too divisive?
NY is taking them to court over it - just as a note. States do have the ability to enforce things themselves, so a court ruling in their favor can be enforced by the state itself
I like this idea cause there is no way health insurance companies will comply for free. They will pass the cost of completing audits and loss of profits on to the payers. We need a system where there is an incentive to make healthcare and insurance competitive and affordable without sacrificing adherence to the FDA and Joint Commission.
Oh an audit was generally overdue. What's happening now isn't an audit, it's a political purge, nothing more. The rest is to give just enough to cover to hide behind for the idiots that believe what they're told.