Texas largest cancer centers not taking ACA patients

[bigdarryl]

Fucked up!! I would never live in that crazy ass state or even visit it. They better vote for Wendy Davis for Governor http://www.dailykos.com/story/2013/11/15/1255760/-Alarming-news-TX-largest-cancer-treatment-centers-will-not-accept-ACA-patients

[wercal]

1. This line seems to be the problem:

According the law, patients who haven't paid premiums are given a 90-day grace period before their coverage is dropped. But the insurance company isn't obligated to pay the claims for the last two months of that period.

[Sheri]

7. why? i thought the ACA prevented ins. companies from dropping patients.

what am i missing?

[wercal]

11. They can drop you if you dont pay premiums

But they have to wait 90 days....and in theast 60 days of that period, you could rack up bills that the insurance company doenst have to pay for.

[dairydog91]

12. It doesn't matter if the insurance company can't drop the patient.

That doesn't stop hospitals from refusing to treat people with specific insurance plans. The 90-day grace period, as written, seems to create a situation where a hospital might provide two months of treatment for which the insurance company has no legal requirement to pay. In the case of advanced treatment, that could be mighty expensive for the hospital.

[Sheri]

15. i don't expect doctors or hospitals to provide treatment for free.

i don't want to see people holding bake sales to pay for cancer treatment, either. i thought the ACA was supposed to fix this for people who had insurance.

[wellstone dem]

29. I think it gives people

a 3 month grace period to pay their premium. So they have to be behind 3 months before they can be dropped. If they are dropped, it is retroactive, but only to months where the premium wasn't paid.

[Sheri]

42. i didn't know that. thanks. nt

[Niceguy1]

36. you can gorce people to pay their bills

[doc03]

2. How would they know, don't you get treatment with a regular

insurance card just like always?

[Lex]

13. Yes.

[lpbk2713]

3. Death Panels are alive and well in the Lone Star State

They are sentencing innocent people to death in order to make a lame political statement.


Shame.

[Rstrstx]

4. I'll believe it when I see it

They supposedly haven't (or have) maybe kind of made up their minds about taking plans from the Federal Exchange. Sounds like they're negotiating rates with the insurance companies but doubt they'd pass up millions and get all the bad press. As long as MD Anderson takes the policies people who need high quality cancer treatment will get it.

[NCTraveler]

5. We continue to embolden the for-profit health insurance...

industry and for-profit medical providers. This is the type of thing you are going to get. In the end they will probably end up continuing to serve these patients. But they will flex their muscles along the way, letting us all know who is in charge.

[Lex]

6. But the insurance is with a regular for-profit insurance company.

For instance, you'll have a Blue Cross policy with a Blue Cross card to give to the medical provider.

ACA is not insurance itself.

[TwilightGardener]

8. Why is an exchange policy by private insurers now different than any other policy by

private insurers? It's not Medicare, Tricare or Medicaid government-set rates, so where is the difference?

[Lex]

10. And further, how would the doctors know? It's a regular insurance policy.

I do not think your med card will say if it's ACA or not.

[TwilightGardener]

14. Exactly. I thought the ACA exchanges were just clearinghouses for insurance co's to offer

plans that meet federal requirements for coverage at different price levels. The ACA is not an entity, it doesn't exist somewhere, interfering with hospitals and insurance co's. Just totally ridiculous.

[doc03]

19. Yes but the Faux News watchers believe that Obamacare is guvmnt healthcare. They can make those

morans happy thinking they won't accept Obamacare and take insurance just like always. The Faux News morans won't know the difference.

[Capt. Obvious]

9. Without even clicking on the link - the headline is a lie

[politicaljunkie41910]

17. I thought the same thing. Because since the ACA is the law of the land

all policies except those covered by grandfather clause's will be ACA policies. No hospital or treatment center will be able to remain in business without ACA policies. I too don't need to read the linked to article.

When are we Dems going to stop reacting to every personal anecdote we read about from some blogger or some hysterical news site.

[SickOfTheOnePct]

23. They're talking about policies on the exchanges

Not all policies are going to be offered through the exchanges.

Not sure how they'll know, but most likely by the name of the coverage on the insurance card.

[SoCalDem]

16. ACA "patients" will have an INSURANCE CARD

The ACA is JUST about getting them the INSURANCE..

When I present my card, why would a medical facility CARE how I got the insurance or is my Mommy paid the premiums.. This is ridiculous..

[okaawhatever]

18. It appears the clinic has reversed course and hasn't decided yet. One of the comments shows two

copies of statements on their website. One from October saying they won't participate and one newer statement saying they haven't decided.

[renie408]

20. Since there is no such thing as an 'ACA patient', I am having a hard time understanding this post.

I read the article, but this whole thing stinks to high heaven. For one thing, WHY wouldn't the premium be paid and what has that got to do with this woman?

[Lex]

22. Exactly.

It's just dumb.

[scheming daemons]

21. FALSE STORY: There's no way for them to know where the patient got their BCBS card

Whether it came through the exchanges, or through an employer plan... the patient simply has a Blue Cross/Blue Shield insurance card.

There's no way for the cancer center to know whether the patient went through the exchanges or not.

The only way they could refuse "ACA patients" is to refuse *ALL* patients with insurance.

[SickOfTheOnePct]

24. Blue Cross/Blue Shield cards may look alike in many ways

But there may well be differences in the name of the plan that indicate that it is from the exchange.

For example, my BC/BS card says "Federal Employee Program" and states "Government-wide Service Benefit Plan", and has a little map of the U.S. with "PPO" on it.

I don't know for sure, but I would imagine that policies from the exchanges are designated somehow.

[FarCenter]

31. If it is a BCBS card for an ACA plan, it will identify the plan

The insurance companies offer plans through the exchange. The card will identify the insurance company, the name of the plan, and other information, such as copays required.

Each insurance company plan has a network of providers who will accept patients belonging to the plan. It is expected that relatively few doctors, clinics, hospitals, imaging providers, test labs, etc. will sign up to be ACA plan providers.

Even doctors in dark about new health plans

Insurance shoppers often can't choose plans that their doctors take part in or include doctors near them. And doctors may not be able to confirm they're in a plan when patients ask them.

More than a month after HealthCare.gov and 15 state-based exchanges opened for business, consumers and even physicians are finding it's isn't easy or even possible sometimes to find out which doctors and hospitals are in the plans' provider networks.

"Some states, they have it, and for some, it isn't available. It 's a big unknown for the patient," says Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, whose members manage doctors' practices. "It's very much up in the air."

That means insurance shoppers often can't choose plans that their doctors participate in — or that include doctors near them. It also means doctors may not be able to confirm they're in a plan when consumers ask them. While consumers may now occasionally find a doctor listed on their commerical insurance plan isn't accepting patients or is no longer on the network, at least they can reliably find provider lists and doctors at least know what plans they currently participate in.

http://www.usatoday.com/story/news/nation/2013/11/07/doctor-questions-affordable-care-act-plans/3453689/

So "you'll be able to keep your doctor" may well not be true.

[scheming daemons]

33. the plans in the exhanges are the same ones you can buy directly from ins. company

No difference.

They can't NOT accept it unless they fail to accept the same plan purchased outside the exchange.

[ScreamingMeemie]

25. Bull crap.

[Yo_Mama]

26. It's not Texas, it's the federal government regulations

Cancer drugs are very expensive. According to ACA regs, the consumers have to have coverage for 90 days after they paid their last premium, but the insurance companies don't have to pay the bills. This means that the oncologists could incur very large bills (they have to buy the drugs up front), without much hope of collecting from the patient.

A lot of oncology centers may do this, just as many oncology centers stopped treating Medicare patients this summer if they didn't have Medigap coverage as a result of the sequester cuts.

[rustydog]

27. Palin's death panels

not the government, but healthcare facilities who want to deny care to the less wealthy.

[gcomeau]

28. There is no such thing as an "ACA patient"

So how exactly is that supposed to work? They won't take anyone who has insurance with any company that offers plans on the exchanges? Which would be about... all of them? Yeah, good luck with that.

[FarCenter]

32. Hospitals can sign up to accept some plans and not others from an insurance company

For example, a doctor may accept United Healthcare fee-for-service plan patients but not HMO plan patients.

[gcomeau]

37. But both types are likely offered on the exchanges. So... -eom

[bluestate10]

30. There are good hospitals and good Oncologists in Texas. This is a perfect case for

crowd financing new cancer treatment centers. If good people lie down and take this, then where does it stop. Collectively, we have the power for enormous change and good if we collectively demonstrate the guts needed to push through. New cancer centers that actually care about patients and spend profits on researching new therapies instead of bonuses for fat cats will eliminate the threat that Texas Oncology is trying to impose upon it's patients. Fuck Texas Oncology and the doctors that are heartless enough to follow it's lead, there are good people with as much skill, if not much more, and certainly more heart who will take care of patients.

[ScreamingMeemie]

38. And, they are not THE place for cancer treatment in Texas.

MD Anderson
Memorial Hermann
Methodist

[marshall]

34. Two cancer doctors I know in Dallas told this well over a year ago

They said most of that patients they now treat would not be eligible for treatment under the new system. They have been planning their early retirements since then. Granted they did fight tooth and nil for Hillary, and refused to give up on her even when it was obvious she would not get the nomination.

[Skittles]

35. ? how could they tell who are the "ACA patients"?

total BS

[KatyMan]

39. Well as a Texan

If I or any of my loved ones ever have the misfortune of a cancer diagnosis, you can bet that the only place I would seek treatment would be at The University of Texas MD Anderson treatment centers.

[ScreamingMeemie]

40. Yep.

Never even heard of that one in Dallas. We've got three of the top 20 right here in Houston.

[840high]

41. Confusing and most likely

not accurate.