Deceptive Stem Cell Therapy

People spend billions of dollars each year on health-related products and treatments that don’t deliver. People who buy them are cheated out of their money, their time, and even their health.

The Federal Trade Commission (FTC) reports  that California-based Regenerative Medical Group, Telehealth Medical Group, and Dr. Bryn Jarald Henderson, the founder of both companies, sold false hope at high prices.

These companies and Dr. Henderson used social media and websites to promote stem cell therapy for all kinds of health issues affecting older adults and children. Supposedly, it could treat and cure diseases and health conditions such as Parkinson’s disease, autism, dementia, depression, multiple sclerosis, cerebral palsy, traumatic brain injury, heart disease, macular degeneration, chronic kidney disease, osteoarthritis, and stroke. Dr. Gunderson  charged up to $15,000 for their initial stem cell therapy and up to $8,000 for follow-up treatments.

But, according to the FTC, these claims were not backed up by any scientific studies and, in fact, no studies have established that stem cells cure, treat, or reduce the severity of diseases or health conditions in humans. With the exception of a few FDA-approved treatments, stem cell therapy is still largely experimental.

Are you — or someone you know — thinking about stem cell therapy?  If so,

  • Be skeptical about amazing health claims.
  • Don’t trust a website just because it looks professional, uses medical terms, or has success stories from “real people.”
  • Talk to your health care professional before you consider any medical treatment.

For more information, click here.

Teaching Suggestions

  •  Help students understand that health information, whether online or in print, should come from a trusted source.
  • Let students make a list of the richest and most reliable sources of health information and share it with the class.

Discussion Questions

  1. Why is it important to seek a second or even third opinion from a qualified health care provider before trying experimental medical procedures?
  2. What can the FTC and other federal/state governmental agencies do to prevent such businesses to make deceptive treatments.

Fake healthcare plans

If you’re looking online for health insurance, there are lots of results that seem to offer good choices. But dishonest companies are literally counting on you being confused by all those choices. So, before you sign up and pay, take steps to know you’re getting exactly what the plan advertised. Otherwise, fake “coverage” can leave you exposed to substandard benefits and costly payments.

For example, according to the Federal Trade Commission, a Florida-based company, Simple Health Plans, LLC, allegedly tricked consumers into believing its plans offer comprehensive coverage and are compliant with Affordable Care Act (ACA) standards. The company allegedly lured people in through lead-generation sites, using logos of well-known health insurance providers to make itself look credible. Simple Health asked for personal information on the site, followed up with phone calls, and pitched what it said were affordable, comprehensive, ACA-qualified plans with low or no co-pays or deductibles.

But once consumers signed up — often at premiums as high as hundreds of dollars per month — the FTC says they did not get anywhere near the full coverage Simple Health promised, and the benefits were not ACA-qualified.

For more information, click here.

Teaching Suggestions

  • Ask students if they or any of their friends and relatives have received sham health insurance plans calls. If so, how did they handle such calls?
  • Help students understand that two best-known and legitimate sources of the government health insurance are Medicare and Medicaid.

Discussion Questions

  1. What are some ways to protect yourself against false health care plans?
  2. Why is it important to learn the difference between health insurance and medical insurance discount plans?

New Medicare cards are on the way

Changes are coming to your Medicare card.  By April 2019, your card will be replaced with one that no longer shows your Social Security number.  Instead, your card will have a new Medicare Beneficiary Identifier (MBI) that will be used for billing and for checking your eligibility and claim status.

Having your Social Security number removed from your Medicare card helps fight medical identity theft and protects your medical and financial information.

Here are some common Medicare scams relating to the new cards:

  • Someone calling, claiming to be from Medicare, and asking for your Social Security number or bank information.
  • Someone asking you to pay for your new card.
  • Someone threatening to cancel your benefits if you don’t provide information or money?

For more on the new changes to your Medicare card, visit Centers for Medicare & Medicaid Services.  And report scams to the FTC.

For more information, click here.

Teaching Suggestions

  1. How do you think this change will affect patients? You?
  2. Replacing Social Security number with Health Insurance Claim Number will cost millions of taxpayers dollars. Do you think it is worth the expense?

Discussion Questions

  • What is the biggest reason the Social Security is taking the Social Security Number off of Medicare cards?
  • How will the new system affect people with Medicare?
  • Who will be the affected stakeholders?

Fighting Against Medicare Fraud and Abuse

Don’t Stand by…..Speak Up!

Have you ever witnessed something that you knew was wrong and wondered if you should report it?  Did you want to say something, but didn’t because you were afraid of negative consequences?  Don’t be afraid, because there are federal laws to protect you.   Indeed, as a bystander, you can play an essential role in preventing violence, wrongdoings, and fraud.

Reporting information or activity that you suspect is illegal, dishonest, or false is your right.  Reportable violations could be abuse of authority, gross waste of funds, a specific danger to public health or safety, or gross mismanagement.

Social Security’s programs were originally created to serve the American public, and 80 years later they still provide critical support to people of all ages.  As good stewards of the tax dollars, Social Security Administration designs its systems to protect against fraud, waste, and abuse.  However, its systems can’t catch everything.  And that’s where you can help.  Report wrongful acts and protect lives as well as taxpayers’ dollars.

For more information, click here.

Teaching Suggestions

  • Ask students to comment on the statement: “Nearly 70 percent of consumers believe the Medicare program would not go broke if fraud and abuse were eliminated.”
  • What would YOU do if you suspected fraud or other wrongdoings, including wasting taxpayers’ dollars?

Discussion Questions

  1. Social Security Administration (SSA) will pay about $887 billion in Social Security benefits to almost 60 million individuals in 2015. What specific tools the SSA uses to fight fraud and protect taxpayers’ dollars.
  2. How does the SSA investigate people who provide false, incomplete, or inaccurate information to defraud the government?

The Supreme Court, Health Care, and You

On June 26, 2015, the Supreme Court made an important decision about the Health Insurance Marketplace keeping           quality, affordable coverage for millions of Americans.  The Supreme Court’s decision confirmed that if you qualify, you can receive financial assistance, including premium tax benefit to make coverage more affordable no matter where you live.

On average, consumers enrolled in the Marketplace are receiving $3,260 per year in tax credit, or $272 each month.

About 8 in 10 consumers could find coverage for $100 or less with tax credit through the Marketplace.

If you don’t have health insurance, see if you can get health coverage for 2015.  You may qualify for a Special Enrollment Period due to life change, such as marriage, having a baby, or losing other coverage.  Open enrollment for 2016 starts on November 1, 2015.

For more information, click here.

Teaching Suggestions

  • Ask students if anyone in their family is affected by the Supreme Court ruling, and if so, how?
  • Ask students to prepare a summary of the major provisions of the Affordable Care Act.

Discussion Questions

  1. Why is it important to inform the Marketplace about any changes to your household, income, and insurance status?
  2. If you have health insurance through your employer or purchased it on the individual market, does the Supreme Court ruling impact you?

CMS Proposes Rule to Strengthen Managed Care for Medicaid and CHIP enrollees

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) proposed to modernize Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations to update the programs’ rules and strengthen the delivery of quality care for beneficiaries.  This proposed rule is the major update to Medicaid and CHIP managed care regulations in more than a decade.  It would improve beneficiary communications and access, provide new program integrity tools, support state efforts to deliver higher quality care in a cost-effective way, and better align Medicaid and CHIP managed care rules and practices with other sources of health insurance coverage.  Overall, this proposed rule supports the agency’s mission of better care, smarter spending, and healthier people.

For more information, click here.

Teaching Suggestions

  • Ask students to visit the CMS.gov website to learn how the healthcare delivery landscape has changed and grown substantially since 2002.
  • Ask students how CMS might strengthen the quality of care provided to beneficiaries.

Discussion Questions

  1. Why is the CMS proposing new rules to strengthen managed care for Medicaid and CHIP enrollees?
  2. How does the CMS plan to modernize Medicaid and CHIP regulations?

5 Ways To Become An Informed Medicare Consumer

Each day, you make important choices about your finances, health, privacy, and more.  Medicare has 5 things you can do to help you become an informed Medicare consumer.

  1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law provides.
  2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes.  Keep the following information safe:
    • Your name
    • Your Social Security Number (SSN)
    • Your Medicare Number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan)
    • Your credit card and bank account numbers
  1. Help fight Medicare fraud. Medicare fraud takes money from the Medicare program each year, which means higher health care costs for you.  Learn how to report fraud.
  2. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.
  3. Make informed Medicare choices. Each year during the Fall Open Enrollment Period (October 25-December 7), review your plan to make sure it will meet your needs for the following year.  If you are not satisfied with your current plan, you can switch during the Open Enrollment Period.

For more information, click here.

Teaching Suggestions

  • Ask students to prepare a list of medical expenses that Medicare does not cover.
  • Ask students to check out the Centers for Medicare and Medicaid Services (CMS) videos for tips on preventing Medicare fraud and see how seniors are learning to stop, spot, and report fraud.

Discussion Questions

  1. Why is it vital to fight against Medicare fraud?
  2. Why is it important to review your health care plan during the Fall Enrollment Period?

Emergency Department for Routine Care?

A new study, published in March 2015 in the Annals of Emergency Medicine, shows that the annual rate of emergency department visits by young adults age 19-25 decreased by 1.4 percent in 2011.  This represents 191,000 fewer emergency department visits by young people in this age group.

For this study, currently the most extensive analysis of its kind, researchers examined more than 17 million emergency department visits between 2007 and 2011 from the Nationwide Emergency Department Sample database of the Agency for Healthcare Research and Quality’s Hospital Cost and Utilization Project.

The Affordable Care Act requires health plans that offer coverage to allow young adults to stay on their parents’ plan until age 26.  This has allowed young adults to seek care in the most appropriate setting, reserving costly emergency department use for real emergencies.

For additional information, click here.

Teaching Suggestions

  • Ask students what else can be done to reduce the high cost of healthcare.
  • What can students do to reduce their own personal healthcare costs?

Discussion Questions

  1. What are several reasons for the rising healthcare expenditures?
  2. Has the Affordable Care Act reduced the costs of healthcare?

Your 2015 Tax Return and the Health Care Law

Certain provisions of the Affordable Care Act will probably affect your federal income tax return when you file this year.  The law requires that you and each member of your family have qualifying health insurance coverage for each month of the year, qualify for an exemption from the coverage requirement, or make an individual shared responsibility payment when filing your federal income tax return.

Most taxpayers will simply check a box on the tax return to indicate that each member of their family had qualifying health coverage for the whole year.  Qualifying health insurance includes coverage for most, but not all, types of health care coverage plans.  If you bought coverage through the Health Insurance Marketplace, you should receive Form 1095A, Health Insurance Marketplace Statement from your Marketplace by early February.

For more information, Click Here.

Teaching Suggestions

  • Ask students to search the Internet to gather more information about the new IRS requirements and the Affordable Care Act.
  • What are provisions that might affect an individual and their families?

Discussion Questions

  1. What are the reporting requirements when you file your federal income tax return this year?
  2. How can you determine if you are eligible for an exemption?
  3. What should you do if you are expecting to receive 1095A and you don’t receive it by early February.

Health Insurance Marketplace Application Check List

When you apply for or renew your coverage in the Health Insurance Marketplace, you’ll need to provide information about you and your household, including income, and insurance coverage you currently have, and some additional information.

Use the checklist below to help you gather what you need to apply for coverage.  Open enrollment ends February 15, 2015.

  • Home and/or mailing addresses for everyone applying for coverage.
  • Social Security Numbers.
  • Document information for
  • Employer and income information for every member of your household (for example, from pay stubs or W-2 forms—Wage and Tax Statements)
  • Your best estimate of what your household income will be in 2015.
  • Policy numbers for any current health insurance plans covering members of your household.
  • A completed “Employer Coverage Tool” for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.)
  • Notices from current plan that include your plan ID, if you have or had bad health coverage in 2014.

For more information, go to:

https://marketplace.cms.gov/outreach-and-education/marketplace-application-checklist.pdf

Teaching Suggestions

  • Many states are expanding Medicaid to cover more people. Ask students to find out what Medicaid expansion might mean for them.
  • Why do some people qualify for an exemption from the fee based on income or other situation?

Discussion Questions

  1. Do most people who apply for health insurance through marketplace qualify for premium tax credit?
  2. What penalties are imposed on people who don’t have a coverage in 2015?
  3. Can you buy a plan outside the marketplace and still meet the health care law’s coverage requirement?