2d ago

Gov. Evers: “I Want Wisconsin to Become the First State in America to Start Auditing Insurance Companies over Denying Healthcare Claims”

urbanmilwaukee.com Gov. Evers: “I Want Wisconsin to Become the First State in America to Start Auditing Insurance Companies over Denying Healthcare Claims”

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

Gov. Evers: “I Want Wisconsin to Become the First State in America to Start Auditing Insurance Companies over Denying Healthcare Claims”

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2d ago

Gov. Evers: “I Want Wisconsin to Become the First State in America to Start Auditing Insurance Companies over Denying Healthcare Claims”

urbanmilwaukee.com /pressrelease/gov-evers-i-want-wisconsin-to-become-the-first-state-in-america-to-start-auditing-insurance-companies-over-denying-healthcare-claims/

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41 comments

Yes. YES. This is what we're talking about.
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.
- This literally raised my eyebrow as I was reading. Very smart way to add regulation and public accountability to this.
- 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)
  
  Huzzah!

If you fail the audit, you'll have to meet with
- 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.
  
  Or you could start luigi-ing shareholders. That might work too. (theoretically, of course. I couldn't publicly recommend anyone take illegal actions)

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.

Government providing oversight?!?
What a novel idea!

Imagine if Joe Biden had said this in 2021.
- Gee if only there was some kind of major health emergency that could have catalyzed a national conversation on this.
  
  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?
- Perhaps Luigi+Trump is what it actually took to get them to move...

He's one of the good guys.
- This is amazing. Gj

After today's EO and the attack on NYC congestion pricing, Trump will just tell insurance companies to ignore any laws that limit their power.
- 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

Hell, it's about time.

That’s a man who doesn’t want to be shot at!

Gov DeSantis, "I want insurance companies to keep donating to my administration, so I can keep ignoring the insurance crisis in the state of Florida."

I'm an illinoisian, it already was, but Wisconsin is looking even more good an alternative than usual
- Be careful, we have plenty of weirdos!

Fuckin' based Tim Apple over here.

Wait...they don't do that now!?
- Lol of course not.

Poor gov evers about to lose his job for saying that. Trump believes in big pharma.
- Trump has no say over Gov Evers. WI already voted split ticket with Evers as governor and Russian Ron Johnson as senator.
  
  Laws don't really matter anymore though. The executive branch has no say over the 2 others, alas none of that matters now.
  I'm with ya it shouldn't be this way

Holy shit FINALLY

or you know, just burn it down.
- 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.

Well we know whose state will be first to start losing federal funding!
- California! /s but not really

Remember that "audit the fed" bullshit. It had morsels of a true and good concept
- 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.

How well does the health insurance in Massachusetts work?
Anyway, the Cheese Heads are going to find several mass murderers.

41 comments