Monthly Archives: June 2014
How Massachusetts Blue Cross audited hospitals
There’s nothing really exciting or interesting about this story except this: since I’ve been putting this blog portfolio together, I’ve been struck by how similar the news 30-40 years ago was to now. We’re still seeing stories about medical costs, insurance and reimbursements, not unlike this story from the early 1970s. Hospitals are still complaining about their insurance reimbursements, and insurance companies are still moaning about how much hospitals charge for their services. I found this clip in the Lowell (Mass.) SUN, which apparently didn’t know quite how to play the story — they ran it on the OP-ED page.
By ARTHUR FREDERICK
BOSTON (UPI) – Hospital costs in Massachusetts are audited to determine Blue Cross reimbursement rates, and the 37 men who do the audits are on the Massachusetts Blue Cross payroll.
The auditing procedure has been allowed since May 18, 1956. Chapter 176A of the General Laws says the state Rate Setting Commission can require that an audit be conducted prior to having Blue Cross reimbursement rates established at hospitals.
The Commission contracts Blue Cross to do the auditing. The auditors answer to the Rate Setting Commission, but are paid by Blue Cross and receive Blue Cross fringe benefits.
Blue Cross pays hospitals either what a given treatment costs the hospitals, or what they charge for that treatment, whichever figure is lower. The hospital’s cost of treatment is generally lower than what it charges, and that is usually the figure paid the hospital by Blue Cross.
The audit determines what the hospital costs are.
The governor’s hole in the ground
Every state probably has one of these — a specially built and fortified emergency shelter in case somebody drops the big one on the State House. I found that Maine had such a bunker under the State Office Building, where the governor could take shelter in case of a natural disaster or A-bomb attack. The atomic bomb thing seems strange in distant Augusta, Maine, but the shelter WAS built to exacting atomic shelter specifications. It all seems a bit weird, but there it was … and is. I tried to find a picture of it, but couldn’t.
By ARTHUR FREDERICK
AUGUSTA, Maine (UPI) – Gov. James B. Longley’s office is warm and paneled and carpeted, with a broad desk and an ornate state seal hanging on the wall. But he has another office, little-known and stark, with a tiny desk pressed against a white cement wall.
This other office is the governor’s emergency quarters, buried in the sub-basement of the state office building, which was built in the late 1950s, at the height of the atomic bomb scares.
The office is in the center of the basement, next to a radio room.
There are no windows to the outside and the interior windows are of Plexiglas. The basement, headquarters for the state Office of Civil Emergency Preparedness (CEP), has a 1,000 rating against atomic fallout, the highest rating possible.
William F. Crowley, assistant public information officer for the CEP, said the basement could shelter the governor and 49 other people for two weeks. It could provide food, air and power without any contact with the outside.
“This place is virtually immune to any type of natural disaster,” Crowley said. “This whole basement can take care of 50 people for 14 days. We can generate electricity, we have our own water, food and dormitory space.”
“It is completely self-sufficient.”