And a certain, once, political party wants to strip away All regulations on businesses in their 'free market' ideologies, reagan capitalism. That are not only in place to help keep businesses honest in their practices but to make sure the competition of already honest contractors aren't pushed out of business as well as for the safety of the consumer who need the services, and more!
August 21, 2012 - Health Net Inc., a large company with revenues of $11.9 billion in 2011, encouraged a Veterans Affairs Department employee to set up a service-disabled veteran-owned small business in 2006 so Health Net could increase its own business with the department that involved re-pricing health care claims, a VA inspector general review found.
The veteran-owned business, Enterprise Technology Solutions, performed little work under its contracts with VA and instead subcontracted the work to Health Net in violation of contracting rules, according to an investigation by the VA inspector general released Monday.
The IG staff reviewed five contracts held by Enterprise Technology Solutions valued at $82 million over a two-year period.
Health Net provides managed health care services for private companies and Medicare beneficiaries. In May 2010, its federal division, Health Net Federal Services, won a $17.2 billion five-year TRICARE contract to provide health insurance coverage to 3 million active-duty and retired military personnel in the Northeast, North Carolina and Wisconsin.
To ensure that it pays the lowest possible rate for health care services, VA uses a technique called claims re-pricing, in which a health services contractor compares VA allowable rates, based on fees charged by non-VA health care providers, to rates for providers in the contractor’s own network. “If the network rates are lower than the VA allowable rates, the contractor re-prices the claim and calculates the potential savings.” the IG wrote. read more>>>
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