Yemwe anali loya wamkulu wa Tennessee akuvutitsidwa ndi zolakwika zolipira pazolinga zaumoyo

Nashville, Tennessee (WTVF) – Tennessee imapereka inshuwaransi yazaumoyo kwa ogwira ntchito m’boma opitilira 140,000 ndi opuma pantchito.

Koma, NewsChannel 5 ikufufuza Boma lidapeza, kwenikweni, okhometsa misonkho adawalipiritsa ndalama zina mwa chisamalirochi.

Izi zitha kutanthauza madola mamiliyoni makumi ambiri m’zaka zitatu.

Nanga boma lidachita chiyani kuti libwezerenso zina mwa ndalamazo? Zikuoneka kuti boma lidalipira kafukufukuyu. Koma mlembi wina wakale wa malamulo a boma anachitcha kuti “chiwonongeko.”

“Zikuwoneka ngati kuwononga ndalama za okhometsa msonkho,” adatero Martin Daniel, yemwe kale anali woimira boma m’dera la Knoxville.
Daniel anati: “Tinangobwerezanso pang’ono.

Koma kuposa pamenepo, adadabwa kuti boma lidalipira ndalama zambiri zachipatala kwa ogwira ntchito m’boma, ndipo palibe amene adawoneka kuti akusamala.

“Mwachitsanzo, tiwona mbali imodzi mtengo wa colonoscopy m’malo amodzi $ 800 ndi $ 16,000. Inde, ndizo ndalama za okhometsa msonkho,” Daniel anafotokoza.

Pulogalamu ya inshuwaransi yaumoyo wa ogwira ntchito m’boma imaperekedwa ndi onse awiri a Blue Cross Blue Shield ndi Cigna, ndipo imapereka chisamaliro kwa pafupifupi 146,000 ogwira ntchito m’boma pano komanso opuma pantchito. Nthawi zambiri amalipira ndalama zoposa $600 miliyoni pachaka pazofunsira.

Daniel anali ndi nkhawa kwambiri ndi kuwononga ndalama mochulukira kotero kuti zaka ziwiri zapitazo, akadali paudindo wake, adapempha kuti awonenso zandalama za dongosolo laumoyo.

“Ndikulankhula za kafukufuku wonse wa magwiridwe antchito, ma invoice omwe oyang’anira adalandira, komanso ndalama zomwe zidalembedwa muakaunti yapano ya boma,” Daniel adauza komiti yowona za chuma cha boma mu Januware 2020.

Kampani yakunja inabweretsa ndikuwunika pafupifupi mamiliyoni asanu BlueCross BlueShield ndi Cigna zonena zomwe zidaperekedwa pakati pa 2017 ndi 2019. Ndipo zomwe adapeza zinali zodabwitsa.

Daniel anati: “Anatsimikiza kuti pali ndalama zokwana madola 17 miliyoni zimene zinaperekedwa molakwika malinga ndi ndondomeko ya boma ya zaumoyo,” adatero Daniel. . Woyesa”. NewsChannel 5 ikufufuza.

Izi mwina ndi pafupifupi $40 miliyoni m’ndalama za okhometsa msonkho – ndipo, malinga ndi kuwunika mwachangu, boma lidalipira mopitilira muyeso.

Koma m’malo moyesa kudziwa zomwe zidachitikira ndalama zonsezo komanso kuyesa kubweza zina mwa izo, boma la Tennessee linatenga chidziwitsocho ndipo silinachitepo kanthu.

M’malo mwake, pomwe opanga malamulo aboma adavomereza ndalama chaka chatha kuti ziwunikenso mwatsatanetsatane dongosolo lazaumoyo, kuwunika sikunabwererenso kuti apeze madola mamiliyoni ambiri kuyambira 2017 mpaka 2019.

Yemwe kale anali Loya wamkulu wa Tennessee Herbert Slattery ndi ofesi yake adalemba ntchito kampani ina kuti ifufuze zonse ndikuwapempha kuti azingoyang’ana zomwe zachokera mu 2020.

Ndipo pomwe ndemanga yoyamba idapezanso pakati pa $ 17 miliyoni ndi pafupifupi $ 40 miliyoni pakulipira molakwika kwamakampani a inshuwaransi, kuwunikiranso zonena kuchokera ku 2020 kunangopeza $ 268,770 pakubweza kwa BlueCross BlueShield ndi $ 1,398,893 pakubweza kwa Cigna.

“Ndiko kusiyana kwakukulu,” NewsChannel 5 ikufufuza Iye anauza wachiwiri kwa Danieli.

“Inde” adavomera.

Claim Informatics, ya a Stephen Karappa, adawunikiranso zonenazo kuyambira 2017 mpaka 2019, zomwenso sizodabwitsa kuti kafukufukuyu adapeza zochepa bwanji.

“Ndinadabwa pang’ono ndi kusowa kwa zotsatira kuti ndinene pang’ono,” adatero Caraba. NewsChannel 5 ikufufuza.

“Kodi mukuganiza kuti (maudindo) akanapeza kapena amayenera kupeza zingati? NewsChannel 5 ikufufuza Karba anafunsa.

“Osachepera 20 kuchuluka komwe adapeza,” adatero Carrappa.

Healthcare Horizons, kampani yochokera ku Knoxville yomwe idawunikiranso zonena za 2020, idakana kufotokoza momwe pangakhalire kusiyana kwakukulu kotere.

NewsChannel 5 ikufufuza Adafunsanso ofesi ya AG.

Attorney General Herb Slattery asanasiye ntchito kumapeto kwa Ogasiti, womulankhulira adati alola kulankhula nafe za kafukufukuyu. Koma atadziwa kuti tikufuna kulankhula za zinthu zofunika kwambiri zomwe anthu ankanena zokhudza iye, mwadzidzidzi, analibe ndemanga.

Koma nanga bwanji mamiliyoni onsewa a madola opitilira boma mu 2017 mpaka 2019?

AG office anatero NewsChannel 5 ikufufuza Anasankha kuyang’ana ndemanga yonse pa “zaposachedwa kwambiri komanso zomveka” zomwe zilipo.

Koma Martin Daniel akufunsa chifukwa chiyani kulipira ndemanga yatsopano yomwe imanyalanyaza zomwe zapezedwa kale?

“Ndikuganiza kuti anthu akuyenera kuyankhidwa pankhani ya ndalama zomwe zimagwiritsidwa ntchito pofufuza ngati izi,” adatero Daniel.

Boma lidalipira $174,000 pa kafukufukuyu. Ofesi ya AG ikunenetsa kuti amayenera kulipira $490,000 kuti afufuze zonse zazaka za 2017-2019 kuti adziwe zambiri zoti abwerere ndikuyesera kubweza zina mwazokwana $40 miliyoni.

Martin Daniel analembanso lipoti lofunika kwambiri ataona zotsatira za kafukufukuyu. Anamutumiza ku ofesi ya loya wamkulu wa boma koma anati anakana kuyankha lililonse mwa mafunso ake kapena kuthetsa nkhawa zake. Iye tsopano akufika kwa aphungu a boma omwe alipo tsopano ndipo akuyembekeza kuti azindikira komanso kuphatikizapo ofesi ya woyang’anira boma.

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