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Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Health | Which health insurance plan may be right for you? Health | Airport authority, Delta unveil $500k multi-sensory room at Metro Airport Health | Your cool black kitchenware could be slowly poisoning you, study says. Here’s what to do Health | Does fluoride cause cancer, IQ loss, and more? Fact-checking Robert F. Kennedy Jr.’s claims Health | US towns plunge into debates about fluoride in water Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.hapabapa Rivian: November Gains Nearly Dissipated Rivian Automotive ( NASDAQ: RIVN ) investors have failed to shake off the market's anxieties over its growth profile as RIVN's recent post-earnings gains dissipated. Notably, investor sentiment was lifted markedly as the Rivian-Volkswagen ( A Unique Price Action-based Growth Investing Service We believe price action is a leading indicator. We called the TSLA top in late 2021. We then picked TSLA's bottom in December 2022. 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His approach combines sharp price action analysis with fundamentals investing. He tends to avoid overhyped and overvalued stocks while capitalizing on battered stocks with significant upside recovery possibilities. He runs the investing group Ultimate Growth Investing which specializes in identifying high-potential opportunities across various sectors. He focuses on ideas that has strong growth potential and well-beaten contrarian plays, with an 18 to 24 month outlook for the thesis to play out. The group is designed for investors seeking to capitalize on growth stocks with robust fundamentals, buying momentum, and turnaround plays at highly attractive valuations. Learn more Analyst’s Disclosure: I/we have a beneficial long position in the shares of AMZN either through stock ownership, options, or other derivatives. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). 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Merkel laments influence of big business on TrumpUS citizens and green card holders on edge
CHICAGO, Dec. 06, 2024 (GLOBE NEWSWIRE) -- Monroe Capital Corporation (the "Company”) (NASDAQ: MRCC) announced today that its Board of Directors has declared a distribution of $0.25 per share for the fourth quarter of 2024, payable on December 30, 2024 to stockholders of record as of December 16, 2024. In October 2012, the Company adopted a dividend reinvestment plan that provides for reinvestment of distributions on behalf of its stockholders, unless a stockholder elects to receive cash prior to the record date. When the Company declares a cash distribution, stockholders who have not opted out of the dividend reinvestment plan prior to the record date will have their distribution automatically reinvested in additional shares of the Company's capital stock. The specific tax characteristics of the distribution will be reported to stockholders on Form 1099 after the end of the calendar year and in the Company's periodic report filed with the Securities and Exchange Commission. About Monroe Capital Corporation Monroe Capital Corporation is a publicly-traded specialty finance company that principally invests in senior, unitranche and junior secured debt and, to a lesser extent, unsecured debt and equity investments in middle-market companies. The Company's investment objective is to maximize the total return to its stockholders in the form of current income and capital appreciation. The Company's investment activities are managed by its investment adviser, Monroe Capital BDC Advisors, LLC, which is an investment adviser registered under the Investment Advisers Act of 1940, as amended, and an affiliate of Monroe Capital LLC. To learn more about Monroe Capital Corporation, visit www.monroebdc.com . About Monroe Capital LLC Monroe Capital LLC (including its subsidiaries and affiliates, together "Monroe”) is a premier asset management firm specializing in private credit markets across various strategies, including direct lending, technology finance, venture debt, alternative credit, structured credit, real estate and equity. Since 2004, the firm has been successfully providing capital solutions to clients in the U.S. and Canada. Monroe prides itself on being a value-added and user-friendly partner to business owners, management, and both private equity and independent sponsors. Monroe's platform offers a wide variety of investment products for both institutional and high net worth investors with a focus on generating high quality "alpha” returns irrespective of business or economic cycles. The firm is headquartered in Chicago and maintains 10 offices throughout the United States and Asia. Monroe has been recognized by both its peers and investors with various awards including Inc.'s 2024 Founder-Friendly Investors List; Private Debt Investor as the 2023 Lower Mid-Market Lender of the Decade, 2023 Lower Mid-Market Lender of the Year, 2023 CLO Manager of the Year, Americas; Global M&A Network as the 2023 Lower Mid-Markets Lender of the Year, U.S.A.; DealCatalyst as the 2022 Best CLO Manager of the Year; Korean Economic Daily as the 2022 Best Performance in Private Debt - Mid Cap; Creditflux as the 2021 Best U.S. Direct Lending Fund; and Pension Bridge as the 2020 Private Credit Strategy of the Year. For more information and important disclaimers, please visit www.monroecap.com . Forward-Looking Statements This press release may contain certain forward-looking statements. Any such statements, other than statements of historical fact, are likely to be affected by other unknowable future events and conditions, including elements of the future that are or are not under the Company's control, and that the Company may or may not have considered; accordingly, such statements cannot be guarantees or assurances of any aspect of future performance. Actual developments and results are highly likely to vary materially from these estimates and projections of the future. Such statements speak only as of the time when made, and the Company undertakes no obligation to update any such statement now or in the future. SOURCE: Monroe Capital Corporation Chief Financial Officer and Chief Investment Officer Monroe Capital Corporation (312) 598-8401 [email protected] BackBay Communications (857) 305-8441 [email protected]
The Los Angeles Lakers’ three-point shooting hasn’t been stellar to begin the 2024-25 season, but they could make a wise move to help bolster that aspect of their team. Trading away a reliable role player and acquiring a near-automatic perimeter shooter would instantly solve the Lakers' long-range shooting woes. “The Lakers have shown promise this season, but their roster still lacks an elite shooter to space the floor consistently for Anthony Davis and LeBron James,” Fadeaway World’s Eddie Bitar wrote Saturday. “Michael Porter Jr. would address this need perfectly. His career 40.9% three-point shooting makes him one of the league’s top marksmen, and his ability to stretch defenses would open up driving lanes for LeBron and opportunities for Davis to dominate inside.” “Porter Jr. also adds versatility with his 6-foot-10 frame, making him a tough matchup on both ends of the floor.” "Adding Porter Jr. would bolster the Lakers' title hopes, as his shooting complements their star duo's strengths and he would be a "Splash Brother" alongside Dalton Knecht as well." “Playing alongside elite playmakers in James and Davis would likely improve Porter Jr.’s efficiency, pushing him closer to his career shooting norms.” "While Porter Jr.’s defensive limitations might pose challenges, the Lakers’ existing defensive structure could mitigate his weaknesses, especially with Davis anchoring the paint." “Essentially, the Lakers having two shooters who can nail over 38% consistently would be a perfect case for their starting lineup.” “The downside of this trade for the Lakers is losing Austin Reaves, who has emerged as a reliable role player and secondary ball-handler.” “However, the upgrade in shooting and offensive firepower Porter Jr. provides outweighs the loss of Reaves, (Jarred) Vanderbilt, and (Gabe) Vincent, none of whom offer the same game-changing skillset. This trade could cement the Lakers as a top contender in the West.” Bitar’s proposed trade would send Reaves, Vanderbilt, Vincent, and a 2029 first-round pick to the Nuggets for Porter Jr. Porter Jr. has been one of Denver’s most consistent outside shooting threats since making his Nuggets debut in 2019. The Missouri product has utilized his impeccable off-ball instincts, impressive manipulation tactics, and clean release to shoot above 39% from three-point land during five of his first six NBA seasons. Without Porter Jr.’s significant contributions from deep, there’s a good chance the Nuggets wouldn’t boast a 9-6 record through the first 15 games of the 2024-25 season. The Lakers could use a three-point shooting specialist like Porter Jr., but the franchise would likely be reluctant to pull the plug on Reaves. The 6-foot-5 guard is a steady contributor who’s earned James’ trust over time, but landing Porter Jr. would give the Lakers the boost they desperately need from beyond the arc. If Los Angeles truly wants to frighten teams in the Western Conference, they’ll consider contacting Porter Jr. More NBA: Warriors may part ways with future All-Star in trade for $215.2 million Hawks phenomHow to design the perfect space for socializing – expert tips from interior designers - Homes & GardensRising price of paying national debt a risk for Trump's promises on growth, inflation
One of the country’s largest health insurers reversed a change in policy Thursday after widespread outcry, saying it would not tie payments in some states to the length of time a patient went under anesthesia. Anthem Blue Cross Blue Shield said in a statement that its decision to backpedal resulted from “significant widespread misinformation” about the policy. “To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services,” the statement said. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.” Anthem Blue Cross Blue Shield would have used "physician work time values," which is published by the Centers for Medicare and Medicaid Services, as the metric for anesthesia limits; maternity patients and patients under the age of 22 were exempt. But Dr. Jonathan Gal, economics committee chair of the American Society for Anesthesiologists, said it's unclear how CMS derives those values. In mid-November, the American Society for Anesthesiologists called on Anthem to “reverse the proposal immediately,” saying in a news release that the policy would have taken effect in February in New York, Connecticut and Missouri. It's not clear how many states in total would have been affected, as notices also were posted in Virginia and Colorado . People across the country registered their concerns and complaints on social media, and encouraged people in affected states to call their legislators. Some people noted that the policy could prevent patients from getting overcharged. Gal said the policy change would have been unprecedented, ignored the “nuanced, unpredictable human element” of surgery and was a clear “money grab.” “It’s incomprehensible how a health insurance company could so blatantly continue to prioritize their profits over safe patient care,” he said. "If Anthem is, in fact, rescinding the policy, we’re delighted that they came to their senses.” Prior to Anthem's announcement Thursday, Connecticut comptroller Sean Scanlon said the “concerning” policy wouldn't affect the state after conversations with the insurance company. And New York Gov. Kathy Hochul said in an emailed statement Thursday that her office had also successfully intervened. The insurance giant’s policy change came one day after the CEO of UnitedHealthcare , another major insurance company, was shot and killed in New York City. The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
