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How to Be a Smart Medical Consumer

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Dangers of sleep apnea

Sleep apnea is a relatively common condition, especially among those over 40.

Sleep apnea is a relatively common condition, especially among those over 40.

What is it? It is a condition where the soft tissues of the throat relax and narrow, or completely collapse, during sleep. This obstructive breathing results in cessation of breathing, also called apnea. Periods of apnea decrease oxygen levels in the blood (hypoxemia) and within minutes can cause major organ dysfunction and permanent brain damage.

For a proper diagnosis, a person should have their sleep patterns studied. This usually involves overnight monitoring. If you have sleep apnea, your doctor may recommend the use of a continuous positive airway pressure (CPAP) machine. This is a machine that keeps the airway open so the throat does not completely collapse.

Sleep apnea not only has health risk to the person with the condition. It also makes more dangerous drivers. According to studies of both U.S. and Canadian drivers, patients with sleep disorders were 2.5 times more likely to have automobile accidents. Its estimated that 20-30 percentage of accidents involved tractor-trailers are sleep related.

For those of you who think you or someone you love may have sleep apnea, please consider a sleep study. It may save someone's life.


A guide to appealing denied health insurance claims

The Oregon Department of Consumer and Business Services has a new online tool which will help consumers understand how to appeal a denied health insurance claim.

The Oregon Department of Consumer and Business Services has a new online tool which will help consumers understand how to appeal a denied health insurance claim.

The department says that only a small number of Oregonians actually file appeals, but that 44% of those who file them succeed in getting the denial overturned.

"Consumers should know that they often benefit by asking their company to take another look at their claim," Insurance Division Administrator Teresa Miller said.

"Often, additional information is needed to clarify whether something is covered under an insurance policy or is medically necessary or to correct an error in paperwork."

In addition to the online tool, the department also has consumer advocates available to answer questions and help consumers. They can be reached at 888-877-4894.

Check out the Consumer Guide to Health Insurance Appeals here.


October 29: National Prescription Take Back Day

Unused medicines present a threat to households, and to the environment.

This Saturday, October 29, is National Prescription Take Back Day.

The US Drug Enforcement Agency (DEA) is sponsoring this day nationwide, which will allow consumers to safely dispose of their prescriptions nationwide.

The state of Oregon will have over forty locations statewide that will take prescriptions, no questions asked.

Unused medicines present a threat to households, and to the environment. They are dangerous to households with children or pets who may ingest them, and because they degrade over time, they are not safe for adults to take, either.

Medicines that are improperly disposed of when consumers throw them in the trash or flush them down the toilet become an environmental concern and end up in community drinking water supplies or harm wildlife. Organizations such as The Sierra Club are concerned about "the stew effect," which occurs when medications mix in the water system, causing unknown effects in our environment.

While the Food and Drug Administration provides a tip sheet (pdf) for disposing of medications, one of the best ways to get rid of them is to drop them off at a collection location this Saturday, October 29, from 10am to 2pm. You can check out the DEA's site for more information.


Health Insurance enrollment open to children year-round beginning August 1

Insurance eligibility has changed for Oregon's kids.

Starting August 1, 2011, Oregon's children can be enrolled in health insurance anytime during the calendar year. This is a change from recent insurance company enrollment rules that only allowed for new sign ups during February and August.

A new law passed by the 2011 Oregon Legislature required that insurance companies lift the restriction of specific months. Federal law last year prohibited insurance companies from denying coverage to children due to health conditions.

In response to that law, insurance companies restricted enrollment of individuals under the age of 19 as much as possible, fearing lowered profits and rising costs to the insurance companies. This year, the Oregon Legislature passed a new law which requires insurance companies to make enrollment services open to children year-round.

The Oregon Insurance Division has issued a factsheet advising parents who would like to enroll their children in new health insurance. In addition to facts for all parents, the press release points out that children in limited-income families have coverage options:

"In Oregon, children have additional coverage options through the Healthy Kids program -- and these options are also available year-round. For more information or to request an application, visit www.OregonHealthyKids.gov or call 1-877-314-5678."

Read More

Health Reform: Coverage for kids gets easier. The Oregonian, 08/02/11
Year-Round children's enrollment starts August 1. Oregon Insurance Division, 08/11/11


Health Insurance for Oregon's Kids

Insurance eligibility has changed for Oregon's kids.

As of September 23 this year, insurance companies are no longer allowed to deny health coverage to children under age 19 who have pre-existing health conditions. In order to implement this rule, the Oregon Department of Consumer and Business Services set an "open enrollment" window for enrolling children that will close on December 31.

This one-time open enrollment means that parents of uninsured children should be using the period until December 31 to apply for insurance. Since group health plans are prohibited from denying coverage to anyone on pre-existing conditions, this rule mostly applies to children who are independently insured by parents.

After this, children who need insurance can be enrolled in February and August of each year, beginning in February 2011.

In Oregon, chldren also have coverage options through the state-sponsored Healthy Kids program which provides free or low-cost health care coverage to children who don't have health insurance. In January 2010, a final funding piece for Healthy Kids kicked in which allowed an additional 15,000 children to be enrolled in low-cost insurance. The program is funded through a 1 percent tax on health insurance premiums.

Further Reading:

Oregon's Healthy Kids insurance program expands coverage to more children. The Oregonian, 02/05/10.
Oregon kids assured health insurance. KTVZ, 11/1/10.


Hospital Acquired Infections Cost Oregonians Millions

IV_Bag_JPEG.51161840Healthcare acquired infections cost Oregonians upwards of $15 million per year according to report released this week by The Office for Oregon Health Policy and Research. Healthcare acquired infections (HAIs) are defined as infections that occur during or after treatment for a separate medical condition. And in the United States alone, 1.7 to 2 million are infected with a HAI and at least 100,000 people die from these preventable infections each year.

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How To Be a Smart Medical Consumer

Doctor Visit; Smart PatientAll patients, regardless of their means or health challenges, should expect to be treated respectfully and without discrimination by their providers, practitioners and payers. With the recent passing of the Patient Protection and Affordable Care Act it now illegal for insurers to refuse children coverage based on preexisting conditions. Beginning in 2014, this will apply to all Americans and not just children.

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How To Get "Massively" Safer Results in Surgery

According to the Institute of Medicine, 98,000 people die each year from preventable medical errors. What can we do to prevent these errors? According to Atul Gawande, a surgery professor at Harvard Medical School and a staff writer for the New Yorker, we create a checklist. Pilots and mechanics use checklists and according to Gawande, so should doctors.

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How to choose the right nursing home

Latest news in Patient Safety:

Jul. 18

Oregon fines insurer for denying women's exams

The State of Oregon requires that health insurers pay for breast exams and Pap smears for women, and the MEGA Life and Heatlth Insurance Company has been fined $40,000 for...
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Feb. 25

Choosing the right nursing home

Do you have a loved one who needs nursing home services? In Oregon, you have many protections that will help make the tough transition to assisted living more safe and...
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