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Federal prosecutors say plaintiffs attorney Stephen L. Snyder“ did exactly what” disgraced lawyer Michael Avenatti did when Snyder sought a $25 million payout from the University of Maryland Medical System to keep problems with the hospital’ s transplant program quiet. “His reliance on the Michael Avenatti case is telling, as Avenatti recently received a…

According to KBIA radio, the Family Support Division of the state Department of Social Service has already received more than 4,000 applications. These applications are presumed to be just sitting there, as an Aug. 11 video meant for staff shows Kim Evans, director of the Family Support Division, saying that while people can start applying now, staff would not be…

State regulators say the cost will rise in the coming year for many Marylanders who buy their own health insurance, largely a result of the ongoing coronavirus pandemic. The rates approved Friday are only for those who buy plans through the state’ s health exchange or directly from a carrier under the program created by the Affordable Care Act.
Former NFL ran a health insurance fraud scheme, authorities say.

A Florida man pleaded guilty yesterday in the Southern District of Florida for his role in a $73 million conspiracy to defraud Medicare by paying kickbacks to a telemedicine company to arrange for doctors to authorize medically unnecessary genetic testing.

The lawsuit, brought under whistleblower provisions of the False Claims Act against Sacramento- based Sutter Health and several affiliated medical foundations, alleged the company violated the act while handling information about Medicare beneficiaries, who would enroll in managed health-care insurance plans. “The government alleged that Sutter…

OKLAHOMA CITY- Home health care services are a valuable Medicare benefit that provides a wide variety of part-time or intermittent in-home skilled nursing care, therapy and other aid to beneficiaries in need, if they meet Medicare's criteria. In order to secure coverage for home health care, Medicare first requires that you're homebound.

Aug. 29— State officials believe at least 30,000 people in New Hampshire are getting health insurance under the federal Medicaid program even though they no longer qualify for it. For New Hampshire, the extra money will total $350 million over 24 months through the end of 2021.. Councilor Cinde Warmington, D- Concord, wanted to know why the state wants to pay Maximus…

As the oldest child, then the mother of two and grandmother of seven, Susan Marsh has always been the rock for others. And because Marsh lives in Georgia, one of 12 states that have refused to expand a less-than-generous Medicaid program, she and an estimated 678,000 residents fall into a coverage gap that leaves them with no relief from hefty medical bills.
Some companies are beginning to add surcharges to employees who decline vaccination.

An announcement Wednesday by Atlanta-based Delta Air Lines that it will charge a monthly surcharge for employees who have not been vaccinated against COVID-19 may be a harbinger of things to come.
Colorado lawmakers are trying to shore up health care with a public option.

The Colorado insurance department is meeting with insurance companies and others on Thursday to discuss the details of and concerns about the state’s new public option law. Momentum has meanwhile stalled at the state and federal level.

Delta Air Lines said Wednesday it will impose a $200 monthly surcharge in its health plan to employees who haven't been vaccinated against COVID-19. Following the U.S. Food and Drug Administration's full approval of the Pfizer COVID vaccine this week, the Atlanta- based airline is now taking a more hardline approach to vaccinations among its employees.
Lawmakers are looking at creative ways to pass Medicaid expansion in resistant states.

After more than a decade of seeing Republicans block Medicaid expansion, congressional Democrats have hit upon an idea to use the budget reconciliation process to expand Medicaid by working directly with cities and counties.

Tony Evers announced on Tuesday that he will use $250 million of the state's American Recovery Plan Act funds to establish two new programs to address disparities in health care. The announcement came as the governor visited Racine, stopping at the proposed Julian Thomas Elementary School Health Clinic, 930 Dr. Martin Luther King Jr. Drive.

“These are professions where you have to be trained and certified. Margaret Moore worked 13 years in the Department of Children and Families sexual predator unit until July. When plans for her unit to return to a suite at the Centre of Tallahassee arose, she complained that DCF was creating a workspace that was the “complete antithesis of everything the Centers…

Health insurance companies today can legally charge smokers up to 50 percent more in premiums than non-smokers, based on the simple fact that smokers have made a dangerous lifestyle choice. Monday's full regulatory approval of the Pfizer vaccine strengthens that argument. Alabama, a national hotbed of vaccine obstinance, is completely out of intensive care…

Maryland's health exchange added 200,000 enrollees during the coronavirus emergency, an increase of 12% from pre-pandemic levels, officials said Tuesday. Maryland was among the more than three dozen states that expanded the federal-state health program for low-income residents. “We are pleased that so many Marylanders were able to enroll in affordable…

2021 AUG 24– By a News Reporter-Staff News Editor at Insurance Daily News– TROY, N.Y.- When public health insurance like Medicaid expands its dental coverage, by increasing the types of procedures it covers and the total amount a dentist can spend on an individual patient, more dentists will locate to the expansion areas, therefore increasing access.

The Food and Drug Administration is pushing to approve Pfizer-BioNTech's two-dose COVID-19 vaccine on Monday, further expediting an earlier timeline for licensing the shot, according to people familiar with the agency's planning. Regulators were working to finish the process by Friday but were still working through a substantial amount of paperwork and…

Blue Cross and Blue Shield of N.C. said Friday it has received approval of an average 2.8% rate increase for individual federal health insurance plans. Blue Cross projects that its plans will cover more than 475,000 North Carolinians in 2022.. For example, for the 2021 plan year, Blue Cross said there would be an overall 1% rate decline statewide, but an average…
A South Carolina shooting is tied to $10 million in life insurance proceeds.

WSU’s lawsuit against Factory Mutual, originally filed in July, has been moved to federal court in Spokane. Factory Mutual, operating under the trade name FM Global and based in Rhode Island, requested that the lawsuit be heard in federal court.

–With confirmed cases of COVID-19 on the rise in the United States, Cigna has established new requirements to help protect its workforce. Employees who work remotely must be fully vaccinated before entering any U.S. worksite, beginning September 7. Steve Miller, Chief Clinical Officer of Cigna Corporation.

Ron DeSantis and GOP Florida lawmakers by expanding Medicaid in Florida, perhaps by working directly with counties and cities. More: Ted Deutch, new HHS chief tout stimulus, call on Florida to expand Medicaid. More: Florida Democrats hail Supreme Court Obamacare ruling that deals GOP defeat.

“Structural racism and discrimination impact health outcome and healthcare systems in the United States,” said Dieleman, an associate professor of health metric sciences at the University of Washington in Seattle. Black and Hispanic people in the United States are believed to be at higher risk for severe infection compared to White people, but have reduced…
Rhode Island regulators will decide how much health insurers can raise rates.

Rhode Island Attorney General Peter Neronha has filed objections to rate increases sought by Blue Cross Blue Shield of Rhode Island, Neighborhood Health Plan and other insurers that offer polices to state residents.

Aug. 16— Thousands of San Luis Obispo County residents will retain access to their current doctors, after Anthem Blue Cross and Dignity Health announced they have reached a new contract agreement Monday. “We are pleased to continue working with Dignity,” John Pickett, Anthem Blue Cross regional vice president of provider solutions, said in a news release.

Debt obligations of publicly traded U.S. health insurers more than quadrupled over the last decade, to $138.3 billion in 2020 from $32.7 billion in a 2011, according to a new AM Best special report. The Best’ s Special Report, titled,“ U.S. Publicly Traded Health Insurers Take on Debt to Support M&A Strategy,” states that the aggregate increase in debt obligations was…
Insurance brokers are prepared to offer more benefits' options.

The COVID-19 pandemic forced agencies and companies alike to reassess employee benefits. As employers continue to face a hiring shortage, attracting talent will almost certainly be contingent upon being able to offer employee benefits that cover a full spectrum of needs.
Former NFL ran a health insurance fraud scheme, authorities say.

Two women allegedly conspired to enter the names of licensed medical practitioners into billing information for Medicare claims without the practitioners’ knowledge, the U.S. Attorney’s office said.

Aug. 15— A COVID-19 patient who suffered a 141- day stay at a local Asante hospital generated a $3 million bill. She said the patient's insurance covered $500,000 of the bill, and Asante absorbed the rest. For now, patients in the Rogue Valley aren't being charged by Asante or Providence hospitals for the cost of their medical care.

Despite record hospitalizations, Florida isn’ t under a state of emergency as the highly transmissible delta variant sends cases soaring, frustrating one Central Florida emergency manager’ s response and tying the hands of other local leaders confronting the new pandemic challenge. The Department of Health had a team of contractors who wanted to set up a…

Aug. 14— WASHINGTON, D.C.— Officials from Ohio offered differing opinions on the decision by the Centers for Medicare and Medicaid Services, a part of the President Joe Biden's administration for ending a policy approved by the Donald Trump's administration that placed work requirements on Medicaid recipients. Sherrod Brown, D- Ohio, praised the decision, which…
Lawmakers are looking at creative ways to pass Medicaid expansion in resistant states.

The New York State Department of Financial Services reduced health insurers’ 2022 requested rates to a 3.7% hike, despite health care costs increasing to pre-pandemic levels.
Gov. Mike DeWine called the decision by the Biden administration "disappointing."

Two years ago, the U.S. Centers for Medicare and Medicaid Services under the Trump administration approved Ohio’s request to make the changes, which hadn’t been implemented due to the ongoing pandemic.

Nearly two years after seeking bankruptcy protection, the company is scheduled to appear before a U.S. Bankruptcy Court judge to ask for approval of its plan to reorganize into a new entity no longer controlled by members of the wealthy Sackler family, and with profits dedicated to abating the opioid crisis. Ed Neiger, a lawyer representing individual victims…

A group of residents from western North Carolina filed a lawsuit Tuesday, Aug. 10, against HCA Healthcare and Mission Health alleging the anti-competitive business practices have driven medical prices up and the quality of health care down in that part of the state. The group bought the non-profit Mission Health in 2019 for $1.5 billion, a deal approved by N.C.

Missouri cannot deny or restrict those newly eligible for Medicaid benefits, a trial court judge ruled Tuesday, requiring the state to expand its low-income health care program to include roughly 275,000 additional Missourians. Cole County Circuit Judge Jon Beetem sided with three women suing the state and their attorneys, following the orders of a state…

“We're investing California's historic surplus to accomplish transformative changes we've long dreamed of– including this historic Medi-Cal expansion to ensure thousands of older undocumented Californians, many of whom have been serving on the front lines of the pandemic, can access critical health care services,” Newsom said. He added that it would “bring…
Former NFL ran a health insurance fraud scheme, authorities say.

California regulators have charged two people with 36 felony counts of insurance fraud and grand theft for collecting long-term health care benefits allegedly as a result of fraudulent claims.
Jonathan Adam Schlue of Davenport, Iowa and Whitney Michelle Roth of Clinton, Iowa.

Insurance producers Jonathan Adam Schlue of Davenport, Iowa and Whitney Michelle Roth of Clinton, Iowa, were recently sentenced in Scott County District Court after pleading guilty to their parts in a healthcare insurance fraud scheme.

The seven-day average for new daily COVID-19 infections has surpassed 100,000 in the U.S., returning to levels not seen since the winter surge. Florida, Louisiana and Mississippi have had hospitals overrun with patients. The U.S. first crossed the 100,000 average number in November and peaked at about 250,000 in early January before bottoming out in late June.

Both Schlue and Roth are required to pay a civil penalty of $750, and Schlue is also required to pay $2,250 in restitution. Schlue pleaded guilty in July to one count of Insurance Fraud, one count of Conspiracy to Commit Non-forcible Felony and one count of Fraudulent Sales Practices under $10,000, all class D felonies. Roth pleaded guilty in May to one count each of…

Heyward Donigan became Rite Aid’ s CEO months before the coronavirus pandemic brought some big changes to how drugstores operate. Like its rivals, Rite Aid started offering same-day prescription deliveries. The company also partnered with Instacart and DoorDash to deliver other products.

“Dignity Health has offered Anthem a proposal with rates that do not even cover hospital inflation costs and are below increases in prior agreements.” Anthem sent a letter to policyholders last week stating the current contract expired July 15. Anthem on its website is directing policyholders to find alternative in-network facilities.

Newsom made the announcement while signing Assembly Bill 133 during a visit to the Clinica Sierra Vista Elm Community Health Center in south Fresno, which serves a large number of undocumented workers. The expansion comes after the state expanded Medi-Cal, the state's version of Medicaid, to undocumented children in 2016 and young adults up to the age of 26 in…

Moving with uncharacteristic speed, the high court overruled Cole County Circuit Judge Jon Beetem's decision that upended the long-running push to add as many as 275,000 low-income Missourians to the government-run health insurance program. “The Supreme Court has now spoken and decided that our clients are eligible for coverage,” said attorney Chuck…

A Mississippi pharmacist pleaded guilty today for his role in a multimillion-dollar scheme to defraud TRICARE and private insurance companies by paying kickbacks to distributors for the referral of medically unnecessary compounded prescription medications that were ultimately dispensed by his pharmacies. A federal district court judge will…

On June 17 the Affordable Care Act survived a third attempt to eliminate it via the Supreme Court. If that mood holds, what's next for healthcare in the United States, and what values should guide what comes next? According to the Department of Health and Human Services, as of June 2021, “31 million Americans now have coverage through the Affordable Care Act.”

Michigan health insurers are seeking bigger rate increases next year from some employers and individuals as health care spending returns to “normal” after the worst of the COVID-19 pandemic. Now that the pandemic has eased, Michigan health insurers are seeing patients return to clinics and hospitals. More: Some fear new Michigan no-fault auto insurance rule…

Jul. 20— The state program that provides insurance for health insurers was renewed for one year by Minnesota legislators, and some lawmakers worry that's not enough to keep premiums down in coming years. Tama Theis in a July 1 newsletter, just after the budget became law. Dan Wolgamott in a text message to the St. Cloud Times. “