A Long Beach dock worker pleaded guilty on Wednesday, Jan. 10, to a federal charge of allowing phony claims to be submitted to his labor union's health plan for the use of prostitutes under the guise of chiropractic services. Cameron Rahm, 39, of Pico Rivera entered his plea to a federal charge of conspiracy to commit healthcare fraud, according to the U.S….

An investigation by the Medicaid Fraud Control Unit in the Colorado Department of Law allegedly found that on or between Aug. 1, 2020, and June 6, 2022, Stephanie Hudgins, 50, Quinetta Hunter, 40, and Bobby Hunter, 68, filed claims and received Medicaid reimbursement for home care services that did not occur. Hudgins and Bobby Hunter, according to the AG's office,…

Seeing a system in need of change is why Billittier is excited with the growth Independent Health has seen with its Care for You program, which launched in late 2021 and brings health care directly into the home of the health plan's Medicare Advantage members with chronically complex medical conditions. Billittier, chief medical officer of Independent…

He takes insulin, the cost of which will be capped at $35 per month for Medicare recipients by the Inflation Reduction Act. He spoke before numerous television, radio and print reporters at Rutland Pharmacy on Monday, alongside newly elected U.S. Sen. Peter Welch, D- Vt., and Xavier Becerra, secretary of the Department of Health and Human Services, who were there to tout…

Michael Ligotti, who owned a medical clinic in Delray Beach that profited from the scheme, was sentenced Monday to a maximum sentence of 20 years in prison in Miami federal court by U.S. Ligotti, 48, must turn himself into prison authorities in June, but he still faces a restitution hearing to determine how much money the physician must repay Blue Cross/ Blue Shield,…

A newly formed company made up of eight Medicaid providers requested the Oklahoma Supreme Court compel the Oklahoma Health Care Authority to alter and reissue its request for proposals to award multibillion-dollar contracts for companies to oversee care for many of the state's Medicaid recipients. "As written, the RFP makes it impossible for any Oklahoma-…

For Medicare Part D enrollees, annual out-of-pocket spending on insulin increased 76% per user between 2007 and 2020, according to the Kaiser Family Foundation, or KFF. The American Diabetes Association found that of the 8.4 million Americans who rely on insulin, 1 in 4 reports using less than what is prescribed because of the cost. Help arrived on Jan. 1 with a…

More people have signed up for a health plan under the Affordable Care Act in 2022 according to the Centers for Medicare and Medicaid Services. "There has been a higher traffic, more folks are coming in," said Mark Arnam, director of the North Carolina Navigator Consortium. "North Carolina has always been one of the most successful states in the country when it comes…

Members of Mayor Adams’ administration faced jeers and hours of critical questioning during a Monday City Council hearing on his controversial attempt to make retired municipal workers pay for some forms of health insurance. Courts have for over a year blocked the administration from implementing the plan due to a provision that would slap $191 monthly…

At Tazewell Community Hospital in Southwest Virginia, the insurance company Aetna will pay $13,000 to perform a lifesaving procedure to break the clots in a lung, allowing the patient to stabilize and breathe again. The difference, $11,000, is the result of the larger hospital's ability to negotiate better prices with insurers, like Aetna, Anthem and United,…

Lawmakers are again set to consider whether this is the year for legislative action on medical marijuana, Medicaid expansion, legislation dealing with the state's water crisis and changes to Kansas' election laws. Heading into 2023, despite years of progress, the question of whether Kansas will finally legalize medical marijuana remains an open one.

Medicaid expansion is a popular policy among voters, in Kansas and across the country. More than 7 in 10 Kansas voters support expanding Medicaid eligibility, according to a survey from Fort Hays State University. Laura Kelly to see it passed, Kansas remains among a dwindling few states that have not adopted Medicaid expansion, leaving around 150,000 Kansans…

Included in the big omnibus budget and legislative package that Congress passed on Dec. 23 was a provision that ends a COVID-era emergency rule that protected Medicaid enrollees. While Congress did not mandate an end to the overall COVID public health emergency, they did mandate the end of the emergency Medicaid continuous eligibility provision that has…

Tennessee has the opportunity to access a Federal government program, which provides 90% of the cost, to cover these 350,000 Tennesseans, through expanding Medicaid. Sixty-two percent of the state's citizens are in favor of Tennessee accepting the Federal funds and expanding Medicaid. Do you know that Tennessee ranks first in the nation with the closure of…

Chip Roy, a Texas Republican and member of the so-called far-right Freedom Caucus told Tapper, was a promise to not raise the debt ceiling without first coming up with a way to reduce spending. According to Roy, his party has no intention of touching“ the benefits "going to those on Medicare or Social Security,“ but we all have to be honest about sitting at the table and…

In a significant course change, the California Department of Health Care Services announced that it has negotiated with five commercial health plans to provide Medi-Cal services in 2024, scratching a two-year-long bidding process for the coveted state contracts. It means more Medi-Cal enrollees will likely get to keep their current insurer and doctors,…

HARRISBURG– Acting Insurance Commissioner Michael Humphreys on Wednesday announced the results from a comprehensive Affordable Care Act market conduct examination that the Pennsylvania Insurance Department conducted on the practices and procedures of Capital Blue Cross. "Capital Blue Cross has been cooperative in its response to the exam, and we…

Since February 2020, enrollment in Medicaid and the Children's Health Insurance Program has gone up almost 30% nationally. Meanwhile, the number of uninsured kids in Georgia has gone down significantly since the pandemic, largely due continuous coverage under PeachCare for Kids, Georgia's state CHIP program. But public health agencies are expecting an end…