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29 Jun 2015, 9:00 am by Mindi M. Johnson
An Exchange serves as a marketplace where individuals can compare various health insurance plans and ultimately purchase health insurance coverage. [read post]
Authorities Uncover $20 Million Health Care Scheme in California Federal authorities arrested five individuals connected to San Fernando Valley clinics and a significant health care fraud scheme. On May 22, a federal grand jury indictment was unsealed. The indictment alleges that the five individuals engaged in a health care fraud conspiracy over multiple years and targeted at least eight health insurance companies and the International Longshore and Warehouse Union, the Pacific Maritime Association Benefit Plan, and the Federal Employees Health Benefits Program. The Conspirators According to the Department of Justice (DOJ) press release, the co-conspirators included: Roshanak “Roxanne” or “Roxy” Khadem, 50: Khadem owned and operated two clinics, R&R Med Spa and Nu-Me Aesthetic and Anti-Aging Center. Dr. Roberto Mariano, 59: Mariano helped operate the clinics. Marina Sarkisyan, 49: Sarkisyan was a clinic office manager. Lucine Ilangezyan, 38: Ilangezyan was an insurance biller for the clinics. Gary Jizmejian, 44: Jizmejian was previously a senior investigator at the Anthem Special Investigations Unit, the insurer’s anti-fraud unit. The Allegations The indictment alleges that the co-conspirators induced patients to visit the clinics for free cosmetic procedures, such as Botox injections, facials, and laser hair removal. These procedures were not covered by insurance. The co-conspirators would gain the patients’ insurance information and bill their insurers for medical services that were unnecessary or never provided. The defendants then used some of the illegally obtained proceeds to calculate a “credit” the patients could use for discounted or free cosmetic procedures. The defendants submitted at least $20 million in insurance claims and were paid approximately $8 million. The indictment also states that Jizmejian, for cash payments, would provide Khadem and others with confidential Anthem information. This information helped the defendants submit fr
30 May 2018, 5:43 am by Gregory J. Brod
The indictment alleges that the five individuals engaged in a health care fraud conspiracy over multiple years and targeted at least eight health insurance companies and the International Longshore and Warehouse Union, the Pacific Maritime Association Benefit Plan, and the Federal Employees Health Benefits Program. [read post]
13 Jun 2012, 6:42 am
Arbitration award granting relief to both active employees and retired employees confirmed Matter of City of Buffalo (Buffalo Professional Firefighters Assn., IAFF Local 282), 2012 NY Slip Op 04527, Appellate Division, Fourth Department The City of Buffalo modified the health insurance plan provided to members of in several negotiating units. [read post]
29 Apr 2024, 10:00 pm by Sherica Celine
Implementing a Healthcare Compliance Plan Advise your healthcare clients to adopt a compliance plan—or, more likely, review and assess their existing plans. [read post]
27 Jun 2013, 12:35 pm
WellCare Health Plans, Inc. is a publicly owned health care company that offers Medicaid and Medicare managed health care plans for more than its 2 million participants. [read post]
30 Jun 2023, 2:02 am by Michelle Cassorla, Davis Malm
Health Coverage Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), most employees are entitled to elect to continue participation in employer-sponsored health insurance plans for up to 18 months at their own expense. [read post]
7 Sep 2012, 8:17 am by admin
Let’s take a closer look at each component: “Essential” Base Coverage Requirement In order to satisfy the minimum essential coverage requirement, individuals will have to enroll in or otherwise pay for a plan such as Medicare or Medicaid, an employer sponsored health plan, an individual market plan, some sort of a grandfathered plan or some other coverage – where state health insurance exchanges are expected to play a role… [read post]
9 May 2021, 3:57 pm by Sabrina I. Pacifici
The Rockefeller Foundation: Arizona State University Survey of Employers Shows Companies Doubling Down on Covid-19 Testing and Support Vaccinations to Achieve a Post-Pandemic Workplace – “A comprehensive business survey, conducted by Arizona State University’s College of Health Solutions with support from The Rockefeller Foundation, finds that nearly 9 out of 10 employers in the United States and UK plan to encourage or require vaccination for… [read post]
6 Jul 2011, 12:17 pm by Administrator
In that opinion, the DOL found that a health benefit plan established by the Pennsylvania Division, Horsemen’s Benevolent & Protective Association Inc. to provide benefits to individuals associated with thoroughbread racing at Pennsylvania National Turf Club was not an employee welfare benefit plan within the meaning of ERISA section 3(1). [read post]
27 Oct 2014, 11:46 am by John L. Litchfield
Depending on employees’ risk of exposure to EVD based on their industry, OSHA may require development of a plan (typically called an “OSHA Response Plan”) with specific procedures to protect employees against infection. [read post]
9 Apr 2012, 9:54 am by Gretchen Harders
  These include, by way of example, the requirement that employers provide group health plan coverage at a certain level of coverage or pay a penalty (the “employer responsibility penalties”), requirements that annual limitations under group health plans generally are prohibited, as well as the requirement for large employers to automatically enroll full-time employees in their group heath plans. [read post]
19 Oct 2016, 9:32 am by Holland & Hart
After all, the major tenet behind the FMLA is to permit employees to take job-protected time off when serious health or family concerns arise. [read post]
12 Mar 2014, 9:22 am by Marty Lederman
  The singular exception is that HHS has exempted churches and their auxiliaries from the requirement to include contraception if they offer an employee health insurance plan. [read post]
27 Mar 2013, 4:18 am by Cynthia Marcotte Stamer
If you find this of interest, you also be interested reviewing some of our other Solutions Law Press resources available at www.solutionslawpress.com including: Test Your Health Care Reform Knowledge On 3rd Anniversary of Reform Passage Insured “Expatriate Plans” Get Temporary Reprieve From Affordable Care Act Compliance Thru 2015 If Meet Other Health Plan Mandates Insured “Expatriate Plans” Get Temporary Reprieve… [read post]
29 Apr 2022, 7:50 am by Written on behalf of Peter McSherry
There is no legal cap on damages, however the laws around damages are different than in the United States. [read post]
29 Apr 2022, 7:50 am by Written on behalf of Peter McSherry
There is no legal cap on damages, however the laws around damages are different than in the United States. [read post]
18 Apr 2018, 6:55 pm by Yetunde Oni and Jennifer Pike
On April 17, 2018, FDA announced its plan to launch the Medical Device Safety Action Plan: Protecting Patients, Promoting Public Health (Action Plan), which aims to support and advance innovation in medical devices while also assuring the safety of the devices throughout their Total Product Life Cycle (TPLC). [read post]
3 Apr 2024, 11:32 am by Christie Lindor, Tessi Consulting
Election Results Could Affect Hiring, Work Engagement, and DEI The stakes are high for U.S. employees, as their well-being and mental health are on the line. [read post]