News for Insurers
Top stories summarized by our editors
3/24/2017

After Thursday's planned vote on the American Health Care Act was delayed, President Donald Trump told House Republicans they must vote on and support the measure today, or he will move on to other policy priorities. The Rules Committee is expected to meet this morning to determine terms for debate, with a vote planned for afternoon.

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President Donald Trump
3/24/2017

Changes made to the American Health Care Act earlier this week would reduce the federal deficit by $150 billion between 2017 and 2026, compared with $337 billion that would have been saved under an earlier version, the Congressional Budget Office found. The revised legislation would still add 24 million to the ranks of uninsured by 2026, according to the report.

3/24/2017

Some US hospitals have postponed expansion and investment projects as they await clarity regarding the fate of the Affordable Care Act, particularly concerning the Medicaid expansion population. Denver Health Medical Center has deferred $73.7 million in projects for low-income residents, while the University of Alabama at Birmingham Health System has cut back on hiring of nonclinical staff, reflecting a national slowdown in hospital hiring.

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Reuters
3/24/2017

SmartBox Web Marketing began an unlimited time off policy to help meet millennial employees' expectations of a good work-life balance. Company founder Colin Receveur said the company created rules, covering issues such as advance notice, to guide the policy.

3/24/2017

A Financial Finesse report found employee financial wellness scores improved last year and credited the increase partly to more repeat usage of financial wellness programs. Survey data showed 38% of repeat users were financially on track for retirement, compared with 23% of new users.

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PlanSponsor.com
3/24/2017

Pfizer CEO Ian Read said national health systems in Europe are taking advantage of innovative drugs developed by US pharmaceutical companies, a contrast with President Donald Trump's past statements that foreign countries get better deals than the US and that Medicare and Medicaid should be able to negotiate drug prices.

3/24/2017

Roberto Fernandez, a Miami-based physician, was indicted on charges including health care fraud and conspiracy to defraud the United States and pay and receive health care bribes and kickbacks. Fernandez, owner and operator of Latin Foundation for Health, allegedly accepted kickbacks in exchange for referring Medicare and Medicaid patients to a Medicare Part D pharmacy, illegally distributed controlled medications and falsely billed Medicare for unnecessary services, resulting in a total of about $24.4 million worth of improper Medicare payments, the indictment says.

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Medicare, Roberto Fernandez
3/24/2017

Donald Willems, a physician based in Florida, pleaded guilty Thursday to charges of conspiracy to commit health care fraud over his role in a sober home fraud scheme operated by Kenneth Chatman. Willems, who served as medical director for Chatman's Reflections Treatment Center between October 2015 and May 2016, admitted to signing off on drug monitoring and allergy tests that were actually ordered by Chatman, according to the plea.

3/24/2017

A North Carolina-based underwear business faces allegations of defrauding the state Medicaid program. A Perfect Fit for You is accused of submitting claims for services and products without proper documentation, and received over $12 million in improper Medicaid payments as a result, authorities say.

3/24/2017

Fred Gott, a cardiologist from Bowling Green, Ky., is scheduled to appear in court for jury trial on Sept. 6. Gott faces a 50-count indictment on charges including health care fraud resulting in death and unlawful distribution and dispensing of controlled substances on allegations of improper and unnecessary distribution of fentanyl and methadone, which resulted in two patient deaths.

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Fred Gott, fentanyl