News for Insurers
Top stories summarized by our editors
8/16/2018

An app called Toothpic allows users to take photographs of their mouth using a smartphone and send the photos to one of 300 participating dentists for a basic assessment. The price of a consultation is $39, but the service is being offered to Florida residents for free for the next few months.

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Florida
8/16/2018

Floss Bar offers dental cleanings, exams and whitening at workplaces in New York City, Boston and Connecticut including WeWork, General Electric and Lego, and plans to expand to California and Texas next year. The startup accepts most dental insurance plans, and employers may see it as a way to attract and retain employees.

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Inc. online
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Floss Bar
8/16/2018

Two studies presented at an International Association for Dental Research meeting found significant correlations between poor periodontal health and chronic kidney disease. Periodontal inflammation was associated with impaired kidney function, and low clinical attachment levels were linked to future kidney function decline.

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kidney disease
8/16/2018

Value-based care encourages medical professionals to prioritize outcomes and efficiency with preventative health care, but the strategy can be difficult to incentivize for health professionals. Analytics could help solve this problem by collecting patient data, indicating where there are gaps in the patient's care and creating priority and outreach lists, says Jennifer Carney of Beth Israel Deacons Care Organization.

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InformationWeek
8/16/2018

A Fidelity survey found 14% of sponsors this year said the main reason for working with an adviser was fiduciary compliance, compared with 4 in 10 sponsors in 2017 who said the top reason was to help meet statutory fiduciary obligations under the Employee Retirement Income Security Act. With the Labor Department's fiduciary rule no longer in the mix, the top concern among plan sponsors for 2018 was whether their plan was designed to prepare workers for retirement.

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fiduciary, Labor Department
8/16/2018

Fintech startup Genivity is working with financial advisers, brokers and others to help project client life expectancies and long-term health care costs. Genivity collects medical and other data and runs it through an algorithm to produce detailed health projections that can help financial professionals better tailor planning for their clients.

8/16/2018

The US government filed a civil forfeiture complaint against Muhammad Cheema, a licensed doctor from Pittsford, N.Y., who was charged with health care fraud and making false statements relating to health care matters for allegedly submitting inflated claims to private insurers and fraudulent claims to health benefit programs for unprovided psychiatric services. The complaint seeks forfeiture of Cheema's New York residence, two cars and $806,871.91 from three bank accounts, which authorities believe were obtained through fraud and were involved in money laundering.

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Department of Justice
8/16/2018

Pennsylvania-based hospital operator Post Acute Medical and some affiliated entities agreed to pay almost $13.2 million to the US government, Louisiana and Texas to resolve a whistleblower lawsuit accusing them of violating the False Claims Act and defrauding Medicare and Medicaid. Authorities said the company deliberately submitted fraudulent claims to the programs resulting from violations of the Stark Law and the Anti-Kickback Statute.

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Department of Justice
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Stark Law, Medicare, Medicaid
8/16/2018

Leon Little of Cherry Hill, N.J., received a 34-year prison term after being convicted of conspiracy to distribute controlled substances for orchestrating a pill-mill scheme, which distributed 400,000 oxycodone pills in several areas including Philadelphia and Delaware. Authorities said Little recruited at least 55 people to pose as patients to fraudulently obtain prescription drugs from a licensed doctor in Philadelphia, and then he collected and redistributed the drugs to his customers.

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Delaware Business Now
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oxycodone
8/16/2018

Mandie Rollins of Graysville, Tenn., was ordered to serve five years of probation and pay $54,933 in restitution after entering a guilty plea to TennCare fraud and theft of services.

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TennCare