News for Insurers
Top stories summarized by our editors
2/20/2018

More than 50% of parents didn't receive guidance from health care providers on when their children should begin receiving dental care, according to a national poll by the University of Michigan's C.S. Mott Children's Hospital of 790 parents of youths ages 5 and younger. The findings also showed that children's young age was the most common reason cited by parents for delaying a first pediatric dentist visit.

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HealthDay News
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Mott Children's Hospital
2/20/2018

Medicare Part B drug coverage does nothing to encourage competition and "really is a dinosaur," said Pharmaceutical Care Management Association President and CEO Mark Merritt. "There's no encouragement to use less expensive options when there are several equally effective drugs to choose from," Merritt said.

2/20/2018

Novartis is preparing to sell its US generic pills unit and concentrate on complex generic drugs, such as injectables and inhalables, sources say.

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Reuters
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Novartis
2/20/2018

Yury and Rimma Baumblit, operators of flophouses that targeted poor and mentally ill individuals in New York, were ordered to forfeit up to $2.5 million in assets after entering a guilty plea in a Medicaid fraud case. The couple were accused of receiving over $1.5 million in illegal kickbacks from Medicaid-funded providers NRI Group, Canarsie Aware, and Narco Freedom in exchange for forcing their tenants to attend the providers' outpatient drug treatment programs, prosecutors say.

2/20/2018

John Cornachio, a resident of Oyster Bay, N.Y., is facing a maximum 15-year prison term after being convicted of grand larceny for having a "no-show" job that allowed him to collect money from Narco Freedom, a New York City-based Medicaid-funded nonprofit that provides substance abuse treatment services. Prosecutors say Cornachio conspired with Narco Freedom's corrupt officials to fraudulently collect over $500,000 in salary and benefits for more than five years, among other offenses.

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Narco Freedom, Medicaid
2/20/2018

Nakia Palmer, a Social Security office worker from Montgomery, Ala., and her husband, Nathaniel Palmer, are both facing up to 20 years in prison after being convicted of theft of government property and other charges over fraudulently collecting Social Security funds. Authorities say the couple lied about their incomes and living arrangements, allowing them to fraudulently receive $25,000 worth of food stamp and Social Security benefits on behalf of their child.

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USA Today
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Nathaniel Palmer
2/20/2018

Danny Robbins of Cumberland County, Tenn., was ordered to serve one year in prison and four years of supervised probation after entering a guilty plea to TennCare fraud and sale of oxycodone obtained through the program. Robbins admitted to using his TennCare benefits to fraudulently obtain oxycodone and then selling the drugs to undercover police officers in September 2016.

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oxycodone
2/20/2018

The Trump administration has proposed new rules that would make short-term health insurance, with low prices and less coverage, more widely available. Proponents say the move will allow for greater choice and affordability in the market, but critics say it will destabilize insurance markets.

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Politico
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Trump administration
2/19/2018

CDC officials reported 22 additional influenza-related pediatric deaths for the week ending Feb. 10, bringing the season's total to 84, while nearly 68 people per 100,000 had flu-related hospitalizations, up from about 60 per 100,000 the previous week. The CDC said activity remains widespread in 48 states, and 1 in 13 doctor visits involved fever, cough and other flu symptoms, the same level as the week before.

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CDC
2/19/2018

Frank Lazzerini, a physician from Jackson Township, Ohio, was charged with drug trafficking, involuntary manslaughter and other charges in a 272-count indictment on allegations that he operated a pill mill through his practice, Premiere Family Practice. Lazzerini was accused of improperly prescribing strong painkillers, which led to the deaths of two patients, according to prosecutors.

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painkillers