Five people have been sent to federal prison for their roles in a $25 million Medicare fraud scheme that involved people from Nicaragua and the Dominican Republic posing as U.S. patients. One person, 70- year-old Jose Eloy Sanchez, remains at large and is believed to be in Nicaragua. Court records show the scheme involved use of foreign individu
July 05 Five months after the Healthy Indiana Program 2.0 was launched, more than 297,000 Indiana residents have enrolled in the Medicaid expansion program, which is well on its way to providing coverage to an estimated 350,000 Indiana residents. Of the 297,000 signed up so far, 60,000 participants were rolled over from existing Medicaid programs
July 05 ROCHESTER Nurses Jennifer Meindel and Chad Ditlevson stand in front of monitors in a small room at the Mayo Clinic reading vital signs and occasionally calling up video images of patients lying in beds. All of the 40- some patients cycling across the screens are in intensive care in the Mayo Clinic Health System. Daniel Brown, Mayo's ch
By a News Reporter-Staff News Editor at VerticalNews Health& Science Patients rehospitalized with complications after major surgery are 26% more likely to survive if they return to the hospital where they had their operation compared to those readmitted to a different hospital, according to a national study involving over 9 million Medicare patie
Aetna aims to spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul. Aetna's acquisition of Humana would make it the largest provider of Medicare Advantage coverage, with 4.4 million members, a figure that could change depending
Aetna Inc. and Humana Inc. have agreed to join forces. He noted that to approve that purchase, the Department of Justice required divestitures of customer bases in 45 counties in five states, because otherwise, the merger would have resulted in the combined company controlling 40 percent to 100 percent of the market for Medicare Advantage plans.
FIVE RESIDENTS OF MIAMI Dade County and one resident of Nicaragua were sentenced yesterday for their participation in a $25.2 million Medicare, Medicaid, and wire fraud scheme. Erendira V. Delgado, a/k/a Eren Delgado, 31, of Miami, Edgardo Rodriguez, 47, of Nicaragua, Rodney Montoya, 36, of Miami, Deborah Smith, 53, of Hialeah, and Augusti
Tenders are invited for Fully Insured Health Plans for Medicare Eligible Retirees Description: The City of San Antonio, Human Resources Department seeks proposals from organizations qualified to provide or arrange health services for Medicare- eligible retirees and eligible dependents. Pre-Submittal Conference: Friday, July 10, 2015 at 10:00 A.M...
Tenders are invited for Fully Insured Medicare Advantage Plans Purpose: The State of Louisiana, Office of Group Benefits requests proposals from any Louisiana HMO approved by the Centers for Medicare and Medicaid Services to offer a fully insured Medicare Advantage Health Maintenance Organization medical plan with an option to include prescription.
He explained that shifts in Medicare and Medicaid have given private insurance carriers an expanded role in determining medical reimbursement rates for government-funded programs. Illinois has moved to a managed care system for Medicaid and the federal government is promoting Medicare Advantage, which is also a managed care system.
Aetna will spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul. Humana has nearly 3.2 million people enrolled in Medicare Advantage plans, a total that falls just sort of market leader UnitedHealth Group Inc.. Hartford, Conn.-
Aetna will spend $37 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul. Hartford, Conn.- based Aetna announced its deal with Humana a day after the Medicaid coverage provider Centene said it will spend $6.3 billion to buy fellow insurer Heal
Tenders are invited for Medicaid Quality Assurance Anaylst Bid Opening Date: 22/06/2015 Available Date: 06/01/2015 02:15: 00 PM Major organization: MARYLAND STATE DEPARTMENT OF EDUCATION Address: 200 W. Baltimore Street Baltimore, MD 21202 Attn: June Dwyer Country: United States Email: firstname.lastname@example.org Tender notice number: MDR0031021021 Not
July 03 FARMINGTON Sensing a local need by people with medical appointments but no means to get there, a Gallup- based transportation company has opened a satellite office in Farmington. Shim Transport, a Navajo- owned medical transport service in Gallup, opened an office on North Behrend Avenue in May. The medical transportation service was
By a News Reporter-Staff News Editor at Insurance Weekly News Investigators discuss new findings in Medicare and Medicaid. According to news reporting from Philadelphia, Pennsylvania, by VerticalNews journalists, research stated, "Medicare Part B physician payment indicates a cost to Medicare beneficiaries for a physician service and connotes...
Roy G. Heilbron, 51, a cardiologist in Santa Fe, N.M., was arraigned in federal court in Albuquerque, N.M., on a 24- count indictment charging him with health care fraud and wire fraud, announced Damon P. Martinez and Special Agent Carol K.O. Lee of the FBI' s Albuquerque Division. The indictment alleges that Heilbron, a physician licensed to pract
By a News Reporter-Staff News Editor at Insurance Weekly News Patients rehospitalized with complications after major surgery are 26% more likely to survive if they return to the hospital where they had their operation compared to those readmitted to a different hospital, according to a national study involving over 9 million Medicare patients in
According to a release from the company, the Centers for Medicare& Medicaid Services requires each state's new Medicaid application processing platform to be certified to validate that it meets all federal requirements, along with state Medicaid goals and objectives. With the certification, New Hampshire is eligible to receive the maximum amount of
During the session, participants learned the ins and outs of the sustainable growth rate formula repeal and what it means for fee-for-service and alternative payment schemes in Medicare, and how to identify patients who will benefit the most from a little extra care. Medicare has set up a choice going forward: either staying in fee-for-service and
Less than one week after the US supreme court vindicated his healthcare law, Barack Obama embarked on a push calling on recalcitrant states to expand access to Medicaid for low-income Americans. But he lamented that millions of Americans were being deprived of the benefits, criticizing in particular the nearly two dozen, largely Republican-controll
The deal announced Thursday gives St. Louis- based Centene a chance to expand in two hot growth areas for health insurers, the state- and federally-funded Medicaid program for the poor and people with disabilities; and the federally-supported Medicare Advantage program, which has seen its overall enrollment triple over the past decade. Centene said
Medicaid coverage provider Centene will pay about $6.3 billion to buy fellow insurer Health Net, as managed-care companies look to bulk up while adjusting to the federal health care overhaul. Lous-based Centene a chance to grow in two hot areas for health insurers, the state- and federally funded Medicaid program for the poor and people with disabi
ST. LOUIS and LOS ANGELES, July 2, 2015/ PRNewswire/ Centene Corporation and Health Net, Inc. announced that the Boards of Directors of both companies have unanimously approved a definitive agreement under which Centene will acquire all of the shares of Health Net in a cash and stock transaction valued at approximately $6.8 billion, including the
July 02 The state Bureau for Medical Services said it will move forward with expanding coverage under certain Medicaid contracts, which could be subject to a legal challenge claiming the contracts are illegal and void. The decision to move forward follows a state Supreme Court decision that put on hold a Kanawha County judge's ruling that prevent