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Ohioan charged with embezzling $2.9M from insurer

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A former longtime employee of Ohio's biggest health insurance company has been charged in federal court in Cleveland with embezzlement for diverting nearly $3 million in phony payments that he deposited into his own bank account. Reported by Miami Herald 6 hours ago.

Here's the First Released Footage of Better Call Saul

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During a Breaking Bad marathon last night, AMC slipped in a few seconds of the show's upcoming spin-off Better Call Saul, which is set to bow in February. It features Saul Goodman (Bob Odenkirk) making a lame joke comparing lawyers to health insurance. (I think the joke is that Saul makes bad jokes.)

Read more... Reported by Gawker 5 hours ago.

Alabama ranks low for health ROI, but better than other southern states

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Although Alabama has some of the lowest health insurance premium prices in the country, the state's high death rate due to poor health places Alabama among the country's lower third in terms of health-related return on investment. That's according to a study from WalletHub that analyzes 47 states based on their average health insurance premiums, death rates and America's Health Rankings to come up with their health ROI. Alabama came in at 39th. The state ranked highly for its low health insurance… Reported by bizjournals 5 hours ago.

School Leaders Benefit From Gaming The Medicaid System

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By DR. ROGER STARK: The Centralia Chronicle recently reported that the Centralia School District in Washington state submitted false claims to the Medicaid program at least 200 times. What does a school district have to do with Medicaid, a health insurance entitlement for children of poor families? Reported by Forbes.com 5 hours ago.

Health Insurance Innovations beats by $0.04, beats on revenue

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Reported by SeekingAlpha 3 hours ago.

Softheon to Provide Exchange Integration Solution to Transition Health Republic Insurance Company to the FFM

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Softheon to Provide Exchange Integration Solution to Transition Health Republic Insurance Company to the FFM STONY BROOK, N.Y., Aug. 11, 2014 /PRNewswire/ -- Softheon, Inc., a proven leader in health insurance marketplace integration and business operation, announced today that Health Republic Insurance Company (HRIC) has chosen the Marketplace Connector Cloud (MC2) as their software... Reported by PR Newswire 2 hours ago.

Personal Accident and Health Insurance in Brazil, Key Trends and Opportunities to 2018

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LONDON, Aug. 11, 2014 /PRNewswire/ -- Reportbuyer.com has added a new market research report:Personal Accident and Health Insurance in Brazil, Key Trends and Opportunities to... Reported by PR Newswire 2 hours ago.

VIDEO: Saul Makes the Big Sell in New Better Call Saul Teaser

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Not sure if you're going to tune in for AMC's upcoming Breaking Bad spin-off Better Call Saul? In the first teaser for the new series, which premieres in February, Saul makes the big sell on an unseen client and even goes so far as to compare lawyers to... health insurance? Reported by SeattlePI.com 13 minutes ago.

Obamacare At Risk For 310,000 Who Must Provide Proof Of Citizenship, Immigration Status

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President Barack Obama's administration is contacting 310,000 Obamacare enrollees starting Tuesday to warn them that they must verify they are U.S. citizens or legal residents -- or their benefits will be cut off.

In letters being delivered in English and Spanish, the Centers for Medicare and Medicaid Services instructs the enrollees to provide additional documentation regarding their citizenship or immigration status by Sept. 5. Without that documentation, their health insurance plans will be rescinded Sept. 30. The recipients of these letters are people who have not responded to five to seven previous attempts to obtain their documents, according to a press release from the agency.

"We want as many consumers as possible to remain enrolled in marketplace coverage, so we are giving these individuals a last chance to submit their documents before their coverage through the marketplace will end," Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, said in the press release. Discrepancies in an individual's application does not necessarily mean that person is ineligible for coverage, the press release notes.

The 310,000 people being contacted represent only a small fraction of the more than 8 million individuals who have enrolled in private coverage via the Affordable Care Act's health insurance exchanges. Nonetheless, this effort by the administration underscores the challenges left from Obamacare's troubled first open enrollment period, which began last October for benefits that took effect this year.

Since the sign-ups in that six-month period ended, the Department of Health and Human Services has been working to reconcile problems with more than 2 million enrollees, including questions about the income they reported to qualify for subsidies and about their immigration status or citizenship.

Undocumented immigrants are barred from receiving subsidies under the Affordable Care Act or even using their own money to purchase health insurance on the exchanges. Immigrants who are legal residents or have become naturalized citizens can do both.

Initially, there were questions related to the citizenship or legal residency of some 970,000 individuals who applied for Obamacare subsidies, according to the Centers for Medicare and Medicaid Services. To date, the issues with 450,000 applicants have been resolved and another 210,000 are in process, the agency reported. These issues are specific to applications made through the federally run exchanges in 36 states, not the exchanges operated by the states themselves.

The largest number of letters are going to Florida, where 93,800 people haven't replied to prior requests by mail, phone or email, according to the agency. The next two states on the list are Texas, with 52,700 people affected, and Georgia, with 20,900.

Even after the letters are sent, federal authorities will try to make contact with these enrollees three more times before their benefits are canceled, an HHS official said on condition of anonymity. To help people document their eligibility for benefits, the federal government also is enlisting the aid of community-based organizations that provided application assistance during the enrollment period, Tavenner said in the press release.
*Where Are The Obamacare Warning Letters Going?*

Source: Centers for Medicare and Medicaid Services*Read the letter sent to Obamacare enrollees who have not adequately documented their citizenship or immigration status.*
Act by September 5, 2014 or Your Marketplace Health Insurance May EndLetter Reported by Huffington Post 5 hours ago.

NAHU Offers Total HIPAA Compliance‘s Online HIPAA Privacy and Security Training 2.0 as a Certification Course

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NAHU adopts Total HIPAA Compliance's HIPAA Privacy and Security Training 2.0 Certification. Agents who complete the training earn 3 CEs.

Washington, DC (PRWEB) August 12, 2014

The National Association of Health Underwriters (NAHU) announces the inclusion of Total HIPAA Compliance’s (http://www.totalHIPAA.com) HIPAA Privacy and Security Training 2.0 Certification in the NAHU Online Learning Institute http://bit.ly/1kXj2EZ. Completion of the training will earn agents and brokers three (3) CEs. This is comprehensive online training for HIPAA compliance is part of the requirements by Health and Human Services (HHS) for agents and brokers who sell health, dental, vision or long-term care insurance.

“Health and Human Services is actively auditing healthcare providers and business associates (insurance agents). They are levying major fines in excess of $1 M for non-compliance with HIPAA. Total HIPAA’s training can help prepare agents so HIPAA violations are less likely,” commented Jan Karn, President of Total HIPAA.

This comprehensive HIPAA training covers both privacy and security. The training modules are customized to the requirements of agents with scenarios highlighting common HIPAA pitfalls, how to avoid them and triage recommendations when needed.

Host David C. Smith, a nationally recognized HIPAA and benefits expert, hosts a video tour of a typical agency and discusses HIPAA requirements as they apply to each position in the company. In addition to HIPAA, the training materials include guidance on Gramm-Leach-Bliley and Personally Identifiable Information (PII) as defined in the State and Federally Facilitated Marketplace.

“We are pleased to include Total HIPAA’s HIPAA Privacy and Security Training 2.0 in our continuing education portfolio. Our members will be able to benefit from this comprehensive training and prepare our members so that they will know how to avoid HIPAA violations and meet the requirements of the law,” commented Farren Baer, Vice President of Education, NAHU.

ABOUT TOTAL HIPAA COMPLIANCE
Total HIPAA Compliance (THC) prepares health insurance agents, HR professionals, Privacy and Security Officers, healthcare professionals and subcontractors of business associates at both the leader and workforce level to meet federally mandated HIPAA Omnibus compliance regulations. THC provides both training and compliance documents. With more than 100 years of combined regulatory, educational, professional management and health care experience, our staff prepares and delivers educational products and communications training in a variety of media that best meets the needs of individual learners. - See more at: http://www.totalhipaa.com

ABOUT NAHU - The National Association of Health Underwriters represents more than 100,000 professional health insurance agents and brokers who provide insurance for millions of Americans. NAHU is headquartered in Washington, DC. For more information, visit our web site at http://www.nahu.org. Reported by PRWeb 5 hours ago.

Health Plans to End Without Proof of Citizenship

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The Obama administration said Tuesday it would cut off health insurance coverage for up to 310,000 people who signed up for plans through the troubled HealthCare.gov system unless those people provide documents in the next few weeks to verify they are U.S. citizens or legal residents. Reported by Wall Street Journal 4 hours ago.

Debate over $15 wage is hardly over: Washington's Best Workplaces execs weigh in

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In June, Seattle became the first major city to implement a $15 minimum wage. The law ramps up the requirement over several years until all businesses are paying their employees at least $15 per hour. Businesses with fewer than 500 employees, for example, will have seven years to reach the $15 wage floor. Large businesses and franchises will have three years, or four if they provide health insurance. The law put Seattle in the spotlight for the national debate over income inequality just as President… Reported by bizjournals 4 hours ago.

State Spending on Employees' Health Insurance Varies Significantly, According to New Report

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WASHINGTON, Aug. 12, 2014 /PRNewswire-USNewswire/ -- Spending on health insurance for state employees was up slightly in 2013 over the previous two years, with the cost varying widely from state to state. According to a first-of-its-kind analysis from the State Health Care Spending... Reported by PR Newswire 4 hours ago.

Federal warning: Thousands of Virginia health exchange users could lose coverage

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Nearly 14,000 Virginians may be at risk of losing health insurance coverage obtained under healthcare.gov due to “inconsistencies,” the Centers for Medicare & Medicaid Services said Tuesday. The federal insurance marketplace began sending notices to 310,000 consumers nationwide who signed up through the exchange and need to submit documentation to keep their coverage. At issue with most of these consumers are citizenship or immigration data matching issues, CMS said. Those contacted must respond… Reported by bizjournals 3 hours ago.

Accused Obamacare spammer settles FTC charges

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A company accused of sending unsolicited and deceptive email before the roll out of the U.S. Affordable Care Act will pay US$350,000 to settle a complaint from the U.S. Federal Trade Commission.

The FTC accused Yair Shalev and his Florida-based company, Kobeni, of sending spam email that falsely claimed recipients would be violating the Affordable Care Act, often called Obamacare, if they did not immediately click a link to buy health insurance.

The FTC in January filed a complaint against the company in U.S. District Court for the Southern District of Florida. The agency alleged that the emails violated the unfair business practices section of the U.S. FTC Act.

To read this article in full or to leave a comment, please click here Reported by PC World 3 hours ago.

France is the home of liberalism – it’s high time the country rediscovered this

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Who wrote that the state is “that great fiction by which everyone tries to live at the expense of everyone else”? Milton Friedman? Ayn Rand? Surely an Anglo-Saxon libertarian? Not at all. It’s Frederic Bastiat, a French economist and politician who fiercely fought the protectionist camp over the liberalisation of the grain trade in the mid-nineteenth century.

Far from being a lone wolf in a country of socialist sheep, he’s part of a French intellectual tradition that runs from Enlightenment philosophers to nineteenth century thinkers such as Alexis de Tocqueville and Benjamin Constant, right up to twentieth century economists and sociologists like Raymond Aron, Jacques Rueff and Jean-Francois Revel.

I would even argue that the French initiated the Liberal school of thought. It is well-known that the idea of protecting individual freedoms owes a lot to the French Revolution. But that also applies to economics.

The French coined the term “liberal”, as well as “laissez-faire” and “entrepreneur”. Adam Smith himself explicitly draws on the French Physiocrats, in particular Francois Quesnay.

Good ideas once led to good practice. France was a highly capitalist country until the end of the 1930s. Electricity and railway companies competed freely, creating the infrastructure now wrongly attributed to public investment. Stock ownership was even more widespread than in the US.

New companies emerged in a business-friendly environment, helped by a political class groomed in the then-free-market Sciences Po college.

But for the last 70 years or so, this tradition has gone undercover. Almost all politicians, chiefly Marine Le Pen of the Front National, blame France’s ills on liberalism – a reviled word.

Intellectuals blush at any association with markets. The French mentality remains defined by a post-war Communist consensus which nationalised vast sectors of the economy, created the public service privilege, collectivised health insurance and retirement schemes, and appointed a “planification minister” – still in many ways a title the current economy minister should bear.

As a result, France has record public spending (seventh in the world), a bloated state (20 per cent of the workforce belongs to the civil service), over-regulation (labor laws now include 12,000 different articles), rent-seeking (Parisian taxis defeated two governments in a row), and constant paternalism.

Our “social model” only pampers bureaucrats and retired baby boomers, feeding a tangible social unease and leading many to seek a better life abroad.

But I remain confident that, under this gloomy surface, things are changing. Civil society activists, techies and entrepreneurs of all hues (over 1m French are self-employed) are building an underground network that will eventually overthrow the old state structures: France is defiant of reforms, but keen on revolutions.

Triggers may be the looming debt crisis, a tax rebellion, or political turmoil created by the predictable victory of a far-right party. Liberals should prepare to seize the momentum and implement radical reforms.

Let France revert to its proper self. Let us prove wrong the cliche of “Colbertism” – noting that Jean-Baptiste Colbert himself, who famously said that a state-owned enterprise not making profit after five years should be closed down, would probably be horrified at the way the country is currently run. Reported by City A.M. 3 hours ago.

Obamacare Enrollments Tank

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Obamacare Enrollments Tank America's third-largest health insurer, Aetna, says its Obamacare enrollments are on pace to fall as much as 30% by the end of 2014. 

As Investor's Business Daily reported on Monday, Aetna had 720,000 Obamacare sign-ups as of May 20. By the end of June, Aetna's paying Obamacare customers had fallen to less than 600,000. By year's end, the health insurance giant told IBD it projects that number will drop to "just over 500,000." 

"I think we will see some attrition...We're already seeing it. And we expect that to continue through the end of the year," Aetna CEO Mark Bertolini said during a conference call. 

Aetna is not alone. Cigna says its Obamacare enrollments are moving down as well. 

The Obamacare retention problem could be the result of myriad factors, including individuals who never paid their first month's premium, fell on hard economic times, changed to a job with insurance, or hit the harsh wall of reality surrounding Obamacare's high deductibles, reports IBD. 

Nationally, Obamacare remains deeply unpopular. According to the latest Henry J. Kaiser Family Foundation poll, just 37% of Americans now support Obamacare. Reported by Breitbart 2 hours ago.

Oprah Winfrey’s Magazine Recognizes Breakthrough.Com as Innovative Leaders in Web Therapy

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O, The Oprah Magazine Highlights Breakthrough Behavioral in August 2014 Issue

Redwood City, CA (PRWEB) August 12, 2014

Oprah Winfrey’s magazine, O, The Oprah Magazine, has highlighted Breakthrough Behavioral (Breakthrough) in the August 2014 issue. The magazine recognized the company as an innovative leader in online mental health care. Breakthrough offers access to mental health care providers, including psychiatrists and therapists, through their secure online live video counseling system.

Oprah says on the cover of her magazine, “Your Breakthrough is on its way,” and highlights the benefits of web-based mental health therapy offered by the company. The overall theme of The Oprah Magazine is to inspire her readers to improve their lives with solutions that they may not have previously known about and the August 2014 edition focuses on personal breakthroughs.

The feature story about Breakthrough calls attention to its ability to reach individuals in need of therapy who have barriers preventing them from seeking care. According to the story, an alarming 59 percent of mentally ill Americans don’t receive mental health treatment due to reasons including access, affordability and awareness. Furthermore, the stigma associated with receiving mental health therapy continues to be prevalent amongst all other variables.

Breakthrough hopes that the promotion of web-therapy by The Oprah Magazine will help raise awareness amongst a population often challenged with finding time to get care. For example, approximately 20 percent of expecting and new mothers will experience depression or anxiety, yet never receive the help they need according to Postpartum Support International. Additionally, the company sees demand for services from people who live in remote areas, are stay-at-home moms, or simply have too much to juggle between their personal and professional lives to make time for regular therapy sessions.

Breakthrough’s CEO, Julian Cohen, remarks, “Due to the stigma associated with therapy and the growing need for accessible and affordable mental health therapy, we are greatly appreciative that The Oprah Magazine has presented Breakthrough as a viable solution to those that need it most.”

In the magazine, Oprah Winfrey says, “I love the very idea of breakthrough moments, breakthrough times in our lives. I would have to say that the biggest breakthroughs for me have always happened when I was going through a difficult time and suddenly came across an ‘aha’ moment or an opening.” Breakthrough hopes that their online video therapy service might just be that ‘aha’ moment for those seeking mental health therapy.

Even prior to The Oprah Magazine feature, online video therapy has been catching on. One of Breakthrough’s contracted web-based therapists reports a 41 percent increase in online video therapy clients in the last year. Additionally, the company has seen a significant increase in provided services month-over-month during the past twelve months. Breakthrough is looking to continually expand its services into additional markets as it working to secure providers and health insurance contracts across the nation.

Headquartered in Redwood City, Breakthrough Behavorial is the leading telehealth provider of mental health care. Breakthrough contracts with insurance companies for Commercial and Medicaid populations to provide HIPAA compliant, online video counseling service to consumers. For more information please visit http://www.breakthrough.com. Also follow us on Facebook, Twitter and LinkedIn.

Providers can email network(at)breakthrough(dot)com and payers may contact sales(at)breakthrough(dot)com for partnership opportunities or to join Breakthrough. Reported by PRWeb 3 hours ago.

Obamacare shrinking? 310,000 could lose coverage over immigration issues

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Around 310,000 consumers who signed up for health insurance through the federal Obamacare exchange will lose their coverage if they don’t document that they are U.S. citizens or legal residents by Sept. 5. In May, the Centers for Medicare & Medicaid Services found citizenship or immigration data-matching errors for 970,000 people who enrolled for coverage through the federal marketplaces. About 450,000 of these cases have been resolved, and another 210,000 cases are being reviewed. The agency… Reported by bizjournals 3 hours ago.

Wellpoint Changes Its Name to Anthem

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WellPointInc., the second-biggest U.S. insurer, plans to change its name to Anthem Inc., elevating the brand that it now uses for most of its health-insurance products. Reported by Wall Street Journal 3 hours ago.
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