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ACA Marketplace Enrollment Solutions Provides Tips on How Ancillary Health Insurance Can Work In Conjunction With Major Medical Insurance Policies

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Ancillary health insurance products play an important role in an insured’s health insurance coverage portfolio.

BEDFORD PARK, Ill. (PRWEB) October 26, 2017

Bob Dial, Chief Compliance Officer, ACA Marketplace Enrollment Solutions (ACAEnroll.com), explained, “With the Open Enrollment Period (OEP) ready to begin November 1, 2017, individuals should be exploring what major medical health insurance plans align with their insurance needs and budget. For many insured, in order to keep health insurance premium down, they will be selecting a plan that has a higher deductible. Ancillary health insurance products can complement a major medical health plan and help offset the cost of the high deductible marketplace plans. Being a knowledgeable consumer will help ensure they have the health insurance plan best tailored to their individual insurance needs.”

Dial details each of the primary ancillary health insurance products and details attractive features of each. It is important to fully review any insurance policy to understand it features, restrictions and specifics for each company offering ancillary health products.
Accident Hospital Insurance

Health Insurance doesn’t normally cover all of a person’s health care costs or the everyday expenses that still have to be paid while they are recovering and unable to work. This plan pays a daily benefit while a person is confined in the hospital.

Attractive Features:· Guaranteed Acceptance
· Portable, Nationwide coverage
· Benefits Payable with Other Insurance Plans

Dental Insurance
Routine dental care contributes to good overall health. A dental insurance policy provides the peace of mind that expensive routine dental care is covered.

Attractive features:· Guaranteed acceptance, no wait time for treatment for routine dental care, and the ability to choose any dentist are features included on most dental insurance policies.
· Most dental insurance policies offer plans that cover expensive dental treatments such as bridges, crowns and dentures.

Critical Illness
Critical Illness Insurance provides a lump-sum cash benefit to help cover expenses associated with a qualifying serious illness.

Attractive features:· Financially, a payout can help individuals pay medical bills as well as pay routine bills while they are sick or unable to work and provide critical resources during recuperation.
· Critical Illness plans usually cover illnesses such as cancer, heart attacks, and strokes. Depending on the policy, coverage may also include kidney failure, severe burns, paralysis, loss of sight, hearing or speech and other conditions.

Telemedicine Program
Telemedicine provides phone and online access to U.S. based physicians 24 hours a day, seven days a week, and 365 days a year for a flat yearly fee. Participants use telemedicine services for common ailments such as sore throat, sinus infection, earache, urinary tract infection and upset stomach.

Attractive features:· No copays or out-of-pocket costs to use the service.
· On average speaking to a doctor in under 5 minutes.
· Prescriptions can be called in to your pharmacy when appropriate.
· Available to the insured and up to seven additional family members.

Short Term Major Medical Insurance
Individuals who financially cannot afford permanent major medical insurance offered on the ACA Exchange may want to consider Short Term Major Medical insurance (STMM). STMM is also a viable solution for: individuals waiting for group or individual major medical coverage to begin; young adults no longer covered by their parent’s plan; and individuals who are between jobs, often consider STMM plans as an alternative. Dial explained, “The Short Term Major Medical product was designed to fill the gap until permanent major medical insurance can be secured. More importantly, it protects the insured from the devastating financial burden of not having any health insurance.”    Although the Short Term plans do not cover all of the essential health benefits, and are underwritten, for the healthy segment of the population, STMM may be a nice alternative.

Attractive Features:· Insured can visit any out-of-network doctor or hospital without incurring penalty.
· Prescription drug coverage is included.
· Insured can select the deductible amount that best aligns with their budget.

Dial added, “Most STMM plans do not cover pre-existing conditions, preventative wellness doctor visits, or optical and dental treatment. It is important to go over the full list of exclusions with an insurance agent,” added Dial. “The Affordable Care Act requires that most Americans pay a fee for each month they go without health coverage. To avoid the penalty, insured must maintain minimum essential coverage throughout the year or get an exemption. The insured should carefully weigh all of the benefits of STMM and the burden of penalties that may apply, should they purchase a STMM plan” concluded Dial.

ACAEnroll.com stands ready to assist consumer with all their enrollment needs. Their dedicated Call Center consists of a team of multi-lingual, health insurance professionals, that are trained to walk a client through the entire process of selecting a healthcare plan and enrolling them for their coverage, as well as responding to any questions they may have regarding their new health insurance policy. The ACAEnroll.com Call Center will be available to assist consumer with enrolling for their 2018 health plan. Go to http://www.ACAEnroll.com or call 1-800-342-0631 for more information.

About ACA Marketplace Enrollment Solutions:
Headquartered in Bedford Park, Illinois, ACA Marketplace Enrollment Solutions (aka ACAEnroll.com) is a national enrollment firm specializing in the Health Insurance Marketplace as well as variety of other ancillary health insurance products, including Dental, Critical Illness, Short Term Medical, and others. ACAEnroll.com provides enrollments services throughout the country, through national and regional insurance carriers. Effective November 1, 2017, the health insurance Marketplace opens for enrollment and the ACAEnroll.com Call Center will be available to assist consumer with enrolling for their 2018 health plan. Go to http://www.ACAEnroll.com or call 1-800-342-0631 for more information. Reported by PRWeb 2 hours ago.

The Wall Street analysts who called CVS's huge potential deal last month explain why it could 'realign' the entire industry

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The Wall Street analysts who called CVS's huge potential deal last month explain why it could 'realign' the entire industry· *CVS Health is reportedly in talks to buy Aetna, a major health insurer, in what could be a $66 billion deal.*
· *Analysts at RBC Capital Markets said in September they expected this to happen.*
· *"We believe the next wave of industry consolidation will be on a larger scale and in directions that could realign traditional industry competitors," they said in a September report. *

--------------------

 

Pharmacy giant CVS Health is in talks to buy health insurer Aetna in what could be a $66 billion deal, The Wall Street Journal reported.

If the deal pans out, it would be the biggest takeover in the US in 2017. It would also create a new type of healthcare company that includes a health insurer, retail pharmacy, and several other key businesses. 

But the news is in line with what analysts at RBC Capital Markets anticipated — down to the companies involved.

"We believe the next big opportunity in M&A comes from CVS Health, a company with the ability to redefine what a healthcare company is, and at the same time, potentially create significant value for shareholders," RBC's George Hill and Stephen Hagan wrote in a September report. "Thus, we believe the next big thing in drug supply chain services could come from CVS Health moving into the payer market and vertically integrating more of health care."

And this could have big implications beyond a CVS-Aetna deal.

"We believe the next wave of industry consolidation will be on a larger scale and in directions that could realign traditional industry competitors," the analysts wrote.

There are a few reasons why a company like CVS would want to acquire a health insurer, otherwise known as a payer, according to RBC. 

The most notable is the pricing pressure the drug supply chain is feeling.

"The pricing pressure problem is acute in the drug supply chain for two reasons: first is the increasing role of the government as a buyer of goods and its tendency to reduce reimbursement levels over time. The second is the
concentrated nature of payers in the commercial market, limiting margin expansion opportunities in companies’ more profitable books of business," the analysts said. 

*Why CVS? *

Already, certain parts of the healthcare system have been consolidating. CVS currently owns both a retail pharmacy and a pharmacy benefits manager, an organization that helps negotiate lower prices for prescription drugs for health insurance plans. UnitedHealthcare, for example, owns the PBM OptumRx, while Anthem, which owns a variety of Blue Cross Blue Shield health insurance firms, will be launching its own PBM called IngenioRx. If CVS were to acquire a health insurer, its business model would look more like UnitedHealthcare's, with the addition of a retail pharmacy, and health clinics. 

Here's how the RBC analysts reasoned through it: 

"We believe that CVS is the company best positioned to pursue this vertically integrated strategy due to its collection of assets that could benefit from an integrated relationship with a payer organization. We believe that CVS could use steerage tools as part of the [managed care organization's] benefit design to drive better utilization of CVS’

· PBM unit
· Retail pharmacy footprint
·  Mail prescription fulfillment services
· Retail health clinics
· Specialty pharmacy fulfillment and management services
· Home infusion services
· Long-term care pharmacy services
· NovoLogix specialty prior authorization tools

Join the conversation about this story »

NOW WATCH: I spent a day trying to pay for things with bitcoin and a bar of gold Reported by Business Insider 2 hours ago.

Rural areas face Obamacare enrollment hitches

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Supporters of the Affordable Care Act in Georgia say they are facing a daunting task in getting people signed up for health insurance. Reported by CNNMoney 14 hours ago.

Friday's Morning Email: This Is How Much Your Health Insurance Rates Are Going Up

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If you use the exchanges or purchase coverage directly from a health insurance company or through a broker. Reported by Huffington Post 12 hours ago.

CVS Health to move on Aetna Inc with US$66bn deal - reports

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CVS Health Corp (NYSE:CVS) has reportedly triggered fresh sector consolidation with a US$66bn move for Aetna, America’s third largest health insurer. The touted US$200 per share offer is said to have been made earlier this month, though earlier negotiations reportedly began several months ago and a formal transaction is expected to be another few weeks away. It comes after Aetna earlier this year spurned a possible deal for health insurance rival Humana Inc, amid push-back from competition regulators – the combination of the pharmacy operator and a health insurer opens a corporate route to growth without the antitrust problems. Reported by Proactive Investors 13 hours ago.

Ping An Reports a 17.4% increase in 9M net income; underlying growth was 41.1%

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SHANGHAI and HONG KONG, Oct. 27, 2017 /PRNewswire/ -- Ping An Insurance (Group) Company of China, Ltd. (hereafter "Ping An" or the "Group", HKEx: 2318; SSE: 601318) today announced its 2017 interim results for the nine months ended September 30 2017.

*Major highlights in first nine months:*

· Profit increased significantly. Net profit attributable to shareholders of the parent company rose by 17.4% year on year (up 41.1% year on year if the RMB9,497 million profit from Puhui's restructuring for the first half of 2016 is excluded).
· The number of customers and users grew rapidly. Number of individual customers increased 22.5% year on year to 153 million, and the number of internet users increased 27.4% year on year to 430 million. Ping An's internet users are 2.81x its customer base.
· Life and health new business value rose 35.5% year on year, exceeding the new business value generated in 2016. Strong new business value growth was aided by a 27.9% year on year rise in number of agents (now 1.434 million) and a 9.9% rise in agent productivity over the comparable period.
· Ping An Property & Casualty's premium rose 23.6% year on year, while maintaining a better-than-industry combined ratio of 96.1%.
· Ping An Bank's transformation into a smart retail bank saw significant results, Ping An Bank's retail business revenue accounted for 42.1% of revenue (9M2016: 29.7%) and 65.3% of profit (9M2016: 34.4%). The assets of retail consumers exceeded RMB1 trillion.
· Ping An continued to advance the innovation and application of its technologies. The number of patent applications filed by Ping An rose by 707 to 2,165 in the third quarter. Most of the patents were related to big data, artificial intelligence, cloud and other fields.

*Core Finance Business**: *

*Life and health new business value grew 35.5% to RMB53,738 million in first nine months*. During the period, Ping An Life achieved a net profit of RMB35,682 million, up 55.3% year on year. Ping An Life grew its number of agents by 27.9% year on year to 1.434 million, while at the same time driving a 9.9% increase in agent productivity to RMB9,702 first year premium per agent. In addition, Ping An Life launched a batch of compliant upgraded products in October and will switch to these new ones in the fourth quarter and focus on promotion of long-term protection products, which will lay a solid foundation for business development in 2018.

*Ping An Property & Casualty recorded premium income of RMB**157,507 million**, an increase of 23.6% year-on-year*. With good business quality, Ping An Property & Casualty maintained a better than industry combined ratio of 96.1%. Among which, the service of "510 City Superfast Onsite Investigation" has been launched in 334 cities, 85% of the cases were handled within 10 minutes, which greatly enhanced customer satisfaction.

For the first nine months of 2017, Ping An optimized its asset allocation. As at September 30 2017, Ping An's portfolio of insurance funds reached RMB2.30 trillion, up 16.9% from the beginning of the year. In the first three quarters of 2017, the portfolio of insurance funds achieved an annualized net investment yield of 5.5% and an annualized total investment yield of 5.4%. 

*Ping An Bank's retail business grew substantially, realizing sound business development and benefits of the strategic transformation*. During the period, Ping An Bank's retail business revenue reached RMB33,599 million, up 38.0% year on year and accounting for 42.1% of total income (9M2016: 29.7%). Retail net profit came in at RMB12,506 million, up 94.2% year on year and accounting for 65.3% of total net profit (9M2016: 34.4%). Assets under management (AUM) exceeded RMB1 trillion, an increase of 28.1% to RMB1,02trillion.

*Fintech Business**: *

*Lufax Holding, a leading online asset transaction platform in China, maintained rapid growth across its businesses*. In the third quarter of 2017, AUM of the wealth management business grew steadily by 21.8% year on year to RMB476,225 million. For consumer finance business, the balance of loans under management grew rapidly by 141.1% year on year to RMB269,193 million. Institution business remained robust with trading volume close to RMB4.2 trillion for the first nine months of 2017, up 29.4% year on year. As of September 30 2017, total registered users of Lufax reached 32.36 million, up 26.9% year on year.

*Finance One Connect stepped up efforts to establish ecosystem for serving financial institutions*. As of September 30 2017, it had partnered with 446 banks and 1,782 non-bank financial and quasi-financial institutions. Interbank trading volume was RMB6.64 trillion, with over 644 million credit enquiries. At the same time, Finance One Connect has built the "Smart Insurance Cloud" for the insurance industry and has signed letters of intent for cooperation with 11 companies.

*Ping An Good Doctor dedicates itself to building the largest one-stop healthcare ecosystem in China*. As of September 30 2017, Ping An Good Doctor provided services to over 170 million users with monthly active users peaking at over 20 million and daily queries peaking at 462,000.

*Ping An Social Health Insurance Company has built presence in over 70% of cities across China, covering 800 million people*. In over 250 cities of more than 20 provinces, Ping An Social Health Insurance Company provides expense control, actuarial work, social health insurance accounts, medical resources management, and application of electronic health records.

*Outlook*

*Dr. Peter Ma, Chairman and Chief Executive Officer of Ping An*, said, "China's economy will be on an upward trajectory in 2017. The 19^th National Congress of the Communist Party of China has ushered a new era for China's socialism with Chinese characteristics, indicating that the financial industry's directions and goals to serve the real economy and preventing risks. Ping An will strive to build a new growth engine driven by 'finance + technology'. Ping An is fully committed to serving the real economy, contributing to the rejuvenation of the country, and to give back to the society and investors who showed us their support over the years.

For more information contact:
Vicky Cheng
+86-186-1706-3169
CHENGJING572@pingan.com.cn Reported by PR Newswire Asia 12 hours ago.

ClearHealth Quality Institute to Host Complimentary Webinar on U.S.’s First Mental Health Parity Accreditation Program

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New Program Is Dedicated to Improving Mental Health and Addiction Treatment Coverage

ANNAPOLIS, Md. (PRWEB) October 27, 2017

ClearHealth Quality Institute TM (CHQI), an independent health care accrediting body emphasizing quality and outcomes benchmarking, will host a complimentary webinar to preview its new Mental Health Parity Accreditation Program (MHPAP) on Nov. 8, from noon – 1 p.m. EDT. The innovative accreditation program facilitates compliance with laws that require parity between health insurance coverage for physical health and mental health/addiction treatment.

The webinar, entitled Mental Health Parity Accreditation: A Pathway to Compliance will be moderated by Michael D. Reisman, JD, MA, CHQI president, and will include as guest speakers CHQI Parity Standards Committee Co-Chairs Bradley Lerner, JD, associate general counsel & director, parity compliance, Beacon Health Options; and Connie Galietti, JD, director of legal & professional affairs, practice directorate, American Psychological Association. To register, click here.

“We are excited to join with thought leaders to offer a first look at this vital new program,” comments Reisman. “10 years after the passage of the Mental Health Parity and Addiction Equity Act, health insurers and benefits administrators continue to struggle with how to show compliance with the law. Our new accreditation program will offer them a clear roadmap.” Reisman formerly served as an Assistant New York State Attorney General, where he led efforts to enforce federal and New York mental health parity laws, which resulted in eight settlements with health insurance companies.

The webinar will address four areas critical to mental health parity: medical management techniques, network adequacy, provider reimbursement rates, and the coverage of new technologies and treatments. CHQI’s Parity Accreditation Standards establish a logical, uniform approach to these complex issues.

“A wide range of stakeholders have contributed to the development of CHQI’s parity accreditation standards over the past eight months,” notes Lerner. “The webinar will provide insight into ins and outs of what has transpired thus far and how the process is working.”

The webinar will preview CHQI’s accreditation philosophy and its standards that promote fair reimbursement of evidence-based mental health and addiction treatment services. The Parity Accreditation Program is expected to launch in early 2018.

“The depth and breadth of the policy discussions surrounding the development of the new Parity Accreditation Program is impressive,” adds Galietti. “This presentation will showcase important best practices that can help promote better coverage of mental health and addiction treatment.”

In September, CHQI announced the launch of the Fall 2017 Educational series. The MHPAP webinar is just one, in a series, of educational programs the accrediting body will host through December. Upcoming topics include an overview of CHQI’s Telemedicine Accreditation Program (TAP), and a preview of future CHQI programs for 2018. To view a full listing of upcoming educational events, click here.

For more information regarding all upcoming educational events and training workshops, visit http://www.CHQI.com/Education, or contact Doug Clarke via email at info(at)CHQI(dot)com

About ClearHealth Quality Institute™ (CHQI) (http://www.CHQI.com)
ClearHealth Quality Institute’s (CHQI) mission is to promote quality-based practices for health plans, providers and other stakeholders across the United States and its territories. Our accreditation and certification programs help assess, track and report on trends to enhance key insurance and provider outcomes. CHQI also offers educational programs, publishes issue briefs and underwrites research to raise awareness of patient safety issues and promote best practices. The organization is governed by an independent board and committee system, which is open to a wide-range of volunteers to ensure transparency and accountability. CHQI provides resources to serve patients, providers, payers, government agencies, and other stakeholder groups. To learn more about CHQI, please contact us at (410) 696-7634 or info@CHQI.com. Reported by PRWeb 12 hours ago.

Trump declares opioid crisis as 'public health emergency', NRI billionaire held for medical fraud

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U.S. President Donald Trump declared the opioid crisis a public health emergency on Thursday, stopping short of a national emergency declaration he promised months ago that would have freed up more federal money.

Responding to a growing problem, particularly in rural areas, Trump's declaration will redirect federal resources and loosen regulations to combat opioid abuse, senior administration officials said.

But it does not result in more money to combat the crisis. Some critics, including Democratic lawmakers, said the declaration was meaningless without additional funding.

Republican lawmakers called the president's declaration an important step in combating the crisis.

"This epidemic is a national health emergency," Trump, a Republican, said at the White House. "As Americans, we cannot allow this to continue."



WORKING TOGETHER, we will defeat this #OpioidEpidemic & free our nation from the terrible affliction of drug abuse. https://t.co/iAZjqGMwav pic.twitter.com/mZI5uQN4oZ

— Donald J. Trump (@realDonaldTrump) October 27, 2017



Trump, who also called the epidemic a "national shame" and "human tragedy," was introduced by his wife, Melania, who said she had made fighting the epidemic one of her top priorities as first lady. "This can happen to any of us," she said.

The president also made a personal reference to addiction in his family by citing his deceased brother Fred, an alcoholic whose advice not to imbibe made an impression on Trump, who does not drink alcohol.

The announcement disappointed some advocates and experts in the addiction fight, who said it was inadequate to fight a scourge that played a role in more than 33,000 deaths in 2015, according to the U.S. Centers for Disease Control and Prevention. The death rate has kept rising, estimates show.

Opioids, primarily prescription painkillers, heroin and fentanyl, are fueling the drug overdoses. More than 100 Americans die daily from related overdoses, according to the CDC.

A White House commission on the drug crisis had urged Trump to declare a national emergency. On Wednesday, the president told Fox Business Network he would do so.

Officials told reporters on the conference call that Federal Emergency Management Agency funds that would have been released under a national emergency are already exhausted from recent storms that struck Puerto Rico, Texas and Florida.

The administration would have to work with Congress to help provide additional funding to address drug abuse, they added. They said they determined that a public health emergency declaration was most appropriate after an expansive review.

Under Thursday's declaration, treatment would be made more accessible for abusers of prescription painkillers, heroin and fentanyl, while ensuring fewer delays in staffing the Department of Health and Human Services to help states grapple with the crisis.

'BAD ACTORS'

Trump said he would discuss stopping the flow of fentanyl, a drug 50 to 100 times more powerful than morphine, with Chinese President Xi Jinping during his visit to Asia next month.

In his remarks, Trump said the U.S. Postal Service and Department of Homeland Security were "strengthening the inspection of packages coming into our country to hold back the flood of cheap and deadly fentanyl, a synthetic opioid manufactured in China."



WORKING TOGETHER, we will defeat this #OpioidEpidemic & free our nation from the terrible affliction of drug abuse. https://t.co/iAZjqGMwav pic.twitter.com/mZI5uQN4oZ

— Donald J. Trump (@realDonaldTrump) October 27, 2017



In Beijing, Foreign Ministry spokesman Geng Shuang said China had always paid a great deal of attention to international cooperation against narcotics and had listed 23 components of fentanyl as controlled substances, despite not having a fentanyl abuse problem.

Trump added he would consider bringing lawsuits against "bad actors" in the epidemic. Several states have sued opioid manufacturers for deceptive marketing. Congress is investigating the business practices of manufacturers.

The president also said the government should focus on teaching young people not to take drugs. "There is nothing desirable about drugs. They're bad," he said.

Thursday's declaration allows the Department of Labor to issue grants to help dislocated workers affected by the crisis. HIV/AIDS health funding would also be prioritized for those who need substance abuse treatment, officials said.

As a candidate, Trump promised to address the crisis, including by building a wall on the U.S.-Mexico border to stop the flow of illicit drugs, which he touched on in his speech.
Additional actions under the move would be announced in coming weeks by various agencies, officials said. 

Meanwhile, a 74-year-old Indian-American pharmaceutical billionaire was today charged with leading a nationwide conspiracy in the US by bribing doctors to over- prescribe a powerful opioid to patients and committing fraud on insurance firms for profit.

John Nath Kapoor was arrested by the FBI from his home in Arizona yesterday on charges including racketeering, conspiracy and fraud.

The Amritsar-born entrepreneur and well-known philanthropist, who migrated to the US from India in 1960s, is a current member of the board of directors of the pharmaceutical company Insys Therapeutics.

A superseding indictment, unsealed in Boston, also includes additional allegations against several former company executives and managers who were initially indicted in December 2016.

"More than 20,000 Americans died of synthetic opioid overdoses last year, and millions are addicted to opioids. And yet some medical professionals would rather take advantage of the addicts than try to help them," said Attorney General Jeff Sessions.

"This Justice Department will not tolerate this. We will hold accountable anyone from street dealers to corporate executives - who illegally contributes to this nationwide epidemic," Sessions said.

The indictment also alleges that Kapoor and six former executives conspired to mislead and defraud health insurance providers who were reluctant to approve payment for the drug when it was prescribed for non-cancer patients.

They achieved this goal by setting up the "reimbursement unit", which was dedicated to obtaining prior authorisation directly from insurers and pharmacy benefit managers, it said.

"In the midst of a nationwide opioid epidemic that has reached crisis proportions, Mr Kapoor and his company stand accused of bribing doctors to over-prescribe a potent opioid and committing fraud on insurance companies solely for profit," said Acting US Attorney William D Weinreb.

"Today's arrest and charges reflect our ongoing efforts to attack the opioid crisis from all angles. We must hold the industry and its leadership accountable - just as we would the cartels or a street-level drug dealer," he said.

Following the arrest, the company shares fell 23% to USD 5.74, a three-year inter day low.

According to Insys website, Kapoor received his PhD in Medicinal Chemistry from the State University of New York at Buffalo and a BS in Pharmacy from Bombay University in India.

The building that is home to University of Buffallo's School of Pharmacy and Pharmaceutical Sciences bears the name of Kapoor and his wife in recognition of their long-time philanthropic support for the school and the university.

"The university is aware of Dr Kapoor's arrest. We became aware of the charges through today's media reports and therefore it would be premature to comment further or take any action until the university has more information," the university said in a statement.

Kapoor has served on Insys board of directors since its formation in 1990 and has served as Chairman from 1990 to 2004 and Executive Chairman from June 2006 to January 2017.

He also owns a large stake in generic drug maker Akron.

According to Forbes, his net worth is estimated to be USD 1.75 billion.

He had stepped down as CEO and chairman of the company in January 2017, a month after six of its former executives including Kapoor's predecessor as CEO Michael Babich were arrested and charged with conspiracies to bribe doctors to needlessly subscribe Subsys, which is a Fentanyl spray to treat patients with severe cancer pain, Forbes said. 

ReportWorldPTI and Reuters

· Donald Trump
· John Nath Kapoor
· opioid crisis
· US
· Public Health

Fri, 27 Oct 2017-06:13pm
Date updated: 
Friday, 27 October 2017 - 6:22pm
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U.S. President Donald Trump touches the portrait of an opioid victim while greeting family members after he declared the opioid crisis a public health emergency in the East Room of the White House in Washington
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Confusion abounds as enrollment nears for California health insurance exchange

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If the comments on Covered California’s Facebook page are any indication, you’re all suffering from acute health insurance confusion:

“I wanted to sign up again this year … I'm hesitant now because of what Trump has done. Should I still consider?”

“Does the removal of subsidies mean we might lose... Reported by L.A. Times 12 hours ago.

CVS is said to be in talks to buy Aetna in landmark acquisition

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​CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation’s largest health insurance companies, according to people briefed on the talks. Reported by bizjournals 11 hours ago.

Eighteen Patient, Provider, and Consumer Groups: CBO Report Shows Bipartisan Health Care Stabilization Act Would Lower Premiums, Maintain Coverage for Americans

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WASHINGTON--(BUSINESS WIRE)--Today, a non-partisan group of 18 patient, provider, and consumer groups renewed calls for Congress to act on the Bipartisan Health Care Stabilization Act of 2017 in light of Wednesday’s Congressional Budget Office (CBO) report: “The CBO report on the Senate HELP Committee’s bipartisan health care package confirms that this bill is a strong, first step in the right direction for Americans who rely on affordable, adequate health insurance coverage to stay healthy. Th Reported by Business Wire 11 hours ago.

What you need to know on Wall Street today

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What you need to know on Wall Street today *Welcome to Finance Insider, Business Insider's summary of the top stories of the past 24 hours. Sign up here to get the best of Business Insider delivered direct to your inbox.*

The US economy grew faster than expected in the third quarter even after hurricanes disrupted activity in some parts of the country. The Commerce Department on Friday said gross domestic product, the measure of all goods and services produced, increased by 3%.

But the US economy isn't quite as strong as it looks, according to Business Insider's Pedro da Costa. And Americans are already showing signs of maxing out on debt.

In deal news, CVS Health, the retail pharmacy giant, is in talks to purchase Aetna, one of the five large publicly traded health-insurance companies, according to The Wall Street Journal. The Wall Street analysts who called the potential deal last month explained why it could "realign" the entire industry.

News of the deal emerged shortly after it was reported that Amazon has been approved for wholesale pharmacy licenses for at least 12 states. Traders betting that drugstores will get Amazon'd have made almost $1 billion.

In investing news:

· Maverick Capital, a $10.5 billion hedge fund, told clients it may have "cracked the code"
· A legendary Wall Street strategist set out the stock market's "nightmare scenario"
· A $460 billion investment chief at JPMorgan has an unexpected worry about the global economy
· The investment strategist at $245 billion OppenheimerFunds identified the "biggest risk to markets right now"

And in earnings news:

· Amazon's stock skyrockets on strong earnings
· Traders see Amazon's stock soaring even higher after the company's blockbuster earnings
· Jeff Bezos regains the title of world's richest person
· Google's parent company Alphabet beats on earnings, brings in $27.77 billion in Q3
· Google told investors it needs to pay more money to an unspecified "partner"— and it looks a lot like Apple
· Microsoft reports a big beat on earnings, stock spikes
· JCPenney slides deeper into the retail apocalypse as it slashes profit forecasts

 

Lastly, these are the top nine investment bank internships.

Join the conversation about this story »

NOW WATCH: How Bill Gates and Warren Buffett are changing the world like no other humans in history Reported by Business Insider 7 hours ago.

When Health Insurance Works: A Look Inside Switzerland's Healthcare System

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When Health Insurance Works: A Look Inside Switzerland's Healthcare System Authored by Marcia Christoff-Kurapovna via The Mises Institute,

[Part of a series on the Swiss economy and society.]

The enigmatic independence of Switzerland is perhaps best demonstrated in the fact that* its healthcare system manages to satisfy both free marketers and the statist-socialists in the country*. It is a giant social safety net woven by individual responsibility and self-made wealth. Health insurance is almost entirely consumer-based, though there are strict cantonal regulations and some governing federal laws. Coverage is not created, provided or managed by the federal or by cantonal governments, but is sold and managed by private-sector insurance companies to individuals. It is not provided by employers, except in the case of large multinationals and then only partially. There are no free state-provided health services. There is no Medicare. Subsidies are provided in extreme cases (poverty, the infirm) with strict conditions, including the recipient having to pay back those subsidies eventually.

*Once voluntary, insurance coverage is now, since 1996, compulsory. Public sector care such as hospitals or the administration of public assistance is paid for by taxes.*

A Consumer-Driven Private Insurance Model

To begin with, everyone buys basic and supplementary insurance for himself, the first being mandatory. One purchases it from a choice of just over eighty private insurers that offer competing canton-by-canton plans through which individuals are free to select the insurer they want and may choose any doctor they wish — to ask a doctor if he is “on” a particular plan will be greeted by a confused stare. In addition, with the basic insurance, fees for services are regulated by the state and insurers cannot legally earn profit on those basic benefit packages.

Otherwise, the system of premiums and deductibles is familiar territory to Americans learning about this system. Individuals (not entire families, but each individual family member) pay a premium that varies between cantons and will soon average about $450 a month; on the high-end, this will average about $2500 a month, with children under the age of 18 paying less. The annual deductibles run about these rates, as well. The most someone is allowed to pay for insurance in Switzerland is 8 % of income; anything in excess of that amount may be deducted from taxes.

The basic package is generous by most countries’ standards. The insurance covers the costs of medical treatment and hospitalization, but the insured person has to pay part of the cost of treatment. This is done via an annual deductible also ranging canton-to-canton. Furthermore, a copayment of about $15 a day is required for hospital stays. There are many out-of-pocket costs, but the care is superb. Doctors and hospitals are the very best on the continent. There are no waiting lists, either.

Private insurers make money by selling supplementary insurance policies (private hospital rooms, alternative therapies, those wonderful, alpine-air, Thomas Mann Magic Mountain type retreats; drug rehabilitation, dental), which are risk-adjusted. These are highly prized by Swiss consumers — about 70% of those insured have the supplementary plans.

The Role of State-Mandated Social Benefits 

On the state side of things, each of the country’s twenty-six cantons has its own constitution and is responsible for licensing providers, coordinating hospital services, and subsidizing institutions and individual premiums. The federal government plays the role of regulating the financing of the system—that is, requiring that insurance be compulsory; ensuring the quality (and safety) of pharmaceuticals and medical devices; overseeing public health initiatives and promoting research and training. The federal government also regulates a “General Social Insurance” (detailed below) that provides healthcare to those who cannot pay for it themselves. This state involvement in the health care sector is financed through tax revenues.

To be sure, things are getting pricier — rates are going up across cantons, effective throughout 2018. Critics of the system — the Swiss themselves who are quick to point out Singapore and Taiwan as providing the overall best and least expensive services. Still, taxes are quite low and the system works. Some 99.5% of the population is insured, and in a 2014 referendum vote for single-payer nationwide insurance, the proposal was swiftly rejected. 

How the Swiss Control Costs 

*Key to the functioning of the Swiss health care system, however, are the cultural and social factors that are at the basis of its foundation, rather than the system being imposed “from the top down” by political whim or trend.* Self-reliance is actively encouraged. Abuse of the system and the welfare-dependency of immigrants/asylum seekers are almost non-existent. Corruption (hospitals, insurers, "big pharma") appears to be relatively minor. All of this is critical to the efficiency of the system. Going point-by-point:

*First, Switzerland is not a welfare society.* The “poor” in Switzerland are not an urban poor. It is not a country of food stamps or people living on the streets or under bridges. It has one of the lowest child poverty rates in the world. About 3% of citizens (7% factoring in immigration/asylum seekers) lives below that country’s official poverty level, double what the level was through the 1990s; of Swiss citizens, these tend to be single mothers or unemployed parents. Based on canton-by-canton law, those individuals receive, as single adults, about $900 a month and about $2200 maximum for a family in welfare subsidies. However, this amount is for what is called “life dignity” and covers only food, transportation, “hygiene” and communications. It is not to cover rent, rooms, or basic health insurance.

Yes, the state will pay for close to 100% of health costs in the event that an individual has no support network whatsoever or means of employment — but only in such extreme cases and only up until the point the individual finds means of work (more on this below). Cantons, not the federal government, decide the distribution of such subsidies.

These subsidies, in turn, come out of the tax-based Swiss General Social Insurance fund, mentioned above, a kind of “Bismarckian” insurance system designed to cover risks like disability and accident and, in some circumstances, to provide benefits through health care services. It covers, in particular, spending for rehabilitation in case of disability and the health care costs in case of professional and non-professional accidents of employed persons.

*Secondly, individual responsibility and family responsibility are “national” priorities*: State assistance is required to be paid back once the individual or family is back on its feet. Furthermore, a Civil Obligations Code requires that families take care of those members who cannot take care of themselves (parents, children, grandparents and grandchildren) and authorities can request family members to cover all or a part of social welfare payments and health care payments. Again, responsibility is critical here: keep in mind that Switzerland became the first country in the world to vote at the national level on the issue of universal basic income and shot the idea down by 77% of voters in a referendum of February 2016. 

*Third, Switzerland discourages dependency. *The federal government takes care of asylum seekers across the board (shelter, basic health services), but only temporarily and for usually up to three months. Swiss migration law allows only for the immigration of highly skilled labor.

Authority remains strict: refugees arriving at a Swiss reception center have to hand over to the state any assets worth more than $1000, according to latest figures, and up to a maximum of about $15,000 — to help cover their costs, exempting very personal items (wedding rings). If refugees leave voluntarily within seven months, they can get the money back. If they find work during the time of their temporary protection status, as they are allowed to do so, and win the right to stay and work in Switzerland, these individuals have to surrender 10% of their pay for up to ten years until they repay $15,000 in costs. 

*Fourth, Switzerland is mainly a self-governing society of rich bankers, rich engineers and rich farmers with high educational standards within a largely homogenous society. *The country ranked No.1 on the 2017 Global Competitiveness Index. Additionally, wages are generally high in Switzerland and having low-income individuals performing services is almost non-existent because of the significant costs of even the most unskilled labor. To be sure, in Switzerland, it would be very difficult to get people to buy their own health insurance when a population is working for a modest minimum wage.

*Fifth, health care fraud in Switzerland is relatively low.* In general, Switzerland is not a country where public-private corruption is rife, despite all the hoopla about secrecy. As of July 2016, private sector bribery was codified in the Swiss Criminal Code and Switzerland is one of the least corrupt countries in the world, ranking fifth in the Transparency International Rankings for 2016. The pharmaceutical ‘lobby’ in the country defends the high prices of drugs on the basis of long research cycles and as the leader of the country’s ongoing export wealth. High prices seem to be the extent of controversy.

*In all, the system works with a great degree of efficiency, *perhaps best summarized by Swiss doctor Thomas Zeltner, M.D., the former Swiss secretary of health between January 1991 and December 2009. As Zeltner stated in an interview with an American health journal a couple of years back:* “We [Swiss]will not let people suffer and die when they need health care. The Swiss believe that, in return, individuals owe it to society to make provision ahead of time for their health care when they fall seriously ill. At that point, they may not have enough money to pay for it. So, we consider the health insurance mandate to be a form of socially responsible civic conduct. In Switzerland, “individual freedom” does not mean that you should be free to live irresponsibly and freeload from others, as you would put it.”*

  Reported by Zero Hedge 7 hours ago.

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