News for Insurers
Top stories summarized by our editors
8/22/2017

A study in the journal Paediatric & Perinatal Epidemiology found pregnant women with high blood pressure had higher risks for cardiovascular disease and hypertension after pregnancy than women who did not have high blood pressure while pregnant. Researcher Sonia Grandi said pregnant women with a history of hypertension during pregnancy should have long-term follow-up to manage CVD risk factors.

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blood pressure
8/22/2017

Yearly mammograms for women from ages 40 to 84 would result in a 39.6% reduction in breast cancer-specific deaths, compared with a 30.8% reduction for a hybrid approach that combines annual and biennial screenings, and a 23.2% decrease for biennial screening from ages 50 to 74, according to a study in the journal Cancer based on computer modeling. The annual screening approach also would lead to more testing, negative recalls and benign biopsies, compared with the other testing models.

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cancer
8/22/2017

New Jersey-based firefighter Michael Pepper and pharmaceutical sales reps Steven Urbanski and Thomas Hodnett pleaded guilty to charges of conspiracy to commit health care fraud. The defendants were accused of submitting false claims for unnecessary prescriptions for compounded medications, causing a pharmacy benefits administrator to pay over $50 million in fraudulent reimbursements.

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Patch
8/22/2017

Antoine Skaff, a dentist from Charleston, W. Va., faces up to 10 years in prison and was ordered to pay $738,067 in restitution after admitting to defrauding over $700,000 from Virginia Medicaid and state Medicaid Managed Care Organizations by billing for dental procedures he did not perform. Skaff, who also pleaded guilty to submitting fraudulent bills and receiving double payments for tooth extractions, is scheduled for sentencing Nov. 13.

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Antoine Skaff
8/22/2017

Alfredo Valdes, owner of T-N-T Medical Supplies in West New York, N.J., pleaded guilty to charges of health care claims fraud over falsely billing more than $100,000 to state Medicaid provider Horizon New Jersey Health between January 2008 and March 2016. Valdes admitted to submitting false claims for durable medical equipment supposedly distributed to patients who were deceased, and faces a recommended prison term of four years when he is sentenced in January.

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Daily Voice
8/21/2017

Former HHS Secretaries Kathleen Sebelius, Mike Leavitt and Tommy Thompson urged President Donald Trump and Congress to make insurance market stability their immediate priority by dispelling political and legal uncertainties surrounding cost-sharing reduction payments to health insurers. Thompson urged Trump to hold a health care summit with Republican and Democratic congressional leaders, followed by intensive legislative work until they reach a compromise.

8/21/2017

Insys Therapeutics agreed to a $4.45 million settlement to resolve a lawsuit filed by the Illinois attorney general's office that accused the company of illegally marketing its fentanyl-based cancer pain drug Subsys for off-label uses to high-volume opioid prescribers.

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Reuters
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Insys Therapeutics, Insys
8/21/2017

So far in 2017, 7,350 insurance agents and brokers have registered on HealthCare.gov to sell Affordable Care Act policies for 2018. That number is about 47% of registrations compared to a year ago.

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ACA
8/21/2017

Chris Carosa, president of Carosa Stanton Asset Management, says children could be millionaires by the age of 18 if their parents could open individual retirement accounts for them. Since IRAs require participants to have income, creating them for children poses obstacles, but Carosa says child actors and children working in family businesses would meet qualifications.

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BenefitsPro
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Chris Carosa
8/21/2017

Offering employees onsite health care benefits can save companies money, West Tennessee Healthcare's Corporate Health and Wellness Manager Shelley Hayes told the organization's fourth annual Employer Forum. "Targeting your employee population with different health and wellness solutions is a huge return on investment for employers," Hayes said.