Group items tagged

SEOUL (AFP) - South Korean police said on Tuesday they were investigating 27 North Korean refugees for swindling private insurance firms out of hundreds of thousands of dollars in bogus medical claims. Police said the refugees faked illness in collusion with hospitals to claim a total of 1.04 billion won (S$1.16 million) from insurance firms between 2007 and 2010. While listed as hospitalised, they frequented saunas, restaurants and even nightclubs. The scam also involved a 71-year-old doctor and five hospital employees who conspired with the refugees to claim a separate 104 million won from the state health insurance agency, police said. Police are also investigating two brokers on suspicion of helping the refugees send some of the proceeds to relatives in the North.

Springhill Group Care - Providing for all levels of care, balanced with impressive facilities and exceptional staff. …golden age living and health care at its very best… At Springhill Care Group, our attitude is to exceed the expectations of our residents and their friends, that offer balanced with impressive facilities and exceptional staff. At Springhill Care Group, we firmly believe in safeguarding the interests of our clients and we pride ourselves on offering the most resident friendly environment. Springhill Group look to cater to the special requirements of each person citizen and any changing circumstances that occur throughout their time living in our care. This gives families the comfort that their loved one has the support and care. We fully understand a need to a place that residents will be proud to call their home is what they require most. All are built in attractive locations, nestled amongst existing communities, so our residents can easily retain their ties with their families. Springhill Care offers retirees the finest in clinical care, while receiving the positive aspects of living in our cozy and comfortable community. Email us now at info@springhillcaregroup.net

WASHINGTON - The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses. Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership "puts criminals on notice that we will find them and stop them," while Attorney General Eric Holder called it "a critical step forward" against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies. Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud.

WASHINGTON - The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses. Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership "puts criminals on notice that we will find them and stop them," while Attorney General Eric Holder called it "a critical step forward" against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies. Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud. The agreement is also unusual because it brings the Obama administration and longtime foes in the insurance industry together to tackle a common problem. While carrying out the requirements of President Barack Obama's health care overhaul law, insurers are also lobbying to roll back some of its provisions, such as new taxes on the industry and cuts to private plans offered through Medicare. Obama continues to rail against industry "abuses." Fraud is estimated to cost Medicare about $60 billion a year, and the Obama administration has beefed up the government's efforts to stop it, bringing in record settlements with drug companies for marketing violations as well as using new powers in the health care law to pursue low-level fraudsters with greater zeal. Yet, although Medicare is becoming a harder target, it's too early to say if the tide has turned. Some antifraud efforts launched with great fanfare have yet to deliver convincing results.

Good to know that the previous bug has been fixed now and it's working great on my droid, too! Thanks for this useful entry!

http://seniorhealth.about.com/od/eldercare/a/home_care_opt.htm Nursing home is a home combined with skilled nursing care, rehabilitative care, medical services, personal care, and recreation in a supervised and environment. letting your love ones stay in the nursing home may be hardest decision but choosing the right home will be next hardest. Entering the nursing home doesn't mean that the family involvement ends, instead it is their responsibility to make sure that the home care provides good care. Remember the following when choosing the best home care: * Have a discussion with the loved one who will be living there. This will aid in adjusting to the major life change about to occur. * Work together with other family members and inquire for help in finding the best nursing home. * Be in touch with doctors, nurses, or any other health professionals or social workers who care for your loved one. * Chat with some nursing home employees, especially assistants since they give most of the care. * Solicit a pastor or rabbi for guidance. * Contact the long-term care ombudsman. People often think that home care is expensive and yes nursing home care can be expensive. It can differ widely depending on where you live but often the average cost is more than $50,000 a year and rising. Sadly, employee health insurance does not pay for nursing home care. A great number of nursing home residents, about a third of its population, pay all of their nursing home expenses from their own funds. Long stay in a home care can consume all your or your loved one's savings fast. There are many who exhaust their finances after just six months. And about a five percent of them buys long-term care insurance, which covers the cost of a nursing home or other extended care. Medicare, the federal health insurance program for older persons and some younger ones with disabilities, pays for short-term nursing home stays but the rest, about two-thirds, are from the Medicaid.

South Korean police said Tuesday they were investigating 27 North Korean refugees for swindling private insurance firms out of hundreds of thousands of dollars in bogus medical claims. Police said the refugees faked illness in collusion with hospitals to claim a total of 1.04 billion won ($909,000) from insurance firms between 2007 and 2010.

I wanted to thank you for this great read !! I definitely enjoyed every little bit of it and I have you bookmarked to check out new stuff you post.

On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of this state against Defendants Ifeolumipo O. Sofola, M.D. ("Dr. Sofola"), Navin Subramanian, M.D. ("Dr. Subramanian"), and Humble Surgical Hosp

On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of this state against Defendants Ifeolumipo O. Sofola, M.D. ("Dr. Sofola"), Navin Subramanian, M.D. ("Dr. Subramanian"), and Humble Surgical

sophiamostel: Springhill Care Group : 2012 U.S. Healthcare: UCR or '$99,750 Ear Wax Fraud'? Aetna Wants Court to Stop Hospital's UCR Billing On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of thi

billiepalance: Springhill Group Florida:: Living and Care Options Springhill Group living and care options are available depending on what the residents need and prefer. Independent Living The independent accommodations are occupied for those who wish to maintain a significant standard of flexibility, but also value the friendly relationship, the security, recreational facilities, and care that is provided by to them. The homes are designed to allow residents simple and easy household management encircled by warm and friendly neighbours Assisted Living Assisted Living is desirable to people who need a little extra care with their everyday living. You will also find here theflexibility and security of owning your personal space, to have your valuable possessions and things around you. Resthome Level Care Resthome level care in a Ryman Village, offers residents the very best in clinical care, while receiving the benefits of living in our warm and welcoming community. sophiamostel: Springhill Care Group : 2012 U.S. Healthcare: UCR or '$99,750 Ear Wax Fraud'? Aetna Wants Court to Stop Hospital's UCR Billing On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of

The decision of US to let the blind human rights activist Chen Guangcheng return into China's fold following his escape from authorities is straining ties between the two countries as diplomatic dialogues opened in Beijing. The 40-year old Chen who is now considered a dissident became an international human rights inspiration to many Chinese after earning the ire of the local government for exposing forced abortions in line with the country's one-child policy. The self-taught lawyer took to the US embassy after his escape, apparently to ask for help but was eventually ushered into the Beijing Hospital. According to a senior official's statement to Springhill Care Group, Chen has indeed went into the embassy that day and has requested for medical treatment for his injured foot. American medical personnel have then conducted medical tests and made appropriate treatment during the time he was there. Immediately after the incident, the Chinese government has expressed its disapproval about the entire affair, demanding an apology from the US for taking Chen in. "What the U.S. side should do now is neither to continue misleading the public and making every excuse to shift responsibility and conceal its wrongdoing, nor to interfere in the domestic affairs of China," said Chinese Foreign Ministry spokesman Liu Weimin. This incident came just when the US Secretary of State Hilary Clinton is visiting Beijing in a meeting with Chinese officials on security and trade talks. And although no one mentioned Chen's name, it is evident in their statements that the incident is on the spotlight as the 2 nations struggle to maintain common ground. Clinton said in her opening statement, "The United States believes that no state can legitimately deny the universal rights that belong to every human being - or punish those who exercise them. A China that protects the rights of all its citizens will be a stronger, more prosperous partner for the United State

http://www.washingtonpost.com/business/n ew-campaign-against-health-care-fraud-go vernment-and-insurance-companies-to-mine-c laims-data/2012/07/26/gJQAdSk8AX_story.h tml WASHINGTON - The Obama administration is upping the ante in the fight against health care fraud, joining forces ...

Very informative article. Pretty sure people would love to go to that place for shopping. Specially to those who are semi naughty or semi conservative people. I guess there are a lot of things their that can be bought.

KISSIMMEE, Fla. -- Kicking off a two-day Sunshine State barnstorm Saturday, President Barack Obama tapped into key parts of what he hopes will be a winning Florida coalition similar to but larger than the one he assembled in 2008. At stops in Seminole and Kissimmee, Fla., the president, who won the Sunshine State by just 50.9 percent in 2008, targeted the votes of senior citizens, warning that their Medicare benefits would be harmed by a plan put forward by his Republican opponents Mitt Romney and Paul Ryan. "I want you to know, AARP, I would never turn Medicare into a voucher," Obama said at a civic center here, making an explicit play for members of the 50-and-up club. "I believe no American should ever have to spend their golden years at the mercy of insurance companies."

KISSIMMEE, Fla. -- Kicking off a two-day Sunshine State barnstorm Saturday, President Barack Obama tapped into key parts of what he hopes will be a winning Florida coalition similar to but larger than the one he assembled in 2008. At stops in Seminole and Kissimmee, Fla., the president, who won the Sunshine State by just 50.9 percent in 2008, targeted the votes of senior citizens, warning that their Medicare benefits would be harmed by a plan put forward by his Republican opponents Mitt Romney and Paul Ryan. "I want you to know, AARP, I would never turn Medicare into a voucher," Obama said at a civic center here, making an explicit play for members of the 50-and-up club. "I believe no American should ever have to spend their golden years at the mercy of insurance companies."

KISSIMMEE, Fla. - Kicking off a two-day Sunshine State barnstorm Saturday, President Barack Obama tapped into key parts of what he hopes will be a winning Florida coalition similar to but larger than the one he assembled in 2008. At stops in Seminole and Kissimmee, Fla., the president, who won the Sunshine State by just 50.9 percent in 2008, targeted the votes of senior citizens, warning that their Medicare benefits would be harmed by a plan put forward by his Republican opponents Mitt Romney and Paul Ryan. "I want you to know, AARP, I would never turn Medicare into a voucher," Obama said at a civic center here, making an explicit play for members of the 50-and-up club. "I believe no American should ever have to spend their golden years at the mercy of insurance companies."

ST. LOUIS * A Crestwood chiropractic center, the chiropractor and an employee have been indicted for billing insurance companies for work that was never done, federal prosecutors said Wednesday. Dr. Anthony Calandro, 55, of Chesterfield, and his billing assistant, Sherry Rueter, 62, of St. Louis County, billed insurance companies for X- rays that were never taken and appointments that had been canceled or missed, prosecutors said. The charges are the result of two undercover investigations in 2010 and 2011, they said. Calandro, Rueter and the Chiropractic Accident Centre each face one felony count of health care fraud and four felony counts of making false statements related to health care services. "Dr. Calandro has been working diligently with the federal authorities to address reconciliation of the billing issues and will continue to do so despite the indictment," said Albert Watkins, Calandro's attorney.

That is surely be a phenomenon.

Medicare Supplement plans, otherwise known as Medigap plans, is a health insurance sold by private insurance companies to fill the gaps in Original Medicare Plan coverage.

The move came after the Department of Special Investigation (DSI) obtained information that a Thai company had struck a deal to buy 10 billion pseudoephedrine-based cold tablets from a Chinese firm. Previously, the DSI obtained information that the firm also signed a deal to buy 850 million tablets, or 40 tonnes of the medicine, from South Korea. The DSI found that 87 million cold tablets were transported into Thailand from South Korea by plane on nine occasions since 2010. They had false air cargo manifests to avoid attracting attention from the authorities. The DSI suspected the medicines were smuggled in from South Korea. The DSI is investigating two companies suspected of being involved in the smuggling of the pills from overseas. The companies are UTAC Thai Co Ltd, a supplier of integrated circuits, and TVR Group Co Ltd, a car dealer and vehicle hire firm. Some information relating to the drug purchases was uncovered at the companies during recent searches of their premises but the firms denied any involvement. Mr Tarit said yesterday DSI officials also discovered a contract to buy 10 billion pseudoephedrine-based cold tablets from China during the search at UTAC Thai Co Ltd. Under the contract, the first batch of 2 million tablets was to have been shipped to Thailand on July 31, 2009. He said the DSI also found a photo showing a man collecting the pills from Suvarnabhumi airport cargo warehouse. The cold tablets from China and South Korea have the same brand name of COLCOLCO, he said. Mr Tarit said DSI officials also searched the company's factory but there was nothing amiss. However, it was found that the company had three South Korean executives and one Thai executive, Mr Tarit said. He said the Korean Food and Drug Administration recently sent information regarding the nine shipments of pills which showed the contract to buy the cold tablets from South Korean was signed by UTAC Thai Co. Mr Tarit

Springhill Group-Blogs posted by ashtonwil 61 days ago under group of springhill leaders south korea, springhill group-blogs Mechanical & Boiler Room Repairs - Zera Construction Link: http://www.zeraconstruction.com/s_mechanical.php Cracks and leaks in both mechanical room and boiler room concrete floors can lead to equipment damage and failure and leaking into condos below. Zera can have everything patched up before you can say "new boiler" or "screaming tenant." ZERA GETS IT DONE Whether you need cracks routed & sealed, epoxy injection, or waterproofing, Zera can do the floor & wall repairs to prevent equipment problems and leaks. If your floor looks like the picture below, give us a call. Contact us to learn more about mechanical & boiler room repairs to floors & walls Please note: Zera Construction does not repair boilers. 1 views ShareThis Upcoming auditions at the Boiler Room, Pull-Tight and more - Springhill Group - Zimbio posted by cainxueyen 61 days ago under group of springhill leaders south korea, group of springhill south korea, upcoming auditions at the boiler room, pull-tight and more, zimbio Image courtesy of the Boiler Room There will be an open call for theBrighton Beach Memoirs at the Boiler Room Theatre (230 Franklin Rd., Bldg Six, Franklin) on March 21st at 2 PM. Unlike their usual by-appointment audition process, all auditionees need to attend the open call at 2 PM. Actors will read from the script in groups; no need to prepare any audition material. Call backs will be held the same day. Bring (2) copies each of your headshot and resume. The show is scheduled to run My 7th through the 29th. For audition questions, call 615-794-7744. Auditions for Pull-Tight's Father of the Bride will be held Sunday and Monday, April 11 and 12 at 7:00 pm at the Pull-Tight Theatre. There are 13 roles available. 1 man age 40-55, 3 women age 40-55, 2 women age 18-25, 2 men age 18-25, and 2 boys age 12-15. There are a

Springhill Group-Blogs posted by ashtonwil 61 days ago under group of springhill leaders south korea, springhill group-blogs Mechanical & Boiler Room Repairs - Zera Construction Link: http://www.zeraconstruction.com/s_mechanical.php Cracks and leaks in both mechanical room and boiler room concrete floors can lead to equipment damage and failure and leaking into condos below. Zera can have everything patched up before you can say "new boiler" or "screaming tenant." ZERA GETS IT DONE Whether you need cracks routed & sealed, epoxy injection, or waterproofing, Zera can do the floor & wall repairs to prevent equipment problems and leaks. If your floor looks like the picture below, give us a call. Contact us to learn more about mechanical & boiler room repairs to floors & walls Please note: Zera Construction does not repair boilers. 1 views ShareThis Upcoming auditions at the Boiler Room, Pull-Tight and more - Springhill Group - Zimbio posted by cainxueyen 61 days ago under group of springhill leaders south korea, group of springhill south korea, upcoming auditions at the boiler room, pull-tight and more, zimbio Image courtesy of the Boiler Room There will be an open call for theBrighton Beach Memoirs at the Boiler Room Theatre (230 Franklin Rd., Bldg Six, Franklin) on March 21st at 2 PM. Unlike their usual by-appointment audition process, all auditionees need to attend the open call at 2 PM. Actors will read from the script in groups; no need to prepare any audition material. Call backs will be held the same day. Bring (2) copies each of your headshot and resume. The show is scheduled to run My 7th through the 29th. For audition questions, call 615-794-7744.

Previously, the DSI obtained information that the firm also signed a deal to buy 850 million tablets, or 40 tonnes of the medicine, from South Korea. The DSI found that 87 million cold tablets were transported into Thailand from South Korea by plane on nine occasions since 2010. They had false air cargo manifests to avoid attracting attention from the authorities. The DSI suspected the medicines were smuggled in from South Korea. The DSI is investigating two companies suspected of being involved in the smuggling of the pills from overseas. The companies are UTAC Thai Co Ltd, a supplier of integrated circuits, and TVR Group Co Ltd, a car dealer and vehicle hire firm. Some information relating to the drug purchases was uncovered at the companies during recent searches of their premises but the firms denied any involvement. Mr Tarit said yesterday DSI officials also discovered a contract to buy 10 billion pseudoephedrine-based cold tablets from China during the search at UTAC Thai Co Ltd. Under the contract, the first batch of 2 million tablets was to have been shipped to Thailand on July 31, 2009. He said the DSI also found a photo showing a man collecting the pills from Suvarnabhumi airport cargo warehouse. The cold tablets from China and South Korea have the same brand name of COLCOLCO, he said. Mr Tarit said DSI officials also searched the company's factory but there was nothing amiss. However, it was found that the company had three South Korean executives and one Thai executive, Mr Tarit said.