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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

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.

The FTSE 100 fell 6.5 per cent in 2011 following a 10 per cent rise in 2010. That's disappointing - but it's better than the 15 per cent tumble for Germany and 17 per cent for France. KEY POINTS Up until the turbulence of 2011, the bulls were in the ascendency - it marked an incredible run. The Footsie's total rally to the mid-February 2011 high of 6091, represented a 73% recovery from the low of 3512 in March 2009. Emerging markets did even better in the bull market phase. The FTSE Emerging Latin America index [Bloomberg chart], rose 87% in 2009 and a further 13% in 2010. But fears for the global economy meant a sharp sell-off for the like of Brazil and China in 2011. The bad debts of banks that crippled the financial system have been passed on to governments (and their taxpayers), hence the sticky mess that emerged last year [more on Britain's debt woes]. Now debt threatens to bankrupt several southern European countries - this reality only sunk in during the summer of 2011 and was the reason for the poor performance of the stock markets in the second half of the year. The FTSE 100 hit a low of 4935 on 19 August - a 20 per cent fall from more than 5900 in July. Fresh hopes for a rescue package pumped markets back up in late October: the U.S. market had its best month since 1974. But the exuberance evaporated in November and December when a solid plan to save the euro continued to evade European leaders. Enlarge The stock market crash of 2011 We set out reasons for pessimism and optimism (which have barely changed in three years): The bull points * Central banks will stimulate economies with printed money at the slightest hint of trouble, and this has the side-effect of increasing demand for assets such as shares; * Shares look very cheap vs bonds. When FTSE 100 dividend yields exceed 10-year government bonds, it means shares are a buy. This happened in late summer 2010 and again in the second half of 2011. Others say this measure is flawed because

Abstract: Health care fraud is all about the money. The United States spent an estimated $2.5 trillion on health care in 2009, with over $918 billion of that coming from the federal government. Under some estimates, up to 10 percent of that amount - no one quite knows for sure - might be lost to fraud. But the relationship between health care fraud and the U.S. health care system is far more complex than might first appear. Would-be "fraudsters" are not the only ones who respond to the financial incentives in the system. Due to the unique nature of the laws used to pursue health care fraud, both public and private prosecutors also follow the money in choosing their targets and both may share in the spoils of a successful prosecution. Perceptions about the money lost to health care fraud also have enormous influence on policymakers, as exemplified by the recent health care reform debate. In short, money may drive health care fraud, but not all roads lead in the same direction. This essay explores three different perspectives on the ways in which health care fraud "follows the money" - the would-be perpetrators of fraudulent schemes, the public and private prosecutors who pursue fraudulent activities, and the policymakers who work to prevent fraud and recapture lost funds for legitimate program purposes. Number of Pages in PDF File: 27 Keywords: Health Care, Health Care Fraud, Crime, White Collar Crime Accepted Paper Series

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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

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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 ...

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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.

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Egypt's new president Mohamed Morsi is reconsidering the peace agreement with Israel and ties with Iran in an attempt to build a strategic balance in the region. Morsi was quick to announce that all issues will be addressed by governmental bodies as he will not make decisions on his own, according to Springhill Group Home. "Part of my agenda is the development of ties between Iran and Egypt that will create a strategic balance in the region." Morsi has convened with his advisors to form a new Cabinet prior to his swearing-in on Saturday as the first freely-elected leader. On the other hand, the defeated candidate Ahmed Shafik was found to have left the Egypt in the midst of mounting fraud charges against him since his time as the nation's civil aviation minister. The Muslim Brotherhood's candidate has pledged to become a leader for all Egyptians. "I will be a president for all Egyptians. I call on you, great people of Egypt… to strengthen our national unity - the only way out of these difficult times," Morsi said hours following his being declared the new president. Egypt has breathed a collected sigh of relief when the election and proclamation have finished without the feared bloodshed. Morsi's triumph, also marking Egypt's first fair and free election in the modern times, followed almost 2 years of political upheavel and civil unrest from Hosni Mubarak's military-rule. Britain, France, US and the European Union have deemed the democratic election and the winning civilian president as significant parts of Egypt's history. The US in particular has encouraged Morsi to continue Egypt's transition to democracy that began last year. However, even if Morsi has already resigned from the Muslim Brotherhood of Egypt when he was elected, Israel is still worried of him for his Islam affiliations that could possibly endanger the peace of the two neighboring nations. And although the foreign ministry of Iran has ackno

http://news.springhillcaregroup.net/2012/0 6/04/paypal-scam/ The World Wide Web consortium is one of the well-known partners in business. Due to the growing demand of the business industry, firms use the triple W in order for them to reach their customers across the world. And well as to ...