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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

Wallabies star pens Chiefs deal Exeter Chiefs boss Rob Baxter was delighted with the capture of Wallabies star Dean Mumm who has penned a two-year deal at the club. The south west outfit announced the signing on Monday, with the 28-year-old set to move to the English top flight from New South Wales Waratahs after the conclusion of the current Super 15 season. The 27-year-old made his Waratahs' debut back in 2004 and has won more than 30 caps for the Australia national side. He can also operate at flanker but prefers to do his work in the boiler room, and Baxter feels he has everything required to be a massive part of the club's future over the next couple of seasons. "He's a very good signing for us and a very good player," he told reporters. "He is a back five forward coming into his physical prime. "We've looked at lot at him and we believe he has got a lot of ingredients that we want him to bring to the club." Exeter finished eight in their debut season in the Premiership but are currently fifth in the standings this season with just one regular-season game to go. Victory over Northampton at the weekend would have guaranteed them a play-off berth but the 18-15 defeat means they must now win at Saracens to have any chance of making the top four. Despite the disappointment, Baxter feels that it is testament to how far the club has come that top players now want to come and ply their trade in Devon. "Personally, I think it's a great credit to what the players have achieved this season, and where we are as a club right now, that a guy of that standing wants to come and play his rugby here in Exeter," he added.

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

Wallabies star pens Chiefs deal Exeter Chiefs boss Rob Baxter was delighted with the capture of Wallabies star Dean Mumm who has penned a two-year deal at the club. The south west outfit announced the signing on Monday, with the 28-year-old set to move to the English top flight from New South Wales Waratahs after the conclusion of the current Super 15 season. The 27-year-old made his Waratahs' debut back in 2004 and has won more than 30 caps for the Australia national side. He can also operate at flanker but prefers to do his work in the boiler room, and Baxter feels he has everything required to be a massive part of the club's future over the next couple of seasons. "He's a very good signing for us and a very good player," he told reporters. "He is a back five forward coming into his physical prime. "We've looked at lot at him and we believe he has got a lot of ingredients that we want him to bring to the club." Exeter finished eight in their debut season in the Premiership but are currently fifth in the standings this season with just one regular-season game to go. Victory over Northampton at the weekend would have guaranteed them a play-off berth but the 18-15 defeat means they must now win at Saracens to have any chance of making the top four. Despite the disappointment, Baxter feels that it is testament to how far the club has come that top players now want to come and ply their trade in Devon. "Personally, I think it's a great credit to what the players have achieved this season, and where we are as a club right now, that a guy of that standing wants to come and play his rugby here in Exeter," he added.

Joan H. Krause University of North Carolina (UNC) at Chapel Hill - School of Law August 8, 2012 Annals of Health Law, Vol. 21, No. 1, 2012 UNC Legal Studies Research Paper No. 2018589 Abstract: This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the "intangible right to honest services," has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration's emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

Joan H. Krause University of North Carolina (UNC) at Chapel Hill - School of Law August 8, 2012 Annals of Health Law, Vol. 21, No. 1, 2012 UNC Legal Studies Research Paper No. 2018589 Abstract: This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the "intangible right to honest services," has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration's emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

Wallabies star pens Chiefs deal Exeter Chiefs boss Rob Baxter was delighted with the capture of Wallabies star Dean Mumm who has penned a two-year deal at the club. The south west outfit announced the signing on Monday, with the 28-year-old set to move to the English top flight from New South Wales Waratahs after the conclusion of the current Super 15 season. The 27-year-old made his Waratahs' debut back in 2004 and has won more than 30 caps for the Australia national side. He can also operate at flanker but prefers to do his work in the boiler room, and Baxter feels he has everything required to be a massive part of the club's future over the next couple of seasons. "He's a very good signing for us and a very good player," he told reporters. "He is a back five forward coming into his physical prime. "We've looked at lot at him and we believe he has got a lot of ingredients that we want him to bring to the club." Exeter finished eight in their debut season in the Premiership but are currently fifth in the standings this season with just one regular-season game to go. Victory over Northampton at the weekend would have guaranteed them a play-off berth but the 18-15 defeat means they must now win at Saracens to have any chance of making the top four. Despite the disappointment, Baxter feels that it is testament to how far the club has come that top players now want to come and ply their trade in Devon. "Personally, I think it's a great credit to what the players have achieved this season, and where we are as a club right now, that a guy of that standing wants to come and play his rugby here in Exeter," he added.

In today's economic climate, who will help you protect your company and your clients from the devastating impact of fraud? Fraud can creep into your business in a number of ways. You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution. A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to: * Investigate allegations against one of your employees * Recommend strong anti-fraud internal controls * Conduct interviews related to sensitive issues * Provide assistance with financial dispute resolution * Resolve irregularities discovered during your company's audit * Provide expert testimony on financial and investigative matters A Unique Set of Skills Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud. CFEs work in a variety of disciplines including accounting, auditing, fraud investigation and security, as well as in different industry segments including government, healthcare, financial services, manufacturing and retail distribution. CFEs are knowledgeable in four areas critical to the fight against fraud: * Fraudulent Financial Transactions * Criminology & Ethics * Legal Elements of Fraud * Fraud Investigation Reduce Fraud Risks and Costs Heightened fraud awareness, combined with new laws and regulations, has increased the already growing demand in the workforce for professionals who are highly skilled at deterring, detecting and investigating fraud. CFEs have the ability to: * Identify and reduce opportunities for fraud * Implement effective anti-fraud controls * Continuously improve anti-fraud measures based on new risks and technologies * Educate employees to deter fraud and report wrongdoing * Resolve allegations or suspicions of f

In today's economic climate, who will help you protect your company and your clients from the devastating impact of fraud? Fraud can creep into your business in a number of ways. You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution. A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to: * Investigate allegations against one of your employees * Recommend strong anti-fraud internal controls * Conduct interviews related to sensitive issues * Provide assistance with financial dispute resolution * Resolve irregularities discovered during your company's audit * Provide expert testimony on financial and investigative matters A Unique Set of Skills Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud. CFEs work in a variety of disciplines including accounting, auditing, fraud investigation and security, as well as in different industry segments including government, healthcare, financial services, manufacturing and retail distribution. CFEs are knowledgeable in four areas critical to the fight against fraud: * Fraudulent Financial Transactions * Criminology & Ethics * Legal Elements of Fraud * Fraud Investigation Reduce Fraud Risks and Costs Heightened fraud awareness, combined with new laws and regulations, has increased the already growing demand in the workforce for professionals who are highly skilled at deterring, detecting and investigating fraud. CFEs have the ability to: * Identify and reduce opportunities for fraud * Implement effective anti-fraud controls * Continuously improve anti-fraud measures based on new risks and technologies * Educate employees to deter fraud and report wrongdoing * Resolve allegations or suspicions of f

In today's economic climate, who will help you protect your company and your clients from the devastating impact of fraud? Fraud can creep into your business in a number of ways. You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution. A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to: * Investigate allegations against one of your employees * Recommend strong anti-fraud internal controls * Conduct interviews related to sensitive issues * Provide assistance with financial dispute resolution * Resolve irregularities discovered during your company's audit * Provide expert testimony on financial and investigative matters A Unique Set of Skills Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud. CFEs work in a variety of disciplines including accounting, auditing, fraud investigation and security, as well as in different industry segments including government, healthcare, financial services, manufacturing and retail distribution. CFEs are knowledgeable in four areas critical to the fight against fraud: * Fraudulent Financial Transactions * Criminology & Ethics * Legal Elements of Fraud * Fraud Investigation Reduce Fraud Risks and Costs Heightened fraud awareness, combined with new laws and regulations, has increased the already growing demand in the workforce for professionals who are highly skilled at deterring, detecting and investigating fraud.

Joan H. Krause University of North Carolina (UNC) at Chapel Hill - School of Law August 8, 2012 Annals of Health Law, Vol. 21, No. 1, 2012 UNC Legal Studies Research Paper No. 2018589 Abstract: This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the "intangible right to honest services," has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration's emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

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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 States." Dai Bingguo issued a rebuttal on behalf of China, saying, "I wish to point out in particular the fundamental way to manage state-to-state relations is to abide by the basic norms of international relations, namely to respect China's sovereignty, core interests and choice of social system." Meanwhile, Chinese President Hu Jintao made his point known in his opening speech during the 4th round of US-China Strategic and Economic Dialogues. He remarked that US and China should know how to respect each other despite their disagreements and also appealed to its counterpart to break the conventional belief that superpowers are bound to engage in conflicts.

Joan H. Krause University of North Carolina (UNC) at Chapel Hill - School of Law August 8, 2012 Annals of Health Law, Vol. 21, No. 1, 2012 UNC Legal Studies Research Paper No. 2018589 Abstract: This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the "intangible right to honest services," has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration's emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

In today's economic climate, who will help you protect your company and your clients from the devastating impact of fraud? Fraud can creep into your business in a number of ways. You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution. A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to: * Investigate allegations against one of your employees * Recommend strong anti-fraud internal controls * Conduct interviews related to sensitive issues * Provide assistance with financial dispute resolution * Resolve irregularities discovered during your company's audit * Provide expert testimony on financial and investigative matters A Unique Set of Skills Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud.

In today's economic climate, who will help you protect your company and your clients from the devastating impact of fraud? Fraud can creep into your business in a number of ways. You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution. A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to: * Investigate allegations against one of your employees * Recommend strong anti-fraud internal controls * Conduct interviews related to sensitive issues * Provide assistance with financial dispute resolution * Resolve irregularities discovered during your company's audit * Provide expert testimony on financial and investigative matters A Unique Set of Skills Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud.

I know that Bristol board is usually used for catalog and book covers, tickets, tags and printing brochures. But as a student of architecture and an avid designer, I use this kind of paper for my scale models (which, for those who are not familiar with the term, is a smaller physical version of something bigger, like a building or an automobile). I currently have several sets of two- and three-ply bristol papers that are used as walls of my scale models. One-ply is almost translucent so I rarely use them. Bristol, as it is commonly referred to, is a kind of paperboard which is ideal for tons of things and comes in a variety of colors. I love using Bristol paper because it's very versatile. I buy a whole bunch of them and stack them on my desk so I have something nice to use in various illustrations, technical drawings and even 2D art forms. Actually, illustration boards are also fine in such purposes but I find it impractical for you can only use one side of it. On the other hand, Bristol board have two working surfaces, so basically, you can use either or both sides. And because I normally use charcoal and crayon as my primary media form, vellum finish is more ideal for me. It has a moderate surface texture which is really apt for friction-based medium. Works well with pens, too! (But if you are more focused on using ink, choose the plate finish Bristol paper instead -- it's glass-like texture is better suited for ink.) The current brand I use is from Springhill Vellum Bristol. This Bristol paper works like a charm. And it's very accessible, even online. Just go to Amazon,s website and search for Springhill Vellum Bristol Gold. One pack contains 5 sheets and weighs a total of 1 pound so it's not that costly even if you order online. Their gold colored is consistent all throughout the papers and it is the exact hue I needed, too! I also found out it worked nicely when used in promotional materials (when I once ran out of specialty paper for our theater presentation)

I know that Bristol board is usually used for catalog and book covers, tickets, tags and printing brochures. But as a student of architecture and an avid designer, I use this kind of paper for my scale models (which, for those who are not familiar with the term, is a smaller physical version of something bigger, like a building or an automobile). I currently have several sets of two- and three-ply bristol papers that are used as walls of my scale models. One-ply is almost translucent so I rarely use them.   Bristol, as it is commonly referred to, is a kind of paperboard which is ideal for tons of things and comes in a variety of colors.   I love using Bristol paper because it's very versatile. I buy a whole bunch of them and stack them on my desk so I have something nice to use in various illustrations, technical drawings and even 2D art forms. Actually, illustration boards are also fine in such purposes but I find it impractical for you can only use one side of it. On the other hand, Bristol board have two working surfaces, so basically, you can use either or both sides.   And because I normally use charcoal and crayon as my primary media form, vellum finish is more ideal for me. It has a moderate surface texture which is really apt for friction-based medium. Works well with pens, too! (But if you are more focused on using ink, choose the plate finish Bristol paper instead -- it's glass-like texture is better suited for ink.)   The current brand I use is from Springhill Vellum Bristol. This Bristol paper works like a charm. And it's very accessible, even online. Just go to Amazon.com and search for Springhill Vellum Bristol Gold.   One pack contains 5 sheets and weighs a total of 1 pound so it's not that costly even if you order online. Their gold colored is consistent all throughout the papers and it is the exact hue I needed, too!   I also found out it worked nicely when used in promotional materials (when I once ran out of specialty paper for o

It is normal for aging people to have a physical and mental decline and it happens in varying rates and this varying case sometimes needs a higher level of support. Those elderly who chooses to stay at their own home for as long as possible need somebody to constantly assess whether they are actually coping. And their children should do so but if the children live in a very far place this cant be possible so they need to assign somebody who is in regular contact with them to do the monitoring. But how can you determine if they need to be transferred to home care? Forgetfulness about household matters, it is sometimes normal but if it can costs their lives it is about time.  Going out and leaving the house unlocked  Losing keys and valuables  Stoves and ovens not turned off  Failure to place trash cans out for collection  Newspapers lying uncollected on the front lawn  Uncollected mail spilling out of the letter box  Household chores not attended to  The yard not kept tidy  Inability to care for the needs of a pet Lack of attention to personal care, if they let go of this they already need help.  Clothes not laundered as frequently as necessary  Inability to match colors when dressing  Dressing in inappropriate clothing for the time of day  Failure to keep scheduled medical appointments  Medication not being taken  A refrigerator containing mostly contaminated and unusable food  Weight loss due to illness or lack of proper dietary intake  Outdoor safety, if they are being a risk to themselves and to others it is time to get help.  Driving ability likely to cause accidents  Wandering around the neighborhood aimlessly  Getting lost  Forgetting where they live Inability to manage personal affairs  Bills that are unpaid  Leaving cash lying around the home  Losing money  Not getting to the bank to obtain cash for necessary purchases  Losing checkbooks and other documents Decline