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When the Bergen County couple filing for unemployment certified they were "able and looking for work," they did so the same way thousands of others do from home every week - by logging into the state Department of Labor website. The online world, however, is not quite as anonymous as many believe. Every computer carries a unique electronic address so it can be found on the internet, and what alerted state investigators to this particular claim was the location of the network being used. It was not in New Jersey. It was registered to Royal Caribbean Cruises in Miami, and no one was under any illusion that the couple was looking for work at sea. Unemployment fraud is a multimillion-dollar business in New Jersey, say officials, with 1,600 to 2,000 attempts to bilk the system each week - from the couple on vacation certifying they were able to work while cruising to the Bahamas, to hackers from all over the world trying to game the system, to people still trying to collect unemployment benefits even after finding new jobs. "No one likes to be ripped off, but the volume of money we put out is staggering," said Harold Wirths, the commissioner of the Department of Labor and Workforce Development. New Jersey's Unemployment Trust Fund went broke in 2009, not only under the strain of the severe recession that led to high unemployment levels, but from years of fraud that went on through decades of neglect. Wirths said the fund is now solvent again, due in part to anti-fraud measures being put into play that he said have saved the state $448.7 million the past three years. "We're fighting fraud on every front," the commissioner said. It is a national issue, according to Douglas Holmes, president of UWC Strategic Services, a Washington, D.C., group that represents businesses on unemployment issues.

Westhill Consulting Insurance - How to Avoid Health Care Fraud Mail-order medications Patients who buy drugs through mail-order companies could be rolling the dice with their health says Dr. Deborah C. Peel, a physician and founder of the nonprofit Patient Privacy Rights. There's a high probability in many cases that these drugs are counterfeit Peel added. "And you don't ever know because the fraudulent tablets look just like the real ones," says Peel. She says ordering from companies that specialize in mail-order sales that are not affiliated with a legitimate insurance company, especially from foreign countries, can be very risky. Not only could the quality be questionable, it could also be illegal. "But people are desperate because we're being so grossly overcharged for medication," she says. Peel says you can lessen costs by buying generic. You can spot it by: the best thing to do is to keep away from buying drugs from foreign or obscure pharmacies. And if you decide to go with the mail-order route, just stay with U.S.-based companies because if it's a U.S. company, you can report the health care fraud to the Food and Drug Administration while if it's a foreign company, there's little that can or will be done. False product claims According to the Federal Trade Commission, millions fall victim each year to false miracle cures. Especially vulnerable are victims of debilitating and potentially deadly illnesses such as cancer, multiple sclerosis, HIV and AIDS. The FTC website says scammers take advantage of people with a grim diagnosis such as cancer and "promote unproven - and potentially dangerous - substances like black salve, essiac tea, or laetrile with claims that the products are both 'natural' and effective." But, say physicians and other experts, simply because something is advertised as "natural" doesn't mean it works. And while a patient is experimenting with bogus treatments, he or she can squander the opportu

  Image: Pharmaceuticals. Flickr/Waleed Alzuhair. Some rights reserved.   Commerce has corrupted healthcare in the Irish semi-privatized insurance-based system.   Late last year Senator John Crown revealed under parliamentary privilege in Ireland's Senead that his own hospital, St. Vincent's University Hospital in Dublin, had in 2002 billed the country's largest private health insurer €1 million for the drug trastuzumab (Herceptin). But the drug had in fact been supplied to the hospital free by pharmaceutical giant Roche, as part of clinical trials for women with breast cancer.   This was not an inadvertent error as the hospital claimed, said Senator Crown, but deliberate financial fraud, which the hospital board had spent perhaps tens of thousands trying to cover up, employing 'substantial intimidation' to bury the matter.   Senator Crown is also Professor Crown, arguably Ireland's most distinguished oncologist. He had been told of the fraud in 2002 and at once notified all relevant health authorities.   An investigation started, and then stopped in its tracks. The hospital argued it had not known about this major research program me taking place on its premises.   The debacle had ended with the suspension of the drugs trial for a year, jeopardising the lives of women with breast cancer who might otherwise have participated in this important trial

http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-retire-overseas-8-top-spots-for-quality-health-care/

Retiring overseas may seem like a fabulous idea, but the quality of health care often has post 50s thinking twice before making a move abroad. But they needn't worry.Live and Invest Overseas, an online publication devoted to helping those interested in living abroad, has a list of the eight best places to retire for quality health care. (They also published a list of the 21 best places to retire in 2013 earlier this year.)

Westhill Consulting - Experimental Melanoma Vaccine Responds Positively Experimental Melanoma Vaccine Responds Positively One day late-stage skin cancer may be treated by 'Personalized immunotherapy' Researchers report a finding shows promise for personalized skin cancer treatment since six of seven advanced melanoma patients had a positive response to an experimental vaccine According to the investigators at the Washington University School of Medicine in St.

Wal-Mart endorsed ObamaCare in 2009 and helped drag the bill through U.S. Congress, and so far it hasn't recanted. By holding back economic growth and incomes, perhaps the law is expanding the retailer's customer base. Another plus-at least for management-is that Wal-Mart can jettison its employees into the ObamaCare insurance exchanges. The Associated Press reported Tuesday that the largest U.S. private employer is dropping health benefits for some 30,000 workers, or about 5% of its part-time workforce. Earlier health-plan eligibility triage in 2011 had removed tens of thousands of Wal-Mart workers from the balance sheet, so this latest purge was probably inevitable. Wal-Mart cites its inability to manage higher-than-anticipated health expenses. Perhaps- wasn't ObamaCare supposed to bring those costs down? Obviously the company is also responding rationally to ObamaCare's incentives. With a subsidized government alternative now open for business, and since corporations aren't liable for a penalty for not covering people who work fewer than 30 hours a week on average, cost-control logic says to send such coverage ballast over the side. Other retail and grocery chains including Target, Home Depot and Trader Joe's have already done the same. ObamaCare's critics predicted that such insurance dumping was inevitable, and the only question now is how many and how fast other companies partake of the new all-you-caneat entitlement buffet. Get whatever you like, the bill's on taxpayers. The disruptions will be concentrated in industries with large numbers of low-skilled and low-income workers, like restaurants, hospitality and, yes, retail. The irony is that even as Wal-Mart drops insurance because it is too costly, President Barack Obama is claiming credit for lowering health costs. He boasted the other day that the law gave every U.S. family "a $1,800 tax cut" by supposedly reducing the rate of employer-premium growth. Obama

National Insurance Crime Bureau (NICB) says a bill introduced in the Senate yesterday provides much needed support for fighting healthcare fraud. The Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act, was introduced by Sen. Bill Nelson (D-FL), and is co-sponsored by Sens. Susan Collins (R-ME), Tom Carper (D-DE) and Chuck Grassley (R-IA).] The bill contains important provisions to strengthen the Healthcare Fraud Prevention Partnership (HFPP). The Partnership was established last year to focus on joint efforts to fight fraud by both the public and private sectors. "NICB is particularly focused on the bill's carefully crafted provisions relating to the sharing of fraud-related information and investigative activities among the HFPP's partners," said NICB President and CEO Joe Wehrle. This language is consistent with the HFPP's anti-fraud program and with laws already in effect in many states governing anti-fraud insurance investigations. "The same fraudsters who prey on government healthcare programs and private health insurance also target the medical component of auto and workers' compensation insurance," said Wehrle. "The HFPP is the most comprehensive effort ever undertaken to bring the nation's public and private resources together to protect the integrity of medical care and insurance. The Stop SCAMS Act's support for the HFPP will strengthen it and the anti-fraud program overall." About the National Insurance Crime Bureau: headquartered in Des Plaines, Ill., the NICB is the nation's leading not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through data analytics, investigations, training, legislative advocacy and public awareness. The NICB is supported by more than 1,100 property and casualty insurance companies and self-insured organizations. NICB member companies wrote $371 billion in insurance premiums in 2013, or more than 78 percent of the nation's property/cas

The data breaches of 2014 have yet to fade into memory, and we already have 2015 looming. Experian's 2015 Data Breach Industry Forecast gives us much to anticipate, and I've asked security experts to weigh in with their thoughts for the coming year as well. Experian highlights a number of key factors that will drive or contribute to data breaches in 2015. A few of them aren't surprising: Organizations are focusing too much on external attacks when insiders are a significantly bigger threat, and attackers are likely to go after cloud-based services and data. A few new factors, however, merit your attention. First, there is a looming deadline of October, 2015 for retailers to upgrade to point-of-sale systems capable of processing chip-and-PIN credit cards. As banks and credit card issuers adopt more secure chip-and-PIN cards, and more consumers have them in hand, it will be significantly more difficult to clone cards or perpetrate credit card fraud. That's why Experian expects cybercriminals to increase the volume of attacks early in 2015, to compromise as much as possible while they still can. The third thing that stands out in the Experian report is an increased focus on healthcare breaches. Electronic medical records and the explosion of health or fitness-related wearable devices make sensitive personal health information more vulnerable than ever to being compromised or exposed. The risk of health related data being breached is also a concern voiced by Ken Westin, security analyst with Tripwire. He pointed out that part of the reason that retail breaches have escalated is because cybercriminals have developed the technologies and market for monetizing that data. "The bad news is that other industries can easily become targets once a market develops for the type of data they have. For more info: Westhill Insurance Consulting Data breach trends for 2015: C

How to spot and stop health insurance scams Medical and health insurance scams are rampant. Both government and private initiatives have renewed their focus on preventing health insurance fraud and abuse. Michael Williams, director of communications and membership of the National Health Care Anti-Fraud Association, says new and better technology, improved awareness, and more widely available information combine to combat fraud. Williams adds that while the majority of physicians run honest practices, consumers must also step up to the plate to prevent fraud. "Pay attention, do your research, read your EOBs (explanations of benefits) and beware of free offers," he says. Read on to discover some of the most common health insurance scams making the rounds and ways experts like Williams say you can guard against becoming another victim. Fake insurance policies Like counterfeit money, bogus health insurance is not only circulating, but it's becoming increasingly common. James Quiggle, communications director of the Coalition Against Insurance Fraud, says fake policies are particularly virulent. "These crooks come out of the woodwork and promise affordable premiums, no medical exams and guaranteed acceptance," Quiggle says, adding that the criminals who offer worthless policies often operate through sophisticated networks with strong marketing arms and money-laundering components. Many times they can be tied to organized crime. Often, these con artists target small businesses, unions and associations. It's only when a policyholder needs the insurance that the game's up.

BY PETER KIRAGU Kenya: The number of insurance fraud cases reduced by more than half last year thanks to tighter supervision by the Insurance Regulatory Authority ( IRA)'s Insurance Fraud Investigation Unit. According to the just released industry report for the year ended December 31, 2013, the unit received reports and detected cases of insurance fraud totaling 57 during the period compared to 133 similar cases in 2012. The report shows that fraud remains highest in motor insurance category with 21 cases reported in the year, down from 35 the previous year. Out of this, four fraudulent accident and 14 theft claims were made. Another three fraudulent cases of forged certificates were also reported. There were three fraudulent claims in the medical insurance category down from six the previous year with two fraudulent funeral claims made in the year down from nine in 2012. Fraud related to insurance agents also dropped with only six cases reported down from 38 the previous year. All the six reported cases were theft by insurance agents. The level of fraud related to insurance companies especially theft by employees remained the same with 10 cases reported. See Also: Australia agency opens