15 People Charged in Huge Insurance Fraud Bust in California

shutterstock_225393481California prosecutors have charged 15 people, including a doctor, following a 5-year investigation. The charges against them involve the fraudulent billing of around $150 million from insurers. The Los Angeles District Attorney’s Office is calling it one of the biggest insurance fraud scams the state has ever seen.

The charges involve two indictments in which a number of individuals, including attorneys, referred patients to the medical clinics that were run by Munir Uwaydah, a physician. In exchange, these individuals were paid upwards of $15,000 a month. Uwaydah documented evaluations at these clinics that never actually happened and his staff justified surgeries that were performed by falsifying records. Additionally, these surgeries were performed by a physician’s assistant who had never attended medical school. Nor were any of the surgeries overseen by an actual surgeon. As many as two dozen patients that had these surgeries performed on them now have lasting scars—and many of these patients have had to undergo additional surgical procedures in order to repair damage caused by the initial surgeries.

Those charged in the case, including Uwaydah, are facing 132 felony charges. Uwaydah is currently awaiting extradition in Germany while 11 of the other individuals charged have plead not guilty to the charges. The felony charges include aggravated mayhem and capping, insurance fraud and conspiracy. One of the physicians working for Uwaydah, David Johnson, has been charged with overbilling insurance companies for medical exams that were never performed as well as for prescription drugs. Several others have been charged for falsifying documents that are related to the case.

Uwaydah had his license cancelled in 2013 due to a case brought against him by the California Medical Board back in 2009. He has also been charged in a separate indictment for illegal patient referrals, filing false tax returns, laundering money and for conspiring to commit insurance fraud. Uwaydah and 11 of the others that have been charged could face life in prison if they are convicted.

We want to keep you informed of important medical and insurance issues as they occur. Please Contact The Benefits Store for Prompt, Professional Service for all California Medical Plans.

How Much Do Medical Procedures Really Cost? New Website Reveals Costs and Quality

shutterstock_144337669A lot of people don’t understand how much medical procedures actually cost until they have to pay them. This is why having health insurance is so important and why the Affordable Care Act was passed in order to provide everyone with health insurance. However, knowing the out-of-pocket costs of medical procedures is important too. Knowing this information can help people to determine what type of health insurance will best suit their needs. A new website, California Healthcare Compare, can help people figure out how much medical procedures will cost depending on where they live in the state.

Some California residents might think that medical procedures will cost the same no matter where they live within the state. This, unfortunately, isn’t true. For example, the costs of having a baby in California can be drastically different depending on where someone lives—even if they have health insurance. For example, the out-of-pocket costs of having an uncomplicated birth in Orange County is an average of $1,800. In San Mateo County it’s around $920.

The California Healthcare Compare website is incredibly helpful in that it provides information about five of the most common medical conditions and procedures. These include childbirth, colon cancer screenings, hip and knee replacement, back pain and diabetes. The only drawback at the moment is that the site focuses on comparing information about either the costs associated with these conditions or procedures, or the quality of care provided by the hospitals treating these conditions or offering these procedures, and not both. However, this information can still be incredibly helpful for people since it will help them determine how much they can expect to pay for medical care and procedures where they live, thereby allowing them to plan accordingly in choosing a health insurance policy that will fit their needs best.

Before choosing a health insurance plan, check out the California Healthcare Compare website for helpful information about the costs and quality of medical procedures within the area you live. For more information about healthcare insurance, be sure to contact us at The Benefits Store today.

Your October 2015 Checklist

shutterstock_141564328The fall season is in full swing now that it is October. The fall season marks the beginning of the holiday season for many, with Halloween and Thanksgiving being two of the major holidays that many look forward to. Before beginning to prepare for these holidays, check out the following October checklist first:

  • Fire safety – October marks the first real change in the weather. The temperatures are beginning to get colder, which means that people are going to begin cranking up the heat as well as making use of their fireplaces. It’s important that fire safety becomes a priority through both the fall season and the following winter season. Everyone should make sure that they have smoke alarms installed on every level of their home. Replace the batteries and test every smoke alarm in the house to make sure it’s working properly.
  • Record fall memories – Fall is easily one of the most beautiful times of the year. Begin photographing the trees as the colors begin changing color and dropping off. The addition of more foggy and misty days adds can add mystery and atmosphere to these photographs. Amateur and professional photographers alike should keep an eye out for reflections of these beautiful scenes in water, such as small ponds or lakes, in order to capture particularly striking images.
  • Begin planting for next year – For anyone that wants a bit more color on their property, plan ahead for next October by planting trees and shrubs known for their colorful aesthetic now, such as Japanese maples, sassafras, baldcypress, euonymous bushes and more.
  • Eat healthy to fight seasonal depression – The days are beginning to grow shorter and the weather does take a turn for the gloomy – especially when compared to the preceding summer season. Everyone should make sure that they eat foods that are rich in omega-3s, such as salmon and walnuts. Foods rich in tryptophan, such as spinach and turkey, can help people avoid the seasonal depression as well.

Keep this October checklist in mind this month and be sure to contact us at The Benefits Store for health insurance advice.

October is Breast Cancer Awareness Month

shutterstock_162825059Breast cancer is one of the most serious conditions affecting women around the world. Breast cancer is the second most prevalent form of cancer found in women behind skin cancer and roughly one out of every eight American women born today will develop breast cancer at some point in their lives. Because of this, getting tested regularly is incredibly important, which is why October was designated as National Breast Cancer Awareness Month.

National Breast Cancer Awareness Month was established as a way to spread awareness of breast cancer and to encourage women to get a mammogram, which is a screening test that can identify breast cancer. By identifying signs of breast cancer during the earlier stages of development, there is a much better chance of treating it.

So far, around 231,840 new cases of invasive breast cancer have been reported in 2015. Around 60,290 non-invasive cases have been reported as well. An estimated 40,290 women are expected to die in 2015 due to breast cancer. However, the death rate caused by breast cancer has been dropping steadily since 1989. This is due in part to efforts to spread awareness about breast cancer and to encourage women to get tested early. Earlier detection allows for more effective treatment.

Because one of the risk factors of breast cancer is aging, women between the ages of 40 and 49 should speak with their doctors about when they should get a mammogram. Women between the ages of 50 and 74 should begin getting mammograms every two years. Women that have had a first-degree relative, such as a sister or mother, diagnosed with breast cancer are twice as at risk to develop breast cancer.  In fact, less than 15 percent of women who have breast cancer have had a family member who was diagnosed with breast cancer.

Because it is National Breast Cancer Awareness Month, we encourage all women to speak with their doctors about receiving a mammogram and we encourage everyone to speak with the women in their families about breast cancer. For more information, contact us at The Benefits Store today.

 

The Impact of the Coming “Cadillac” Tax

shutterstock_170812631The Cadillac Tax is a 40 percent tax that won’t be tax deductible and that will be levied on employer-sponsored health coverage that offers high-cost benefits. The annual tax is scheduled to take effect in 2018 – although it’s not without opposition.

What is the purpose of the Cadillac Tax?

The Cadillac Tax has been put into place as a way to reduce the tax preferred treatment of employers that provide health care as well as to reduce any excess health care spending by both employees and employers. Additionally, the Cadillac Tax will assist with financing health care coverage expansion under the PPACA (the Patient Protection and Affordable Care Act).

The tax will be 40 percent of the health coverage cost that exceeds the threshold amounts that were predetermined—$27,500 for family coverage and $10,200 for individual coverage. However, these thresholds will be updated by 2018 to reflect inflation. This will include the contributions made by both the employer and their employees.

What is the potential impact of the Cadillac Tax?

The 40 percent tax is not something employers are going to want to pay, which is why many employers are already beginning to review and trim down their health plans in order to help minimize the impact of the Cadillac Tax.

Employers with generous health plans that include flexible spending accounts will be heavily affected by the Cadillac Tax. Flexible spending accounts are popular with employees since they let them put aside tax-free money for medical expenses. The tax threshold doesn’t just take into account the premiums, but will also factor in other benefits offered to employees by their employers, such as any money that’s put into their flexible spending accounts. What does this mean? Many employers are likely to begin limiting how much their employees can add to their FSA accounts—or they may simply stop offering them altogether. In addition to trimming down their health plans, this could lead to lower quality health plan options for employees.

For more information about the upcoming Cadillac Tax, contact us at the Benefits Store today.