Late July brings a 64% enrollment increase; owner charged with fraudulently billing Medicare over $784 million; COVID-19 hot spots lose nurses due to burnout.
2.5 Million Added to Health Coverage Rolls
More than 2.5 million Americans enrolled in health coverage during the Biden administration’s 2021 Special Enrollment Period (SEP), according to an HHS news release Tuesday. CMS data show that nearly 81.7 million people are enrolled in Medicaid and the Children’s Health Insurance Program as of March 2021. HealthCare.gov saw a 64% increase in Americans signing up for coverage in the last week of July, making it the second-highest week of enrollment since February 15. HHS credited the “Summer Sprint to Coverage” campaign with raising awareness about zero-premium or low-premium health insurance options onHealthCare.gov. The SEP closes August 15.
Florida Telemedicine Company Owner Charged for Fraud, Tax Evasion
A federal grand jury has charged a telemedicine company owner with orchestrating a health care fraud and illegal kickback scheme, which involved submitting over $784 million in false and fraudulent claims to Medicare, according to the U.S. Department of Justice. Creaghan Harry of Highland Beach, Florida, is charged in the superseding indictment with 1 count of conspiracy to commit health care fraud and wire fraud, and 4 counts of income tax evasion. Medicare paid more than $247 million to Harry’s telemedicine companies for orders to durable medical equipment suppliers.. If convicted, Harry faces a maximum penalty of 20 years in prison for the conspiracy to commit health care fraud and wire fraud, 5 years on each count of tax evasion, 5 years for the conspiracy to defraud the United States and pay and receive kickbacks, 10 years for each count of receipt of kickbacks, and 20 years on the conspiracy to commit money laundering.
Hospitals Understaffed Due To COVID-19
A shortage of nurses and other front-line staff in COVID-19 hot spots leaves hospitals struggling to keep up with the amount of COVID-related hospitalizations, according to AP News. Patients with COVID-19 are filling up so many hospital beds in Florida that ambulance services and fire departments are straining to respond to emergencies and some patients are waiting up to an hour before being admitted. According to Joe Kanter, Louisiana chief public health officer, one patient who suffered a heart attack was transferred to 6 different hospitals before finding an emergency room with enough space to take him in. Burnout among nurses a trend of nurses taking out-of-state temporary jobs are major reasons hospitals are losing employees.
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Symptom Documentation Differences in Acute Cancer Care Suggest Sociodemographic Disparities
April 22nd 2025Researchers are calling for more targeted efforts to improve health equity after a new analysis revealed that cancer symptom documentation and burden vary across certain demographics.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Rare Autoimmune Disorder Linked With Increased Risk of Certain Skin Cancers
April 21st 2025The risk of some skin cancers, including squamous cell carcinoma, basal cell carcinoma, and non-melanoma skin cancer, was particularly heightened among patients with severe mucous membrane pemphigoid.
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