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Tag: regulatory compliance

Federal Charges and Guilty Plea in $10M COVID-19 Unemployment Benefits Fraud Scheme

A Nigerian man pleaded guilty to charges related to a $10 million COVID-19 unemployment benefits fraud scheme involving multiple states and sophisticated identity theft and cryptocurrency tactics. DOJ enforcement and task force coordination highlight pandemic relief program vulnerabilities.

Nigerian National Pleads Guilty to $10M COVID-19 Unemployment Benefit Fraud Scheme

A Nigerian national pleaded guilty to a conspiracy that defrauded $10 million in COVID-19 unemployment benefits across multiple US states, involving identity theft and cryptocurrency laundering.

Virginia Court Dismisses TCPA Class Action Against Senior Life Insurance Company

Virginia court dismisses TCPA class action against Senior Life Insurance Company, underscoring the importance of factual claims about call originators for insurance telemarketing compliance.

Federal Cuts Shrink ACA Caseworker Teams Amid Growing Enrollment and Complexity

Federal workforce reductions have eliminated two ACA caseworker divisions, increasing resolution delays amid record 24 million ACA enrollees and upcoming regulatory changes.

2024 Health Insurer CEO Pay Ratios and Medicare Advantage Cost Trends

2024 health insurer CEO pay ratios reveal top executives earning up to 370 times median staff. Medicare Advantage costs remain elevated but manageable as per insurers' financial disclosures.

New Mexico Insurance Office Ensures Consumer Protection and Regulatory Compliance

The New Mexico Office of Superintendent of Insurance enforces state laws, assists consumers with insurance complaints, licenses insurers, and oversees regulatory compliance to maintain a secure insurance market.

HaysMed CEO Represents Rural Healthcare at HHS Policy Roundtable

HaysMed CEO Edward Herrman joined a key HHS healthcare policy roundtable discussing rural healthcare challenges, Medicare Advantage concerns, regulatory burdens, and AI opportunities. Insights to inform federal support and reform.

Caremark Faces Whistleblower Lawsuit Over Medicare Part D Overbilling Claims

Caremark is accused of overbilling Medicare Part D by $240-$330 million in a whistleblower lawsuit, raising significant regulatory and compliance concerns for PBMs.

Supreme Court Likely to Uphold ACA Preventive Services Coverage

The Supreme Court is poised to uphold the ACA mandate requiring insurers to provide coverage for preventive health services with no cost to patients, reinforcing regulatory compliance.

US Insurance Data Reveal Trends in Antibiotic Use, Measles Cases, COVID-19 Outcomes

Analysis of US insurance data shows no link between return-to-school policies and antibiotic use for conjunctivitis, details on measles cases, COVID-19 impacts on fertility, and benefits of Paxlovid for stroke risk reduction.