Federal and local authorities on Wednesday began arresting about three dozen people suspected of belonging to an organized crime ring and operating a health care fraud scheme that netted as much as $ 250 million, according to people briefed on the matter.

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F.B.I. agents and police detectives around the New York City area began taking the suspects into custody early on Wednesday morning, the people said. Those arrested were expected to face charges that include racketeering, health care fraud, money laundering, insurance fraud and wire fraud, in connection with a scheme that was said to have spanned several years.

Most of the alleged crimes involved what the authorities say were bills for medically unnecessary treatments stemming from auto accident claims.

The criminal enterprise focused on the defrauding of

A Texas doctor and six others were arrested Tuesday on charges they tried to defraud federal health care programs of nearly $ 375 million in what U.S. officials described as one of the largest schemes allegedly orchestrated by a single doctor.

Dr. Jacques Roy, 54, of Rockwall, Texas, was charged with certifying or directing the certification of more than 11,000 patients for home health care services, which led to Medicare being improperly billed for more than $ 350 million and Medicaid being billed for more than $ 24 million.

The alleged scheme ran between January 2006 and November 2011, though it was not immediately clear how much was paid out by the two federal programs to Roy and the others accused in the indictment unsealed on Tuesday.

“Dr. Roy’s company is alleged to have certified more Medicare beneficiaries for home health servi…………… continues on Fox News

TUESDAY, FEBRUARY 28, 2012

RALEIGH, N.C. — Salix Pharmaceuticals, Ltd. (NASDAQ:SLXP) today announced that the Company will present at the Cowen and Company 32^nd Annual Health Care Conference in Boston, MA on Tuesday, March 6, 2012 at 10:40 a.m. ET.

Interested parties can access a live audio web cast of the presentation at http://www.salix.com. A replay of the presentation will be available at the same location.

Salix Pharmaceuticals, Ltd., headquartered in Raleigh, North Carolina, develops and markets prescription pharmaceutical products for the treatment of gastrointestinal diseases. Salix’s strategy is to in-license late-stage or marketed proprietary therapeutic drugs, complete any required development and regulatory submission of these products, and market them through the Company’s gastroenterology specialty sales and marketing team.

Salix trades on the NASDAQ Global Select Market under the ticker symbol “SLXP”.

For more information, please visit our Website at

(AP)  AUSTIN, Texas — The percentage of Texans with health insurance would rise from 74 percent to 91 percent under the new federal health care law, a state official told lawmakers Monday.

State Medicaid Director Billy Millwee also said the state is prepared to implement the new rules regardless of whether the U.S. Supreme Court declares them constitutional. Texas, along with a number of other states, has challenged the Patient Protection and Affordable Care Act in court.

“I think we’re going to be well-positioned, whether it’s found to be constitutional or not,” Millwee said.

The law for the first time requires all Americans to obtain health insurance or pay a penalty. Democrats say the law will make the nation’s health care more efficient, while Republicans complain it allows the government to overstep its authority.

The House Public Health and Insurance Committees met at the Capitol to hear about how the new federal law will affect the state. Rep. Lois Kolkhorst, chairwoman of the public health committee, said she was concerned that small and medium-sized businesses may not be prepared to the new requirements on them to offer health insurance to employees.

Katrina Daniel, an associate commissioner at the Texas Department of Insurance, said the agency was working on developing model health plans for the state. She said the federal law requires i…………… continues on CBS News

AUSTIN, Texas (WTW) — The percentage of Texans with health insurance would rise from 74 percent to 91 percent under the new federal health care law, a state official told lawmakers Monday.

State Medicaid Director Billy Millwee also said the state is prepared to implement the new rules regardless of whether the U.S. Supreme Court declares them constitutional. Texas, along with a number of other states, has challenged the Patient Protection and Affordable Care Act in court.

“I think we’re going to be well-positioned, whether it’s found to be constitutional or not,” Millwee said.

The law for the first time requires all Americans to obtain health insurance or pay a penalty. Democrats say the law will make the nation’s health care more efficient, while Republicans complain it allows the government to overstep its authority.

The House Public Health and Insurance Committees met at the Capitol to hear about how the new federal law will affect the state. Rep. Lois Kolkhorst, chairwoman of the public health committee, said she was concerned that small and medium-sized businesses may not be prepared to the new requirements on them to offer health insurance to employees.

Katrina Daniel, an associate commissioner at the Texas Department of Insurance, said the agency was working on developing model health plans for the state. She…………… continues on Herald Times Reporter

Republican U.S. Sen. Scott Brown and the late Democratic Sen. Edward Kennedy.

Although no one knows where Democratic U.S. Sen. Edward Kennedy would stand on the issue of a broad conscience exemption to the President’s health care mandate requiring insurance providers to cover female preventative care procedures and contraception, past legislation and letters he left behind offer some clues.

But the interpretation of those clues varies greatly depending on who you ask.

Republican U.S. Sen. Scott Brown has sided with his party backing the “Respect for Rights of Conscience Act of 2011,” sponsored by U.S. Sen. Roy Blunt, a Missouri Republican. The bill would allow any insurer or employer which administers an insurance plan to deny coverage of any procedure or prescription which is in contrast to their own religious or moral convictions.

And legislation sponsored b…………… continues on MassLive.com

I’m a 23-year old-employee of a Catholic hospital. When I was 20, I was hired as a nurse’s aide. It’s hard, unglamorous and underpaid work, but together with nurses, doctors, social workers, housekeeping and administration, we take care of our patients. We also take care of each other.

The Obama administration recently made a decision to protect affordable access to birth control. Now, millions of women employed at religiously affiliated hospitals or universities will receive the same health and economic benefits as everyone else.

When I first started, I didn’t care about being an active contributor to the system or becoming a better person; I needed a job. My experiences there have taught me the value of discipline, the power of a positive attitude and most importantly, love and tolerance for others whatever their personal differences.

I understand that I’m not there to form opinions about people. I may not refuse to provide a service that medical science has proved to help others because of how it makes me feel, or how I feel about the one giving me the order. Although ministry is valuable, the organization I work for is primarily focused on providing medical care for all who need it by employing people capable of providing it.

That’s all that this provision is trying to do — provide care. Making birth control available and affordable for…………… continues on Springfield News-Leader

Democrats: ACA mandate first promoted by conservative group

The Republican term “Obamacare” has become a lightning rod to citizens concerned about the spectre of “socialized medicine.” However, polls have shown that most Americans welcome the major features of the 2010 Affordable Care Act — outlawing denial of coverage for pre-existing conditions; covering family members to age 26; providing tax credits to small business; and vesting government with power to restrain escalating medical costs, while extending health coverage to the uninsured.

Partisan opponents of the ACA have issued a legal challenge to its “mandate” requiring all eligible citizens to purchase minimum health coverage beginning in 2014, or to pay a penalty. Ironically, the mandate concept was first promoted by the conservative Heritage Foundation as its alternative to the single-payer feature of the proposed 1990s Clinton health plan. Both Mitt Romney and Newt Gingrich were then vocal supporters of the mandate, as essential to viability of a free-market universal health plan. They recognized that without a mandate, young and healthy Americans would opt out of a market-based insurance scheme, rendering it too expensive for the elderly, the poor, and children most in need of reliable coverage.

The mandate issue will be argued in the Supreme Court in late March. Proponents of the la…………… continues on Delmarva Now

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Related story: Prime Healthcare leader steps down

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The Ontario-based Prime Healthcare Services hospital management company found itself at the crosshairs of a joint Senate and Assembly Health Committees hearing in Los Angeles on Friday for alleged unfair billing practices.

State Sen. Ed Hernandez, D-West Covina, who chairs the state Senate Health Committee, called the hearing, in part, to review the allegations, but also to learn more about state reimbursement practices as 6 million Californians are expected to join the ranks of the medically insured under the new federal Affordable Care Act.

According to reported allegations, Prime

diagnosed Medicare patients with conditions they didn’t have to increase profits and cancelled insurance contracts to capture higher fees from out-of-network emergency room admissions.

“I have no problem with an entity turning a…………… continues on San Bernardino Sun

PRINCETON, N.J., Feb. 24, 2012 – /PRNewswire/ – Covance Inc. (NYSE: CVD) today announced that it will present at the Citi 2012 Global Health Care Conference on Tuesday, February  28, 2012 at 9:00 a.m. (ET). Investors may access a live webcast of the presentation at www.covance.com. In order to register and download any necessary software, please log on 10 minutes early.

Covance, with headquarters in Princeton, New Jersey, is one of the world’s largest and most comprehensive drug development services companies with annual revenues greater than $ 2 billion, global operations in more than 30 countries, and more than 11,000 employees worldwide. Information on Covance’s products and services, recent press releases, and SEC filings can be obtained through its website at www.covance.com.

Statements contained in this press release (and in the webcast announced in this press release), which are not historical facts, such as statements about prospective earnings, savings, revenue, operations, revenue, earnings growth, and other financial results are forward-looking statements pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. All such forward-looking statements in…………… continues on Sacramento Bee

CLEVELAND, Feb. 24, 2012 – CLEVELAND, Feb. 24, 2012 /PRNewswire/ – The Health IT Accelerator (H.I.T. Accelerator), designed to grow health care IT companies in the Cleveland region, is being launched today by BioEnterprise in partnership with a number of Cleveland region health care, research, and medical payer organizations.  The novel platform for emerging companies recognizes the growing interest in and opportunities for IT entrepreneurs in the health arena.

“The H.I.T. Accelerator is a new approach to growing the region’s health IT companies.  It harnesses the expertise of the region’s health care leadership to assist emerging companies,” said Baiju R. Shah, President & CEO of BioEnterprise.  ”The focus is on assisting companies by providing them access to customers and business advice, putting them in a better position to continue to grow their ventures.”

The H.I.T. Accelerator provides emerging health IT companies access to IT executives and decision-makers at their targeted customers, including Cleveland Clinic, University Hospitals, Summa Health System, MetroHealth System, Akron General, SummaCare, Medical Mutual, and Case Western Reserve University.   The organizations will provide critical feedback and also engage with selected companies for demonstration projects.  In addition, selected compa…………… continues on Sacramento Bee

While the Affordable Care Act will expand health insurance coverage for low-income persons through Medicaid and state health-insurance exchanges, including much-needed care for 1.8 million uninsured veterans in the U.S., the new insurance coverage option also may have a number of unintended negative effects on health care for veterans, said Kenneth W. Kizer, director of the Institute for Population Health Improvement at UC Davis Health System.

His viewpoint, including recommendations for evaluating services in preparation for 2014, appears in the Feb. 22 issue of the Journal of the American Medical Association.

“The Affordable Care Act will not affect health care for the majority of veterans differently than it will affect nonveterans, and it will not change eligibility for VA health care, covered benefits, co-payment for services, or how the VA health-care system is administered or operated,” Kizer said. “But it will affect health care for many veterans through its effects on access, fragmentation and quality of care, utilization of services, the health-care workforce and cost. We need to define and quantify the potential impacts that additional health-insurance choices from the Affordable Care Act will have on the delivery of health-care services for veterans in 2014.”

Kizer is a member of the Institute of Medicine of the National Academ…………… continues on News-Medical.net

Seven organizations received the funding, which is designed to advance the formation of health insurance co-operatives — an alternative to the idea of a government-run public option and an entity to compete against private insurance plans.

Kaiser Health News: Feds Jump-Start Health Insurance Co-Ops With Loans
Seven organizations will receive a total of $ 639 million in federal low-interest loans to launch new, consumer-governed health insurance plans in eight states, the federal government announced Tuesday (Meyer, 2/21).

The Hill: Administration Announces First Reform Law Loans To Nonprofit Insurance Co-Ops
The Obama administration on Tuesday announced the first low-interest loans to nonprofit health insurance co-operatives funded under the healthcare reform law. The loan program was created as an alternative to the politically doomed government-run public option as a way to compete against private plans. Seven plans covering eight states have been awarded $ 640 million, part of the $ 6 billion the law sets aside in loans and grants (Pecquet, 2/21).

(AP)  MONTPELIER, Vt. — With the Vermont House poised to debate the next big step on the road to what Gov. Peter Shumlin hopes will be single-payer health care, the governor on Wednesday defended his proposed requirement that employees of small businesses get health insurance through a state-backed insurance market known as a health care exchange.

Shumlin said about 96,000 Vermonters working for the 16,000 employers in the state with payrolls of 50 or fewer workers would be able to compare health plans, their benefits and costs on a website. The companies would have the option of continuing to offer employment-based health insurance &#8212 and get federal subsidies to do so &#8212 or let their employees buy federally subsidized health insurance on their own.

His comments came as minority Republicans were drafting amendments to change key parts of the legislation.

“The health care exchange will bring in $ 200 million of federal money in the form of tax credits to Vermonters who are currently struggling to pay for health insurance, or to their employers who are struggling to pay for health insurance,” Shumlin said.

Another $ 100 million to $ 150 million will be available for people who now get their insurance through Medicaid, which covers the poor and disabled, in addition to federal funding that comes into the state for that program now, the govern…………… continues on CBS News

Health care industry fears Medicaid ‘machete’ in state’s budget

By: Micah Maidenberg February 22, 2012

(Crain’s) — Hospitals and other health-care providers are bracing for deep revenue cuts after Gov. Pat Quinn said in his budget address today that he wants to slash $ 2.7 billion from the state’s Medicaid program.

The specifics are still to come, but Mr. Quinn suggested during his speech that there are several ways lawmakers could pare the joint federal-state program.

“In order to reduce cost pressures, we need to reconsider the groups who are eligible for Medicaid, the services we cover under the program, the utilization of these services and the way and amount we pay for them,” he said.

But hospitals fear the magnitude of the potential reductions would damage their ability to provide care.

The Association of Safety-Net Hospitals, which includes hospitals like Swedish Covenant Hospital on the Northwest Side and the Near South Side’s Mercy Hospital & Medical Center, warned “blanket cuts are not a viable solution.”

“All hospitals are not equal and safety net hospitals serving inner city, ethnically diverse communities will be radically impacted by Medicaid cuts,” the group said in a statement.

Greg Hinz: