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Medicare Insurance Fraud Scandals on the Rise in 2015

January 4, 2016

This summer, the largest Medicare fraud bust involved the arrest of 243 people, including 43 doctors and nurses over $712 million worth of illegal billing and bogus patient care. In Miami, a mental health facility billed over $64 million dollars for psychotherapy treatment sessions that never happened; in fact, patients were simply moved to different… Read More

HIPAA and the Business Associate: What to Expect for 2016

December 21, 2015

Over the course of the following year, federal regulators must increase their efforts to apply HIPAA compliance to business associates because so few have mature security controls. Mac McMillan, the security expert and CEO of the consulting firm CynergisTek, argues this point. In 2013, business associates became directly responsible for HIPAA compliance under the HIPAA… Read More

US Department of Labor Announcement- State Sponsored Retirement Plans!

December 8, 2015

The U.S. Department of Labor announced a new proposal to offer more workers access to employer-sponsored, state-run retirement plans that will allow states to choose various roll-out options. With over 70 million employees without a retirement plan, supporters cite its benefits in enabling people to have an option for retirement savings. The rule would allow… Read More

4 Ways to Grow your Agency in 2016

December 8, 2015

Agents can be excited at the opportunities for growth in 2016. Start by taking inventory of your agency book of business. Do you niche? If not, you may be losing out on lucrative opportunities. Niche market agents are those who grow their book of business, through referrals, by becoming experts in all aspects of one… Read More

CMS Issues Guidance for Agent/Broker Compensation Processes

December 8, 2015

The Centers for Medicare and Medicaid Services has recently provided guidance to Section 120.4.2 of the Medicare Marketing Guidelines regarding agent/broker compensation.  This guidance specifies when a carrier can pay full or pro-rated initial compensation. CMS states: There are three scenarios affecting how an organization may pay full or pro-rated initial compensation. For a beneficiary’s… Read More

No Cost of Living Adjustment in 2016

November 18, 2015

The Social Security Administration announced that there will be no cost of living adjustment (COLA) for the upcoming year. Since Part B premium is expected to have a slight increase, Medicare enrollees need to keep this in mind when evaluating the available plan choices. Half of all people with Medicare are living on less than… Read More

Critical Flaws Continue in Obamacare Enrollment Process

November 18, 2015

The Government Accountability Office, GAO, has found critical flaws in the mechanisms of the enrollment process for Obamacare leaving a potential for wide scale fraud. In their tests conducted in 2013 and 2014, using fictitious enrollees into both Obamacare and Medicaid, the fake enrollees were able to obtain subsidized coverage or Medicaid, despite the fact… Read More

Increase in Fine for No Health Insurance

November 18, 2015

Starting November 1, the penalties for the millions of people who are eligible for health insurance coverage but choose to remain uninsured in 2016 is going up; $695 or 2.5 % of taxable income, whichever is greater. This is up from the $325 or 2% of income in 2015. In 2014 the fine was $95… Read More