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A Chicago affiliate of health insurer Anthem won't yet be able to escape a lawsuit accusing it of improperly and regularly rejecting coverage claims, allegedly violating Medicare rules.

However, a federal judge said Anthem itself shouldn't be held accountable for the affiliate's actions.

The decision was issued March 26 by Judge Jorge Alonso, of U.S. District Court for the Northern District of Illinois. 

Alonso’s ruling kept Chicago-based American Imaging (AIM) in a suit brought in 2015 by a former employee, Dr. Susan Nedza. However, Alonso cut loose AIM’s parent comp...

Acting with Empathy During COVID-19

Fear, frustration, panic, anger, confusion … we have all been dealing with these emotions (and many others) during the COVID-19 pandemic. The amount of media attention, whether social media or news media, keeps these emotions at or near the surface seemingly all the time. Our way of life has been impacted in ways we never anticipated or imagined. As a result of these significant disruptions, it is crucial for all of us to demonstrate empathy in each and every encounter — for our patients, our coworkers and ourselves.

Before sharing...

The Department of Justice sued Anthem Blue Cross Blue Shield on Thursday for Medicare fraud after Anthem submitted inaccurate medical codes to receive higher Medicare reimbursement.

The lawsuit alleges that Anthem violated the False Claims Act when it deliberately ignored and submitted coding mistakes from 2014 to 2018. Federal prosecutors claim these coding errors yielded Anthem billions of taxpayer dollars.

The complaint highlights examples of fraud, including an instance from 2015 where Anthem coded a patient member as having active lung cancer. Despite this codin...

California has reached a deal with several financial institutions, including four of the country's five largest banks, to provide relief to homeowners affected by the coronavirus by suspending foreclosures and delaying mortgage payments, the governor announced Wednesday.

The news comes as unemployment claims in the state are soaring.

More than one million residents have filed for unemployment insurance since March 13, Gov. Gavin Newsom says, as workers continue to struggle with job losses and reduced hours, as the state looks to slow the spread of the coronavirus.

JP...

  • The one-year projected costs in the commercial market range from $34 billion to $251 billion for testing, treatment and care specifically related to COVID-19.

  • The potential costs for 2020 could range from 2 percent to 21 percent of premium if the full first-year costs of the COVID-19 pandemic were priced into premiums

  • Premium increases in the individual and employer markets for 2021 — which are in the process of being set right now — could be 40 percent or more solely because of COVID-19 costs in the absence of federal action.

  • This data comes as...

A group of Blue Cross Blue Shield plans in New York has sued Walgreens, alleging that the retail pharmacy giant has been overcharging for prescription drugs for more than a decade, according to Crain's Chicago Business.

The lawsuit accuses Walgreens of submitting prescription drug claims to BCBS at artificially inflated prices since 2007. 

BCBS alleges that Walgreens inflated the prices by billing for inflated "usual and customary prices," or the cost the general public would pay for prescriptions without going through insurance, instead of using a lower rate that ma...

A California state lawmaker said he would introduce legislation to temporarily ban evictions and home foreclosures for residents who can’t pay the bills because of the coronavirus outbreak.

Assemblyman Phil Ting, D-San Francisco, said the bill would keep Californians sheltered as long as they prove the coronavirus has affected their household financially.

“Before the coronavirus, homelessness was the thing people were talking about,” Ting said. “The last thing we want is the virus to exacerbate the problem.”

The legislation would be a similar to San Jose’s 30-day evic...

Durham billionaire Greg Lindberg has been found guilty of orchestrating what the feds have called a widespread political bribery scandal.

Following a trial that lasted from Feb. 19 through this week, a jury in Charlotte handed down its verdict Thursday morning before Judge Max Cogburn. Lindberg was found guilty of trying to bribe N.C. Insurance Commissioner Mike Causey with the promise of campaign money. He was also found guilty on another public corruptions charge.

Lindberg's Associate John Gray was also found guilty on the two public corruption charges. They b...

A settlement of $250 million has been proposed in a class action lawsuit filed against Bank of America and Countrywide Financial Corp by mortgage borrowers who claim that the two companies participated in a real estate appraisal scheme. The plaintiffs in this case allege that the defendants did not give out independent appraisals in conformity with ethical rules set forth by the Uniform Standards of Professional Appraisal Practice.

The Bank of America class action lawsuit was initiated after a former LandSafe Appraisal Services Inc. (LSA) manager named Kyle Lagow fi...

San Jose Neurospine is battling Aetna Health California in court, alleging that the insurer illegally refused to pay for emergency medical services performed by spine surgeon Adebukola Onibokun, MD, the practice's owner.

What you should know:

1. The case centers on a two-level lumbar microdiscectomy that Dr. Onibokun performed in April 2017. San Jose Neurospine submitted two claims to Aetna for reimbursement — one for emergency medical services and one for nonemergency surgery. Aetna only provided payment for the latter.

2. San Jose Neurospine filed a civil action aga...

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