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$23 Million Health Care Fraud Case with Miami Pharmacy Owner

A co-owner and operator of three Miami pharmacies pleaded guilty in to a $23 million health care fraud scheme. Jose Carlos Morales pleaded guilty before the U.S. District Court to conspiracy to commit health care fraud and conspiracy to pay illegal health care kickbacks. Court documents indicate Morales co-owned Pharmovisa Inc. and PharmovisaMD Inc., which together operated three pharmacies in Miami. Morales pleaded guilty to paying co-conspirators kickbacks in return for beneficiary information which he used to submit Medicare and Medicaid claims. The beneficiaries resided in assisted living facilities located in Miami. According to court documents, Morales also paid physicians kickbacks in exchange for prescription referrals. Morales billed the referrals to Medicare. The case also documents a process that began in 2007 in which delivery drivers working for the three pharmacies would visit assisted living facilities to distribute medication. They were instructed to pick up unused medication and delivery ...

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Workers’ Compensation cost increase in third quarter

Commercial insurance prices rose 6% between July and September of this year. This continues the seven straight quarters where commercial insurance increased, according to a recent report by Towers Watson & Co. Workers’ compensation, as a part of the commercial insurance picture, racked up some of the largest increases. According to the report, "The largest price increases year over year included workers' compensation, now approaching double digits, and employment practices liability, followed closely by commercial property, where price increases have moderated somewhat since last quarter." The report was put together with information from 39 commercial insurance companies that represented about 20% of the commercial insurance market in the U.S. The reports noted that the loss ratios for the companies improved over 3% year-over-year for the quarter. As a business owner, it is important to keep an eye on how your employees are classified with workers’ compensation. As duties assigned to di ...

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Obesity Study Ranks States

According to a new analysis issued by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), 12 states have an adult obesity rate higher than 30 percent. The analysis used state obesity rates recently made available by the U.S. Centers for Disease Control and Prevention (CDC). The state with the highest obesity rate is Mississippi at 34.9 percent. Colorado had the lowest rate at 20.7 percent. In addition, 26 of the 30 states with the highest obesity rates are in the Midwest and South. According to the newly released data from the CDC, in the 2011 Behavioral Risk Factor Surveillance Survey” (BRFSS), obesity rates by state (from highest to lowest) were: 1. Mississippi (34.9%) 2. Louisiana (33.4%) 3. West Virginia (32.4%) 4. Alabama (32.0%) 5. Michigan (31.3%) 6. Oklahoma (31.1%) 7. Arkansas (30.9%); 8. (tie) Indiana (30.8%); and South Carolina (30.8%) 10. (tie) Kentucky (30.4%); and Texas (30.4%) 12. Missouri (30.3%); 13. (tie) Kansas (29.6%); and Ohi ...

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Changes to the tax benefits of 401(k) plans affect their perceived value.

The American Benefits Institute (of the American Benefits Council), surveyed 516 companies about the impact some of the fiscal cliff proposal would have on their plans to continue to offer a 401(k) plan. 46% of companies in the poll answered that they would consider dropping their 401(k) plans if tax exclusions are limited to the employees in the 28 percent tax bracket. One out of three companies would end their 401(k) programs with the implementation of a limited tax exclusion or if the 20-20 proposal passes. With the passage of the “20-20” proposal, which limits 401(k) contributions to $20,000 or 20 percent of compensation, businesses with 1,000 or more employees are more likely to consider cutting benefits or dropping the 401(k) plans. The results indicated that business leaders feel the current 401(k) tax exclusion plan contributions strongly contribute to a workers’ decision to open and fund a plan. 72% of employers feel the tax exclusion is a reason why workers contribute more to th ...

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New Survey Shows Work/Life Fit Tops Pay and Benefits

According to a new survey by the American Psychological Association (APA), in spite of uncertainty in the job market, the top reasons working Americans stay with companies are work/life fit and enjoying what they do. The Workforce Retention Survey examined the factors that contribute to employee retention. The survey was conducted with employed adults age 18 and older.  Even though 60 percent of working Americans say they stay with their jobs because of benefits (and 59 percent reported staying due to the pay), more than two-thirds (67 percent) said they choose to stay because their positions fit well with other areas of their lives. The same percentage of people reported staying with their current position because they like the work they do. Just 39 percent of people who took the survey listed a lack of other job opportunities as a reason for staying with their current company. For workers who said they plan to stay with their current company for more than two years, the biggest determining factors w ...

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