News From Around the Web
> The former owner of a California medical supply company was sentenced for 97 months in prison for fraudulently billing Medicare and Medi-Cal more than $3.5 million in unnecessary durable medical equipment. Sylvia Walter-Eze, former owner of Ezcor Medical Supply, was also found guilty of paying patient recruiters and physicians for referrals and fraudulent prescriptions for power wheelchairs. Walter-Eze received nearly $2 million of the fraudulent claims submitted. Announcement
> After prolonged legal battle to allow Salomon Melgen, M.D., accused defrauding Medicare of $109 million, to post bail, the embattled physician may finally be released from prison this week, according to The Palm Beach Post. Although Melgen was allowed to post a villa and land in the Dominican Republic as collateral for a $1 million bond, lawyers hit a snag on Monday when a judge ruled that his wife, Flor, did not speak English well enough to understand that she was required to pledge the family's assets. Melgen, who has been labeled a flight risk by prosecutors, has already given up his passports and signed a sworn statement that he would not fight efforts to bring him back to the United States if he fled the country. Article
> A Long Island chiropractor pleaded guilty to a healthcare fraud scheme in which he inappropriately billed Medicare more than $7 million between 2006 and 2012. For example, on New Year's Eve 2006, Melvin Cwibeker, M.D., billed Medicare for 133 chiropractic treatments at various assisted living facilities. Additionally, Cwibeker responded to Medicare audits by hiring other chiropractors to create fictitious patient records to support previous billings. Announcement
Health Payer News
> Industry experts say the Supreme Court's 6-3 ruling to uphold the Affordable Care Act's federal subsidies creates stability for insurers and avoids a "death spiral." Others echoed those sentiments, arguing that the ruling to keep tax credits means payers have a better grasp on the future of insurance exchanges. Article
> A recent article in the Journal of the American Medical Association (JAMA) notes that benchmarks and start-up costs of state-based health exchanges vary greatly, meaning some state legislators may elect to proceed with caution following the Supreme Court's decision to uphold federal subsidies. Although the federal government spent $4.8 in federal grants to develop state health exchanges, some were forced to cease operations because of low enrollment numbers. Article
And finally … The first rule of auto theft: Check the gas gauge. Article