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Rozwenc David

HealthLawyer

Gregory Pimstone of Manatt Calls It ‘White-Collar Crime’

Fraud occurs when an individual is intentionally deceiving a party for personal or financial gain. Fraud is a nonviolent type of crime and is usually committed by business professionals, hence a white-collar crime. This type of crime has been in existing for a long time even in sectors as sensitive as the healthcare sector, only that it is hidden.

Healthcare Frauds

There are different types of healthcare fraud done by various people to different victims, but in most cases, it involves medical professionals attempting to steal funds from healthcare insurance companies. For example, a patient can go for a checkup with the doctor, which is covered by health insurance where he is subjected to different tests. Later on, the patient receives an explanation of benefits through a mail that lists all the insurance company’s services he has consumed only for such a patient to realize that the most or some of the procedures listed were not performed during the visit.

The Law is there, but it is inadequate to solving this problem

The law states that anyone who intentionally submits a false claim is liable for penalties up to three times the damage incurred. However, some doctors still perform medically unnecessary tests or procedures to bill the insurance company and collect the funds.

Bribery is also a federal white-collar crime, and it is also being involved in healthcare fraud. According to Gregory Pimstone of Manatt, a medical lawyer from America, a doctor can refer patients to a particular specialist with whom the doctor agrees and receives kickbacks, in exchange for the referrals.

Other medical providers involve their patients in fraud schemes by waiving co-pays for the patients or only required patients to pay in-network amounts. Then the providers charge the insurance company a much more significant amount. Since the patients are involved, they are rendered powerless and cannot report such cases to the insurance company.

Conclusion

The government has come out to bring to a stop this kind of crime. Still, the efforts it is putting are somehow inadequate. This is because it involves professionals who understand the law and carefully define methods to maneuver through them with ease. Nevertheless, the perpetrators are highly trusted professionals who are seen by many as helping people, and the patients mainly care about their healing. Pimstone suggests that a good understanding of the methodologies they employ, it is possible to craft a method that will significantly reduce this fraud by encouraging whistle-blowing.

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Health

Ileana Hernandez Explains How Healthcare Fraud is Prosecuted

Healthcare fraud is massive.

As the cost of healthcare continues to rise, fraud in today’s healthcare system is rampant. Examples of fraud include providers overcharging for services or billing prescriptions that were not provided. The US Department of Health and Human Services (HHS) has recognized this growing problem and has set forth several guidelines to help prevent fraud among healthcare providers and patients.

Ileana Hernandez of Manatt says, “The government is taking a lot of action to investigate suspected sources of healthcare fraud.”

Statistics show that the Department of Justice (DOJ) has doubled its number of convictions for healthcare crimes over the past five years.

According to Hernandez, “Healthcare fraud can be prosecuted as a criminal case or can be handled as a civil case.”

In the criminal prosecution of healthcare fraud, prosecutors will charge individuals and companies involved in defrauding government insurance programs such as Medicare and Medicaid with one or more offenses: conspiracy, false claims (or submissions), wire fraud, mail fraud, and health care fraud.

In the healthcare industry, all eyes are on those who have been charged with fraud due to investigations conducted by either a federal or state agency. Hernandez says, “To discourage others from engaging in similar conduct, the government will often publicize its prosecutions.”

Another tool in the government’s arsenal is the False Claims Act (FCA). The FCA is a federal law that allows individuals to file lawsuits on behalf of the federal government. A person may file an action under this statute if they possess information that can be used in a case against someone who has defrauded the government. Furthermore, because the FCA provides for a bounty to whistleblowers whose actions lead to a successful recovery, it has been used as a tool for the government to encourage individuals who possess knowledge of fraud against the government to come forward with that information.

“The FCA is a primary vehicle that the federal government uses to fight healthcare fraud cases,” says Hernandez. “Over 80 percent of the healthcare fraud cases brought by the government are done so via the FCA.”

When pursuing a civil case, the focus is on allocating monetary damages among those responsible for committing healthcare fraud. For example, the False Claims Act provides that any person or corporation who submits false claims to be paid by Medicare or Medicaid will have to pay three times the amount of damages plus penalties for each false claim. Additionally, there are provisions under the FCA that provide civil fines between $5,500 to $11,000 per claim.

Because healthcare fraud can affect people’s lives and well-being, government officials must crackdown on those who choose to participate in it. “When you are talking about Medicare, people are usually thinking of old people,” says Hernandez. “But, 1 out of every 10 Americans is on Medicare right now. Fraud against the government affects all of us in the US.”

In closing, Hernandez explains, “The US Department of Justice, HHS, and Congress are making a concerted effort to go after healthcare fraud.”

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Entertainment

Best Film Leading Ladies of All Time with Ken Julian

We sat down with producer Ken Julian to discuss his picks for the best leading ladies of all time in film. As a longtime Hollywood producer, Ken has worked with some legends of film and screen. Ken is also a certified movie buff who appreciates everything from classic works to modern cinema.

Here are his picks for the 15 best leading ladies ever to grace the silver screen:

  1. Katherine Hepburn:

Ken says, “Katherine was probably one of the toughest actresses that I’ve ever worked with in the best way possible. She was truly a force to be reckoned with and wore many hats on a film set. Katherine has a powerful presence and commanding captivating screen persona.”

  1. Greta Garbo:

“She was very mysterious and aloof. And yet, she could have a great sense of humor. She also had many professional battles with MGM in her time but was still able to give outstanding performances.”

  1. Ava Gardner:

Ken says, “Ava is one tough cookie. She was the epitome of sexy and sensual on the screen. She can even make a tough guy fall for her character. I remember one time, she told me that if you have it- flaunt it. Ava is the best example of this statement.”

  1. Vivien Leigh:

“Vivian was wonderful to work with and quite professional on set.” Ken says, “She has one of the most memorable screen kisses in history with Clark Gable, and their chemistry was just undeniable onscreen.”

  1. Ingrid Bergman:

“Ingrid is a legend to me- I watched her movies growing up. She had this amazing aura about her even when she’s not acting. Her performance in Gaslight, where she plays an evil villain, is one of my favorite roles. She’s just so captivating onscreen.”

  1. Marilyn Monroe:

“Marilyn was mesmerizing onscreen. The iconic scene with the subway grate in The Seven Year Itch where her dress blows up is still very memorable to me.”

  1. Grace Kelly:

“I have nothing but good memories with Grace. She’s very professional and a great actress.”

  1. Sophia Loren:

“Sophia was hilarious and dramatic, but she’s best known for her sensuality onscreen. She always knows how to give a very sexy performance.”

  1. Julia Roberts:

“Julia is such a versatile actress, and I was always impressed with her range. She’s very funny in real life as well.”

  1. Sissy Spacek:

“Sissy is another actress who I have a lot of laughs with. She was very professional on set.”

  1. Emma Stone:

“I’d say Emma Stone is one of the best actresses right now. With her comedic timing and range, it’s just amazing.”

  1. Mia Farrow:

“Mia was very versatile as well. She can play light or dark roles, but it doesn’t matter because she delivers great performances every time.”

  1. Natalie Wood:

“Natalie was just a natural talent. It’s like she was born to do what she does.”

  1. Bette Davis:

“Bette was not an easy actress to work with at all, but her performance in All About Eve is one of the best performances ever on film.”

  1. Elizabeth Taylor:

“Elizabeth is another legend I’m so inspired by. She really knows how to own the screen with her presence and acting chops.”

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Business

Here’s Why You Need Managed IT Solutions In Your Business

What Are Managed IT Services?

Managed IT services is a practice of outsourcing IT tasks, responsibilities and maintenance to an IT services vendor. This practice can include services ranging from on-demand responses to a 24/7 scope to improve operations.

These services allow organizations to get help from external companies, thus reducing the workload and gaps that may be existing due to too many IT-related needs. They can also come on board with their expertise and experience and supplement the existing IT team.

With Managed IT services, companies can outsource tasks such as:

  • Proper monitoring and management of company infrastructure.
  • Communications support
  • Customer services & computer maintenance
  • Effective security services like penetration testing, threat hunting, or incident response.
  • Configuring and managing cloud services.

In more detail, here are three reasons why you need Managed IT Services:

Managed IT Services Promotes Regulated Operational Costs

Setting up IT infrastructure can be pricy and hard to maintain. It is often impossible to know the total operating expenses beforehand, and this gamble leads to even more expenses. There’s also the cost of salaries, benefits and bonuses, training, office or utility maintenance.

However, outsourcing your IT needs will allow you to lump your IT budget into a fixed cost set that can cut back on those large expenditures.

Faster Response Time with Managed IT services

In the fast-paced world, prompt customer response is an essential aspect of successfully running a company. Therefore, getting a process that isn’t affected by downtimes or technical glitches is a good save. This process means that even on days with a lot of web traffic, everything is still under control.

Defined Working Terms

Hiring managed IT services allows companies to set the tone and define the working terms from the beginning. It means that the time that would typically be spent recruiting, granting interviews and training staff will reduce. This allows you to pay for only needed service at a time.

Although we listed three, there are so many benefits from using Managed IT services, all of which focus on increasing compliance, productivity and efficiency.

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Home

How To Choose The Best Type Of Loft Ladder

In our daily life we are inundated with choices, we choose what to eat, what to wear and many other things. This is the same when it comes to home renovations and making changes, there are so many decisions to make even down to that of what type of Loft Ladders to use. It may seem like a really simple choice but there are actually a very wide range of ladders to fit all looks, shapes and sizes. The good thing is though that there are so many choices and there is a perfect fit for everyone. Even better there is the option to have your loft ladder made to measure with specified materials to match your home or environment and the fitting will be done for you too which will save any strains and stresses on what is probably already a stressful renovation.

What things will you need to consider when creating your perfect loft ladder? You may have an image in your head of just how you would like them to look or how you would like them to fold or be hidden so the best thing to do is to take your vision to a company that is dedicated to creating the loft ladders of your dreams. Talking to the professionals will help you to see which loft ladders will be the most beneficial for you and the space that is available around the opening of your loft. When you get talking to the professional you will be surprised at just what is available and there may even be some options available that you have not even considered.  A professional will advise you in the best way to go and they will also be able to draw up a plan so you can see what the finished product would look like before you are actually purchasing the perfect loft ladder of your dreams. This is the best way of making your home renovation dreams a reality. Choosing your specifications will be made a much easier job when you have someone on hand that can talk you through all the makes and models, that can understand the materials that are used when making specific loft ladders and also having a good understanding of an open space or a limited space and what products will work the best in each. Sometimes it may mean that you may have to change your idea slightly but whatever finished product you have and is created especially for you will certainly be the best that could have been made. Once you have your chosen loft ladders you can have full confidence in the long-lasting durability of materials and there will be no need to question your choice. It will be the best design and materials available and they will only compliment your house renovation and will match the new décor of your house without a doubt. You will be amazed at how much a pair of loft ladders can contribute to a space in your home.

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Travel

How to Choose the Perfect Atlanta Airport Limousine

When going for any kind of trip or vacation, one unavoidable ordeal is a tiring airplane flight. While the flight itself is inescapable, one thing that could make your experience more bearable is having a relaxing ride from the airport to your hotel or wherever you’re staying.

Perfect Atlanta Airport Limousine

This article will enlist several different tips you can utilize to select the perfect Atlanta airport limousine that will cater to your every need and make sure your experience is as comforting as it can be.

Pricing

One apparent thing that needs to be considered is pricing. If you have a limited budget, it makes sense for you to choose an airport limousine service that may not be top-notch but is suitable for your needs. On the other hand, if you want to spend lavishly, you could choose a service that’s top of the line, to enjoy the complete luxury experience.

Type of Transport

Similarly, you must keep in mind what type of transport you want. While an airport limousine may seem appealing, if you have a large group of friends and family traveling with you, then a more reasonable and convenient option would be using a shuttle or bus instead.

Luckily, most limousine services also offer premium options for coaches and buses, which you could utilize to avail yourself of an experience filled with luxury for a large group as well.

Service Quality

You should also be on the lookout for the service quality of limousine services. With the internet, reviews of any limousine business are a search away, and you can do an in-depth analysis to find the most customer-friendly services. You could always ask any friends you know from the area if they have had any experiences with a limousine service, and they could also provide a first-hand account.

Additionally, you should always save the contact information of any service you avail of and have a great experience with. In the future, if you visit the same place, you can conveniently just contact them again, instead of going through the whole hassle of finding a good limousine.

These are some tips that could help make it easier for you to find a suitable airport limousine that ensures your trip remains as fun as possible!

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Health

What Is Involved In Having ILasik Procedure

Laser eye surgery is becoming increasingly popular among people today, the option to have 20/20 vision again is becoming very tempting for many. All those years of wearing glasses or contact lenses and now they feel like they will have a new lease of life and confidence by undergoing the iLasik Procedure. A few years ago, it may have seemed impossible to get your eyesight back with the option of laser surgery but technology and science has come so far that almost anything is possible and having perfect vision again is no longer a mere dream, it can become a reality.

So, what is involved then in having laser eye surgery? Laser eye surgery is so safe and does not really provide any risks to your health. It may not be one hundred percent efficient in all cases but a trained and highly skilled Optometrist will be able to advise those with the matching criteria for being eligible for laser eye surgery to move forward with it. Unfortunately, there are some candidates who do not quite fit the criteria to be eligible and an optometrist will advise against it so that the person will not be disappointed with the results but those that do meet the criteria will be blown away by what having laser eye surgery can achieve. An experience of someone that has recently had laser eye surgery shows just how quickly and imminent the results are. They were asked to look at a clock which appeared blurry with their current vision and when they had received the laser treatment in the same room they were again asked by the optometrist to look at the clock and read the time and they could see it clear as day. The results of that laser eye surgery were that quick. With obvious recovery time for the eyes to become les red and a feeling of irritation for a few days where goggles were needed but other than that the vision was repaired through laser eye surgery. What more could you ask for, a quick and productive procedure?

Your optometrist will ensure full comfort and they will fully explain everything that will happen before, during and after your surgery so there will be no surprises along the way and you will have confidence that you are in safe hands. The full procedure will last about 20 minutes from beginning to end although you will be required to stay for a little while longer just to be sure that everything has gone to plan and then you can be on your way. When you take your steps out from the procedure room you will walk out and a new world will be open to you. Your own eyes now able to see the vibrant colors around, the full body of a tree rather than the shape or silhouette that you were able to see before. Laser eye surgery is no doubt life changing and going ahead with it will be the best decision you have made for a long time.

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Health

How to Find The Best Rhinoplasty Surgeon for You

Rhinoplasty is a surgery that involves altering the shape of the nose and like all surgeries, the absolute success and smoothness of this procedure rely on having the best rhinoplasty surgeon in your corner. The surgery which usually takes about 1-3 hours to complete can be classified into two; closed rhinoplasty and; open rhinoplasty.

In closed rhinoplasty, incisions are made within the nostrils, as a result, the changes are minimal. Open rhinoplasty involves making an incision within the nostrils as well as making one across the tissue between the nostrils.

Rhinoplasty may be conducted for aesthetics, to correct an injury, or to correct breathing. Whichever the case may be, it is important to know how to find the best rhinoplasty surgeon for the job.

Ask Around for The Best Rhinoplasty Surgeon

One of the most effective ways to find the right surgeon for you is to get reviews from people who have undergone similar surgery or people whose jobs are related to the field.

Furthermore, you can conduct a search online, compile the names of potential candidates and continue to eliminate them based on the reviews and credentials until you have your pick.

Qualification and Experience

Look out for the qualification credentials of the rhinoplasty surgeon you want to choose and make sure it reflects the reviews you’ve heard or read. Also, ensure that the surgeon performs the procedure you want often. Furthermore, make sure they’ve achieved the desired results of those procedures. Before and after photos may come in handy here.

Communicate With The Surgeon

To make sure you are selecting the best surgeon for the job, it is important to know the kind of person the surgeon is, how they think and what their values are. Furthermore, a competent surgeon will have no problem with explaining precisely how the procedure will go and where the bumps on the road may lie.

Hospital Ambience

A rhinoplasty surgeon who is invested in making their patients happy will pull all the stops to keep their patients are very comfortable. They easily achieve this by ensuring that the waiting areas and hospital staff are as welcoming as possible.

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Shopping

What are the Best Types of Tobacco e-Liquid?

The most popular type of e liquid is the tobacco e liquid because it is similar to the taste of cigars, pipe tobacco, and cigarette. Tobacco e-liquid has the taste of dark and woody taste of leaves. Most people that are into vaping prefer the tobacco e-liquid because it has helped countless people quit smoking.

As the most sought-after e-liquid, tobacco flavor is usually the most preferred choice by customers and its flavors range from earthy and rich to smooth and subtle. There is also another tobacco e-liquid that is combined with cream, nuts, vanilla, and caramel flavors.

Tobacco Shortfills

This type of tobacco e-liquid is mainly for people who use a lot of vape liquid. Tobacco shortfills e-liquid often last for an extended period and it has been rated as the best value for money. It usually comes in 50ml or 100ml bottles so that buyers can enjoy the flavor it brings.

Most tobacco shortfills are often sold without nicotine. However, buyers can request nicotine in their tobacco e-liquid to get similar content as the standard e-liquid.

Tobacco Nic Salts

Tobacco nic salts are usually recommended for people who are finding it difficult to stop smoking. They are fashioned to taste like the actual salt that is found in tobacco leaves. The nic salts give the user a sharp taste of nicotine giving a more subtle vape. The addition of the nic salts and tobacco flavor provides almost the same enjoyment derived from smoking.

Tobacco nic salts are produced to help anyone trying to quit smoking to stay off smoking because it is a reminiscence of the taste and smell of regular cigarettes.

Tobacco High VG

The tobacco high VG provides more vapor with the e-liquid. This type of tobacco e-liquid is suitable for sub-ohm who enjoy vaping. It also gives a smoother vape. Tobacco high VG is modeled to perfectly fit when used with larger vape mods for DL vaping.

This enables it to give perfect clouds often followed by an exotic and rich flavor. However, for people who want to use their tobacco e-liquids on transit, they can buy the tobacco 10mls because it is easier to carry it in a bag or purse while lasting for a whole day.

Conclusion

When buying your tobacco e-liquid, they do not have to be regular in taste and smell because tobacco e-liquid is produced in different blends and with expertise. Every brand of e-liquid has several options of tobacco flavors to choose from.

In addition, it is important to make the best purchase when you are shopping for tobacco e-liquids whether in an online store or on-site shops.

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Business

How to become a professional commodity trader

Becoming a professional commodity trader is a very tough task. If you do the research, you will notice the majority of the retail traders are losing money as they don’t have the basic knowledge. And when it comes to the commodity trading profession, the traders need to focus on long-term goals and trade this market with extreme discipline. Without following strict discipline in the investment business, the traders will keep on losing money and blow up the trading account within a short time.

So, is there any way by which you can become a professional trader? The simple answer is YES. Go through this article as we will give you some advanced tips which will allow you to trade this market in a better way.

Study the asset

Before you take any trade, you need to study the assets. The price movement in the commodity market is a bit different than currency pairs. If you do some research, you will realize trading in the commodity market is much harder as the price movement is not that high. So, you need to get yourself comfortable with the slow market, or else you will not do better at trading. Take your time and learn to evaluate the risk profile in a very strategic way. See how the market reacts to the critical support and resistance level. Once you become comfortable with the price movement of the trading instrument, you should be able to take the trades in the real market.

Curate a simple trading strategy

To become a professional trader, you should never rely on a complex trading strategy. Try to develop a simple trading strategy so that you can do well in the market. Unless you learn to curate a professional trading strategy, you will never succeed in the trading profession. Visit this link and get a professional demo account from Saxo so that you can do well in the trading profession. Once you become good at analyzing the important market variable, you should be able to develop a professional trading strategy. But develop your trading method in the demo trading account so that you don’t have to lose any money. Once you curate the trading strategy, you need to back-test the trading system.

Backtest your trading strategy

Back-testing your trading strategy is one of the most difficult tasks for novice traders. The novice traders think that they know a lot about this market. But after trading the market for few months they realize they have faults in their trading system. Before you jump into the real market, you should trade with your develop your trading method in the demo account. If you can make a consistent profit in the demo trading account for few months, you should consider the trading strategy as a valid one. If not, you need to revise your trading strategy again.

Study the major chart pattern

To make a big profit in the trading industry, you must study the major chart pattern. Analyzing the chart pattern is one of the most effective ways to make a big profit in this market. The traders often think that they don’t have to deal with the chart patterns. But if you trade without knowing anything about the major chart pattern, you will keep on losing money. Thus you will blame the market and loses a significant portion of your trading capital. The only way by which you can solve this problem is by following strategic actions. Learn about the important chart patterns and try to use them in your trading approach.

Trade with a very low risk

As a trader, you should always trade the market with low risk. If you fail to do the proper market analysis, you should not trade the market in an aggressive way. Learn to trade this market with 2% risk exposure as it will allow you to survive in the market. Never get confused with your actions since you don’t have any idea about the outcome of any trade.

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