News
Fake Patients, Fraudulent Billing And A Multi-Billion Dollar Game: Massive Probe Begins Into America's Healthcare System
2+ hour, 50+ min ago (447+ words) The420. in Washington: The Trump administration has launched a major nationwide campaign against alleged fraud and suspicious billing practices linked to America's government-funded healthcare programmes. US Vice President J. D. Vance described the alleged fraud within Medicaid and Medicare schemes as an "organised…...
US Tightens Grip on Healthcare Fraud: Treasury Cracks Down on Medicare-Medicaid Scams, Whistleblowers to Get Rewards
1+ mon, 2+ week ago (473+ words) The United States government has intensified its crackdown on large-scale fraud targeting public healthcare programs, with the Treasury Department's financial intelligence unit Fin CEN issuing a fresh advisory on Monday. The alert calls on banks and financial institutions to remain…...
US Health Insurer Aetna Agrees to "975 Crore Settlement Over Alleged Medicare Billing Fraud
1+ mon, 4+ week ago (556+ words) The case surfaced following an investigation by the U. S. government and a whistleblower lawsuit. According to the allegations, the company submitted diagnosis codes that did not match patients" medical records, leading to increased payments from the federal government. Aetna, however, has…...
IRDAI Reviews Agent Commission Framework To Align Incentives With Policyholders
2+ mon, 1+ week ago (719+ words) The insurance regulator is examining whether spreading commissions across the life of a policy'rather than paying large upfront incentives'could improve customer retention and align agent incentives with long-term policy servicing. India's insurance regulator is considering a significant change in the…...
Consumer Body Faults Oriental Insurance For Wrongful Mediclaim Rejection, Told To Settle With Interest
4+ mon, 3+ day ago (492+ words) AHMEDABAD:" After years of dispute over a rejected mediclaim, a city consumer forum in Ahmedabad ruled that an insurer had failed to substantiate its allegation of a pre-existing disease, ordering payment of the insured amount with interest and compensation. The…...
Wrong Policies, Rising Complaints: The Insurance Sector Faces a Test of Trust
4+ mon, 1+ week ago (328+ words) FCRF Launches Flagship Compliance Certification (GRCP) as India Faces a New Era of Digital Regulation Mis-selling goes beyond simply providing incorrect information. It includes selling insurance policies without adequately assessing a customer's actual needs, risk profile, or financial capacity. In…...
Consumer Court Orders Star Health To Pay Full Medical Claim With Interest
4+ mon, 2+ week ago (502+ words) A routine health insurance claim for a "2. 25 lakh surgery spiraled into a legal test of transparency in India's insurance industry, after a consumer court found that key exclusions were never clearly disclosed to the policyholder. In July 2022, the wife of…...