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Friday, July 6, 2012
Thousands of California Doctors Sue Insurance Giant Aetna
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Thousands of California doctors have banded together against insurance giant Aetna. The doctors filed a suit against the company in the Los Angeles County Superior Court accusing them of denying patients coverage for out-of-network doctors visits.
The thousands of doctors involved in the suit claim Aetna even refused patients who purchased a policy that allowed them to visit any doctors, whether they were in the network or not.
Reuters reports that the suit was brought by Los Angeles County Medical Association, the California Medical Association, and a variety of health care organizations. The complaint totals 29 pages and was filed on Tuesday, Modern Healthcare reports.
Countering the doctors? claims, spokespeople for Aetna claim that the new lawsuit is a retaliation to a lawsuit the insurance giant filed against Bay Area Surgical Management in February. In that lawsuit, Aetna charged that most of the doctors overcharged for procedures, in some cases the insurance company claims they overcharged 10 times what they should have for some procedures.
Additionally, Aetna claims that doctores referred patients to out-of-network facilities that were owned by those same medical professionals, thereby gaining a profit without telling their patients.
Reuters quotes an Aetna spokesperson, Cynthia Michener:
We have sued some of these same doctors and surgery centers named in the suit for their egregious billing practices in February of this year?This is a countersuit disguised as a class action lawsuit.
Michener made it clear that Aetna will continue to go after doctors who have accused the company with charges that are ?grossly out of line.? MSNBC quotes Michener as saying, ?This is a countersuit disguised as a class action suit.? The lawsuit filed by the doctors represents an important stand against the dominance of insurance companies in the medical field. The suit demands compensation for patients and medical professionals in the face of unfair business practices and false advertising.
Actively threatened patients
The newest complaint also asserts that Aetna actively threatened patients with denial of coverage and ejection from the program if they attempted to visit an out-of-network facility.
As Modern Healthcare sums up, the ?plaintiffs also seek an order from a judge directing Aetna to cease and desist from discouraging the use of out-of-network providers, and declaring that any Aetna contracts with providers that restrict referrals for out-of-network care are illegal and not enforceable.?
A pitched battle between healthcare providers and insurance giants illustrates the often strained relations between branches of the health care system in the United States. The personal and business interests of companies, both in insurance to pharmaceuticals, continue to plague individuals who have purchased health care but do not receive the coverage they paid for. In this regard the suit these doctors have presented against Aetna has some ground, if they can find and defend the evidence to back up their claims.
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Source: http://www.care2.com/causes/thousands-of-california-doctors-sue-insurance-giant-aetna.html
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Reversal of Fortune
Yes, we the taxpayers are paying Clement to defend DOMA. We also pay Donald Verrilli, of course, but not $1,000 an hour or $1.5 million?his annual salary is $165,300. Surely, the House Republicans will still bet on Clement as worth the price, never mind his losses this term. But his record is a reminder, welcome or not, that even the best lawyering doesn?t mean victory before the Supreme Court. The argument five justices prefer, plus good-enough lawyering, does.
Source: http://feeds.slate.com/click.phdo?i=e8f6a64b60d8fafa76d225f14457e3aa
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Thursday, July 5, 2012
Underwater Eruption Strews Ocean Surface with Dead Fish
[ [ [['Connery is an experienced stuntman', 2]], 'http://yhoo.it/KeQd0p', '[Slideshow: See photos taken on the way down]', ' ', '630', ' ', ' ', ], [ [['Connery is an experienced stuntman', 7]], ' http://yhoo.it/KpUoHO', '[Slideshow: Death-defying daredevils]', ' ', '630', ' ', ' ', ], [ [['know that we have confidence in', 3]], 'http://yhoo.it/LqYjAX ', '[Related: The Secret Service guide to Cartagena]', ' ', '630', ' ', ' ', ], [ [['We picked up this other dog and', 5]], 'http://yhoo.it/JUSxvi', '[Related: 8 common dog fears, how to calm them]', ' ', '630', ' ', ' ', ], [ [['accused of running a fake hepatitis B', 5]], 'http://bit.ly/JnoJYN', '[Related: Did WH share raid details with filmmakers?]', ' ', '630', ' ', ' ', ], [ [['accused of running a fake hepatitis B', 3]], 'http://bit.ly/KoKiqJ', '[Factbox: AQAP, al-Qaeda in Yemen]', ' ', '630', ' ', ' ', ], [ [['have my contacts on or glasses', 3]], 'http://abcn.ws/KTE5AZ', '[Related: Should the murder charge be dropped?]', ' ', '630', ' ', ' ', ], [ [['have made this nation great as Sarah Palin', 5]], 'http://yhoo.it/JD7nlD', '[Related: Bristol Palin reality show debuts June 19]', ' ', '630', ' ', ' ', ], [ [['have made this nation great as Sarah Palin', 1]], 'http://bit.ly/JRPFRO', '[Related: McCain adviser who vetted Palin weighs in on VP race]', ' ', '630', ' ', ' ', ], [ [['A JetBlue flight from New York to Las Vegas', 3]], 'http://yhoo.it/GV9zpj', '[Related: View photos of the JetBlue plane in Amarillo]', ' ', '630', ' ', ' ', ], [ [['the 28-year-old neighborhood watchman who shot and killed', 15]], 'http://news.yahoo.com/photos/white-house-stays-out-of-teen-s-killing-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120411/martinzimmermen.jpg', '630', ' ', 'AP', ], [ [['He was in shock and still strapped to his seat', 6]], 'http://news.yahoo.com/photos/navy-jet-crashes-in-virginia-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/cv/ip/ap/default/120406/jet_ap.jpg', '630', ' ', 'AP', ], [ [['xxxxxxxxxxxx', 11]], 'http://news.yahoo.com/photos/russian-grannies-win-bid-to-sing-at-eurovision-1331223625-slideshow/', 'Click image to see more photos', 'http://l.yimg.com/a/p/us/news/editorial/1/56/156d92f2760dcd3e75bcd649a8b85fcf.jpeg', '500', ' ', 'AP', ] ]
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Source: http://news.yahoo.com/underwater-eruption-strews-ocean-surface-dead-fish-155619656.html
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Monti: Italy does not need a bailout
Italian Premier Mario Monti, right, listens to German Chancellor Angela Merkel speaking at a press conference during a bilateral meeting at Villa Madama in Rome, Wednesday, July 4, 2012. Merkel is traveling to Rome for a regular meeting of the senior officials from the two countries along with several of her top ministers, including the economy and finance ministers. (AP Photo/Domenico Stinellis)
Italian Premier Mario Monti, right, listens to German Chancellor Angela Merkel speaking at a press conference during a bilateral meeting at Villa Madama in Rome, Wednesday, July 4, 2012. Merkel is traveling to Rome for a regular meeting of the senior officials from the two countries along with several of her top ministers, including the economy and finance ministers. (AP Photo/Domenico Stinellis)
German Chancellor Angela Merkel and Italian Premier Mario Monti arrive for a bilateral meeting at Villa Madama in Rome, Wednesday, July 4, 2012. Merkel is traveling to Rome for a regular meeting of the senior officials from the two countries along with several of her top ministers, including the economy and finance ministers. (AP Photo/Domenico Stinellis)
ROME (AP) ? Italian Premier Mario Monti insisted Wednesday the country doesn't need a European bailout because its public finances will improve, but acknowledges work still needs to be done to cut government spending, boost economic growth and create jobs.
Monti spoke at a press conference with German Chancellor Angela Merkel after meeting about Europe's debt crisis. It was their first encounter since European leaders in Brussels last week agreed to use the continent's bailout fund to funnel money directly to struggling banks and let countries following budget rules apply for financial aid without stringent conditions attached.
Monti, who had pressed for such a deal, insisted Italy didn't need a bailout to help it pay its government debt because its budget deficit was low compared with many other European countries and forecast to improve.
As of the end of 2011, official European statistics put Italy's deficit at 3.9 percent, just above the EU limit of 3 percent. Spain's, by contrast, was much higher at 8.5 percent.
Italy's big problem is the economy is in recession and it has a high public debt load equivalent to 120 percent of GDP. Investors fearing Italy may have trouble repaying that debt have been asking for high interest rates to lend to the country.
The measures announced by European leaders last week have helped relieve the fear that Italy may default. In particular, making it easier for countries to access European bailout funds has convinced investors that Italy has a credible financial backstop should it run into trouble financing itself.
Agreeing to loosen the conditions for bailouts was not easy, however, and was the source of heated debated between Monti and Merkel in recent weeks and at the summit.
Going into the summit, Monti had issued a thinly-veiled jab at Merkel over her opposition to allowing European governments to share debt obligations. Sharing debt is another way to spread individual countries' debt risk across Europe, but Merkel continued to oppose them at the summit.
With debt-sharing ruled out, Monti pushed for the European leaders at the summit to agree to other measures that might increase confidence in Italy's finances. Easing conditions for countries to take bailouts was one of them.
Monti has lamented that Italians have endured the effects of government spending cuts and tax hikes, but that Italy's government borrowing rates remained high in financial markets.
By Wednesday, the two leaders were downright chummy, with Monti calling Merkel by her first name and emphasizing their "excellent" relations.
Merkel, for her part, praised the speed with which Monti's government has pushed through structural reforms and insisted that it was in Germany's interest to keep Italy from failing.
"If our neighbors in Europe aren't well, eventually we Germans won't be in good shape," she said.
Monti nevertheless acknowledged a rough road ahead: the government is embarking on a program of public spending cuts after having pushed divisive labor market reforms through parliament last week.
And new unemployment figures have made clear that the recession and the impact of austerity measures are hitting home: Monti termed "unacceptable" that youth unemployment had now hit 36 percent.
"Reducing the weight of the public sector in the markets, including the financial markets, will give us greater possibilities for productivity and work for young people," he said when asked how much more austerity Italians can take before growth measures kick in.
Both leaders stressed the need for Italian and German companies to collaborate more, particularly in manufacturing, to boost economic growth.
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Monday, July 2, 2012
Eastern U.S. battles heat wave amid power outages
WASHINGTON (Reuters) - Blistering heat blanketed much of the eastern United States for the third straight day on Sunday, after violent storms that took at least 15 lives and knocked out power to more than 3 million customers.
Emergencies were declared in Maryland, Ohio, Virginia, West Virginia and Washington, D.C., on Saturday because of damage from storms that unleashed hurricane-force winds across and a 500-mile (800-km) stretch of the mid-Atlantic region.
The storms' rampage came as sweltering temperatures topped 100 Fahrenheit (38 Celsius) in several southern cities, including Atlanta, where the mercury hit an all-time record of 106 degrees (41 Celsius) on Saturday and reached 105 on Sunday.
Over two dozen cities across 10 states set or tied all-time record high temperatures on Friday and Saturday, including Columbia, South Carolina; Knoxville, Tennessee; and Raleigh, North Carolina.
The heat wave continued on Sunday for millions of people from the Plains to the mid-Atlantic. One of the hardest hit cities was Charlotte, North Carolina, where the mercury reached 104 degrees (40 C) on Sunday.
From St. Louis, Missouri, to Washington, D.C., temperatures were forecast to hit more all-time records.
"CATASTROPHIC" DAMAGE TO POWER GRIDS
Thunderstorms and high winds battered eastern North Carolina on Sunday afternoon, leading to three more deaths on top of at least 12 caused by deadly storms in several states on Saturday.
In Pitt County near Greenville, a man was killed when his shed fell on him as he tried to put his golf cart inside, said David Glenn of the National Weather Service.
A couple were killed in neighboring Beaufort County when a tree fell on their golf cart, he said.
More than 40 people were reported injured in Beaufort County and numerous homes were damaged in Pitt County, said Christy Wallace, spokeswoman for the Pitt County sheriff.
After power outages that affected some 15,000 customers, power was restored to most by late Sunday, Greenville Utilities reported.
Powerful storms that brought wind gusts of up to 90 mph on Sunday knocked out power to more than 200,000 Commonwealth Edison customers in Northeastern Illinois and about 138,000 remained without power on Sunday night, the utility said.
Power crews worked on Sunday to restore service to homes and businesses, and officials in some areas said the job could take up to a week. Utilities in Ohio, Virginia and Maryland described damage to their power grids as catastrophic.
Previous storms had left six people dead in Virginia and more than 1 million customers without power, and killed two people in Maryland, officials said.
A falling tree killed two cousins, aged 2 and 7, in New Jersey and heat was blamed for the deaths of two brothers, ages 3 and 5, in Tennessee who had been playing outside in 105-degree (41-degree C) heat
About 489,000 customers remained without power in Maryland on Sunday night, down from more than 1 million without lights and crucial air conditioning earlier on Sunday.
HEATED LABOR DISPUTE
In Ohio, severe storms knocked out power to about 1 million homes and businesses on Friday across two-thirds of the state. Governor John Kasich sought and was granted federal emergency assistance.
Storms had also left about 614,000 customers without power in West Virginia, about 135,000 in Indiana, and at least 206,000 in New Jersey, officials said.
In New York, a heated labor dispute threatened to compound problems posed by the summer heat wave, which has already put an added strain on the electrical grid for New York City and suburban Westchester county.
Power utility Consolidated Edison Inc locked out its unionized workers early on Sunday after contract talks broke down, both sides said, raising the possibility of power cuts.
The company said it had asked to extend negotiations for two more weeks but the union, which had threatened a strike by its 8,500 workers over a new contract, refused. In response, the firm told union members not to report for work on Sunday.
That left managers and any crews the company can hire to fix whatever problems arise as 8.2 million New Yorkers crank up their air conditioners to beat the heat.
(Reporting by Karen Brooks in Austin, Texas, Alex Dobuzinskis in Los Angeles, Paul Thomasch in New York, Susan Guyett in Indianapolis, Tim Ghianni in Nashville and Alistair Bull in Washington; Editing by Tom Brown, Sandra Maler, Vicki Allen and Alessandra Rizzo)
Source: http://news.yahoo.com/eastern-u-battles-heat-wave-amid-power-outages-065033909.html
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APNewsBreak: Evidence of 'God particle' found
FILE - In this May 20, 2011 file photo, a physicist explains the ATLAS experiment on a board at the European Center for Nuclear Research, CERN, outside Geneva, Switzerland. The illustration shows how the long-presumed Higgs boson particle is thought to look like. Scientists at CERN plan to make an announcement on Wednesday, July 4, 2012 about their hunt for the elusive sub-atomic particle. Physicists have said previously they are increasingly confident that they are closing in on it based on hints at its existence hidden away in reams of data. (AP Photo/Anja Niedringhaus, File)
FILE - In this May 20, 2011 file photo, a physicist explains the ATLAS experiment on a board at the European Center for Nuclear Research, CERN, outside Geneva, Switzerland. The illustration shows how the long-presumed Higgs boson particle is thought to look like. Scientists at CERN plan to make an announcement on Wednesday, July 4, 2012 about their hunt for the elusive sub-atomic particle. Physicists have said previously they are increasingly confident that they are closing in on it based on hints at its existence hidden away in reams of data. (AP Photo/Anja Niedringhaus, File)
FILE - In this May 20, 2011 file photo, a wall painting by artist Josef Kristofoletti is seen at the Atlas experiment site at the European Center for Nuclear Research, CERN, outside Geneva, Switzerland. The painting shows how a Higgs boson may look. On Wednesday, July 4, 2012, CERN plans to announce the status of their long-running hunt for the elusive subatomic particle, whose existence has only been presumed until now. (AP Photo/Anja Niedringhaus)
GENEVA (AP) ? Scientists working at the world's biggest atom smasher plan to announce Wednesday that they have gathered enough evidence to show that the long-sought "God particle" answering fundamental questions about the universe almost certainly does exist.
But after decades of work and billions of dollars spent, researchers at the European Organization for Nuclear Research, or CERN, aren't quite ready to say they've "discovered" the particle.
Instead, experts familiar with the research at CERN's vast complex on the Swiss-French border say that the massive data they have obtained will essentially show the footprint of the key particle known as the Higgs boson ? all but proving it exists ? but doesn't allow them to say it has actually been glimpsed.
It appears to be a fine distinction.
Senior CERN scientists say the two independent teams of physicists who plan to present their work at CERN's vast complex on the Swiss-French border on July 4 are about as close as you can get to a discovery without actually calling it one.
"I agree that any reasonable outside observer would say, 'It looks like a discovery,'" British theoretical physicist John Ellis, a professor at King's College London who has worked at CERN since the 1970s, told The Associated Press. "We've discovered something which is consistent with being a Higgs."
CERN's atom smasher, the $10 billion Large Hadron Collider, has been creating high-energy collisions of protons to help them understand suspected phenomena such as dark matter, antimatter and ultimately the creation of the universe billions of years ago, which many theorize occurred as a massive explosion known as the Big Bang.
The discovery of the Higgs boson won't change people's lives, but will help explain the underpinnings of the universe. It would confirm the standard model of physics that explains why fundamental particles have mass. Those particles are the building blocks of the universe. Mass is a trait that combines with gravity to give an object weight.
The phrase "God particle," coined by Nobel Prize-winning physicist Leon Lederman, is used by laymen, not physicists, more as an explanation for how the wonders of the subatomic universe work than how it all started.
Rob Roser, who leads the search for the Higgs boson at the Fermilab in Chicago, said: "Particle physicists have a very high standard for what it takes to be a discovery," and he thinks it is a hair's breadth away.
Rosen compared the results that scientists are preparing to announce Wednesday to finding the fossilized imprint of a dinosaur: "You see the footprints and the shadow of the object, but you don't actually see it."
Though an impenetrable concept to many, the Higgs boson has until now been just that ? a concept intended to explain a riddle: How were the subatomic particles, such as electrons, protons and neutrons, themselves formed? What gives them their mass?
The answer came in a theory first proposed by physicist Peter Higgs and others in the 1960s. It envisioned an energy field where particles interact with a key particle, the Higgs boson.
The idea is that other particles attract Higgs bosons and the more they attract, the bigger their mass will be. Some liken the effect to a ubiquitous Higgs snowfield that affects other particles traveling through it depending on whether they are wearing, metaphorically speaking, skis, snowshoes or just shoes.
Officially, CERN is presenting its evidence at a physics conference in Australia this week, but plans to accompany the announcement with meetings in Geneva. The two teams, ATLAS and CMS, then plan to publicly unveil more data on the Higgs boson at physics meetings in October and December. Each of the teams involves thousands of people working independently from one another, to ensure accuracy.
Scientists with access to the new CERN data say it shows with a high degree of certainty that the Higgs boson may already have been glimpsed, and that by unofficially combining the separate results from ATLAS and CMS it can be argued that a discovery is near at hand. Ellis says at least one physicist-blogger has done just that in a credible way.
CERN spokesman James Gillies said Monday, however, that he would be "very cautious" about unofficial combinations of ATLAS and CMS data. "Combining the data from two experiments is a complex task, which is why it takes time, and why no combination will be presented on Wednesday," he told AP.
But if the calculations are indeed correct, said John Guinon, a longtime physics professor at the University of California at Davis and author of the book "The Higgs Hunter's Guide," then it is fair to say that "in some sense we have reached the mountaintop."
Sean M. Carroll, a California Institute of Technology physicist flying to Geneva for the July 4th announcement, said that if both ATLAS and CMS have independently reached these high thresholds on the Higgs boson, then "only the most curmudgeonly will not believe that they have found it."
___
Borenstein reported from Washington.
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