Insurance

Santa Ana, Calif. — The California Department of Insurance and the Orange County District Attorney’s Office (OCDA) announced the unsealing of criminal grand jury indictments in the largest medical fraud prosecution in the nation, charging the final two defendants for their role in the Unity Outpatient Surgery Center scheme, in which $154 million was fraudulently billed to medical insurance companies. ...

FARMINGTON, Conn. — Darwin Professional Underwriters, Inc. announced its financial results for the first quarter ended March 31. Highlights include:-- Gross premiums written for the first quarter are $80.0 million. First quarter gross premiums written are 7.8 percent ahead of our gross premiums for the same period a year ago. Net premiums written for the quarter of $58.0 million are ...

Accreditation is a personal matter. Leaders of every ambulatory surgery center (ASC) have their reasons for or against it, and one accrediting body may work better for one facility than for the next. Timing is also important. Now might not work, but next year? The answer is up to the leaders of each business.Some people, however, swear by accreditation. The ...

Several leaders of physician-owned surgery centers and surgical hospitals think they’ve been mistreated by mainstream hospitals and managed care organizations (MCOs), and some have filed suit. Only one case, however, is scheduled for trial, and that suit may determine whether physician-owners pursue litigation in the future, says Patrick Stueve, a lawyer who is trying the case. The outcome may also influence ...

RISK Management: Q & A with Peggy MartinBy Jennifer SchraagQ: Can you explain why root cause analysis is so important to an effective risk management program?A: Root cause analysis (RCA) is important to an effective risk management program because it provides opportunities to design and implement risk reduction strategies based on lessons learned. An important aspect of risk management is ...