Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts

Wednesday, December 18, 2019

DOJ: Member of “The Dark Overlord” Hacking Group Extradited From United Kingdom to Face Charges in St. Louis

The Dark Overlord allegedly released 911 legal documents.

Defendant Conspired to Steal Sensitive Personally Identifying Information from Victim Companies and Release those Records on Criminal Marketplaces unless Victims Paid Bitcoin Ransoms

A United Kingdom national appeared today in federal court on charges of aggravated identity theft, threatening to damage a protected computer, and conspiring to commit those and other computer fraud offenses, related to his role in a computer hacking collective known as “The Dark Overlord,” which targeted victims in the St. Louis, Missouri, area beginning in 2016. 
Nathan Wyatt, 39, was extradited from the United Kingdom to the Eastern District of Missouri and arraigned on Dec. 18 before U.S. Magistrate Judge Shirley Padmore Mensah.  He pleaded not guilty and was detained pending further proceedings.
A federal grand jury indicted Wyatt on Nov. 8, 2017.  According to court records, beginning in 2016, Wyatt was a member of The Dark Overlord, a hacking group that was responsible for remotely accessing the computer networks of multiple U.S. companies without authorization, obtaining sensitive records and information from those companies, and then threatening to release the companies’ stolen data unless the companies paid a ransom in bitcoin.  Victims in the Eastern District of Missouri included healthcare providers, accounting firms, and others. Among other things, Wyatt is alleged to have participated in the conspiracy by creating email and phone accounts that he used to send threatening and extortionate emails and text messages to certain victims, including victims in the Eastern District of Missouri.  
“Today’s extradition shows that the hackers hiding behind The Dark Overlord moniker will be held accountable for their alleged extortion of American companies,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division.  “We are thankful for the close cooperation of our partners in the United Kingdom in ensuring that the defendant will face justice in U.S. court.”
“Cyber criminals who harm victims in the Eastern District of Missouri cannot hide behind international borders to evade justice,” said U.S. Attorney Jeffrey B. Jensen of the Eastern District of Missouri.  “Today’s case demonstrates the United States’ commitment to unmasking criminal hackers and bringing them to justice, no matter where they may be located.”
“Cyber hackers may no longer use territorial borders to shield themselves from accountability,” said Special Agent in Charge Richard Quinn of the FBI’s St. Louis Field Office. “This case is another example of how the FBI successfully works with international law enforcement partners to bring alleged perpetrators to justice.”
The investigation was conducted by the FBI’s St. Louis Field Office.  The FBI’s Atlanta Field Office also provided support.  The Criminal Division’s Office of International Affairs coordinated the extradition of Wyatt. The department thanks law enforcement and international cooperation authorities in the United Kingdom for their substantial assistance in the investigation.
Senior Counsel Laura-Kate Bernstein of the Criminal Division’s Computer Crime and Intellectual Property Section, and Assistant U.S. Attorneys Gwendolyn Carroll and Matthew Drake of the Eastern District of Missouri are prosecuting the case.
The details contained in the charging document are allegations.  The defendant is presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Voting is beautiful, be beautiful ~ vote.©

Thursday, October 3, 2019

DOJ: Former North Carolina State Political Party Chairman Pleads Guilty to Making a False Statement to The FBI

It seems DOJ has thwarted yet another privatized, foreign human asset management forfeiture operation of stealin' the children, land and votes, for the purposes of maximizing profits off "The Poors" (always said with clinched teeth).

These privatized foreign corporate parents always insure their tiny human assets, for the best interests, of course.

North Carolina is special when it comes to the reengineering for the residuals of the peculiar institution.

Global Bankers Insurance to sell off life insurance operations



SNL Image
Greg Linberg
The former chairman of a North Carolina state political party pleaded guilty today to making a false statement to the FBI in connection with a federal investigation into the attempted bribery of a North Carolina elected official.  U.S. Magistrate Judge David S. Cayer presided over the plea hearing.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Andrew Murray for the Western District of North Carolina and Special Agent in Charge John A. Strong of the FBI Charlotte Field Office made the announcement.

On March 18, 2019, a criminal indictment was filed in the Western District of North Carolina, charging Robert Cannon Hayes, 74, of Concord, North Carolina, who at the time was Chairman of a state political party in North Carolina; Greg E. Lindberg, founder and Chairman of Eli Global LLC (Eli Global) and the owner of Global Bankers Insurance Group (GBIG); John D. Gray, a consultant for Lindberg; and John V. Palermo, an Eli Global executive, for allegedly attempting to make improper campaign contributions to the elected Commissioner of Insurance (Commissioner) of the North Carolina Department of Insurance (NCDOI), in exchange for official personnel action favorable to Lindberg’s company, GBIG.

Eli Global
https://www.eliglobal.com/
https://en.wikipedia.org/wiki/Eli_Global
According to admissions Hayes made in connection with his guilty plea, on or about Aug. 28, 2018, Hayes falsely stated to FBI agents that he had never spoken with the NCDOI Commissioner about personnel or personnel problems at NCDOI or about Lindberg or Gray.  At the time that Hayes made the false statements, the FBI was investigating matters related to the attempted bribery of the Commissioner, therefore the defendant’s false statements were material to the investigation.

As Hayes admitted in court today, at the time he made the materially false statements, Hayes knew that it was unlawful to lie to the FBI, and knew that his statements were false because Hayes had in fact spoken with the NCDOI Commissioner about Lindberg and Gray, and about Lindberg’s request that the Commissioner move certain personnel within NCDOI.

Lindberg, Gray, and Palermo are each charged with conspiracy to commit honest services wire fraud, and bribery concerning programs receiving federal funds and aiding and abetting. Their charges are still pending.  The details contained in the indictment are allegations.  The defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

The FBI’s Charlotte Field Office is leading the investigation.

Trial Attorney James C. Mann of the Criminal Division’s Public Integrity Section and Assistant U.S. Attorneys William Stetzer and Dana Washington of the U.S. Attorney’s Office in Charlotte are prosecuting the case.

Hayes’s resume: Congress, legislature, state GOP chair. Now he’s a defendant.

Here's what happened and the key players involved in the NCGOP chairman bribery and corruption charges

Chairman Robin Hayes and major campaign donor Greg Lindberg are at the center for this case. it all started when Mike Causey reported to officials issues with campaign contributions.

As an heir to the Cannon Mills textile fortune, Robin Hayes continued his family’s philanthropic work in Cabarrus County while serving as a Republican member of Congress, candidate for governor and state GOP chairman as the party swept to statewide victories.

This week, the genial, 73-year-old Hayes played a most unfamiliar role: a defendant under indictment for allegedly trying to funnel bribe money to the reelection campaign of North Carolina’s insurance commissioner.

That news came a day after Hayes announced Monday that he wouldn’t seek reelection as state chair, saying he would focus instead on recovery from recent hip surgery.

Party leaders at the time heaped praise on Hayes, crediting him with leading a Republican resurgence while serving as chair from 2011 to 2013 and again since 2016. The role confirmed his long-held gravitas among the party’s leadership, Christian conservatives and the business community.

“I could always count on Chairman Robin Hayes,” former Gov. Pat McCrory said in a statement accompanying Monday’s announcement. “His dedication to public service, the Republican Party and his fellow man are unquestioned.”

“It’s because of his leadership that the national convention is coming to North Carolina in 2020!” added Susan Mills, vice chair of the Ninth District GOP.

On Wednesday, the party said Hayes would turn over his duties to district chair Aubrey Woodard, who will serve as the state GOP’s acting chair. Hayes looks forward to clearing his name from this week’s allegations, his attorney, Kearns Davis, said in a statement.

Hayes is the grandson of textile magnate Charles Cannon, the founder of Cannon Mills, once the world’s largest producer of towels and sheets. The company was sold in 1982 and, following the bankruptcy of its buyer, the landmark main mill in Kannapolis was demolished in 2005.

The family’s fingerprints on the state continue through its philanthropies. Hayes still serves on the boards of the Cannon Foundation, which makes grants for healthcare, higher education, human services and community projects, and the Charles A. Cannon Charitable Trusts, according to their websites.

Hayes was born in Concord on the August day in 1945 when Japan surrendered to end World War II. He’s the only child of Shell oil distributor Robert Hayes and Mariam Cannon Hayes, the daughter of Cannon Mills magnate Charles Cannon. He graduated from Duke University and worked as a hosiery mill owner and highway contractor.

His public service began in 1978, when he was elected to Concord’s town board. Years later he said former President Ronald Reagan had sparked his interest in politics.

Hayes was elected to the N.C. House in 1992, serving two terms and rising to majority whip. He ran for governor in 1996, losing to four-term Democratic Gov. Jim Hunt, but was elected to the U.S. House representing the 8th Congressional District in 1998.

“He was devoted to the Republican Party and to conservative principles of government — that’s why this is so stunning to me. It’s so out of character for him,” said former Charlotte mayor Richard Vinroot, who lost to Hayes in the 1996 Republican primary for governor.

Vinroot said he had been surprised that, following his decade in Congress, Hayes had invested so much of his time in building up the state GOP. “He may have gotten carried away with building the party,” he said, “but I know for sure he didn’t do it for Robin Hayes.”

In 2008, near the end of his five terms, Hayes was the eighth-wealthiest member of Congress with a net worth estimated at $82 million. Following the death of his mother, an auction that year of family treasures included a 19th-century Conestoga wagon and documents signed by presidents George Washington and Andrew Jackson.

As a House member, Hayes came under heavy political fire in 2005 for flipping his vote to support the Central American Free Trade Agreement, breaking a tie that passed the measure. Democrats argued the deal would send textile jobs to Central America. Hayes insisted his vote would help save the ailing industry.

In 2007, he defended NASCAR fans after some congressional aides were told to get hepatitis shots before visiting Charlotte Motor Speedway on a fact-finding trip about public health preparedness at mass gatherings.

“I feel compelled to ask why the heck the (Homeland Security) committee feels that immunizations are needed to travel to my hometown,” Hayes thundered in a letter to the committee’s Democratic chairman. “I have been to numerous NASCAR races, and the folks who attend these events certainly do not pose any health hazard to congressional staffers or anyone else.”

A ‘MOST SUCCESSFUL’ NC GOP CHAIR
Hayes’s 2008 campaign spent $3.8 million on his reelection, compared to his opponent’s $1.5 million, but Hayes lost to former textile worker and teacher Larry Kissell after narrowly defeating Kissell in 2006.

A slip-up two weeks before the election didn’t improve Hayes’s chances. “Liberals hate real Americans that work and accomplish and achieve and believe in God,” he told a crowd in Concord before an appearance by then-presidential candidate John McCain.

Hayes initially denied making the remark but later said he “wasn’t thinking” when he did so. The comment dogged him for the rest of the campaign, and Kissell easily won the seat. Four years later, Hayes’ former district director, Richard Hudson, beat Kissell to reclaim the 8th Congressional District seat for Republicans.

In the 2012 elections, during Hayes’ first stint as state GOP chair, Republicans gained a veto-proof supermajority in the state House and expanded one in the Senate, gained three congressional seats and made McCrory the state’s first Republican governor in nearly two decades.

Tami Fitzgerald, executive director of the “pro-family” N.C. Values Coalition, said it’s hard for her to square this week’s indictment with the kind, likeable Hayes she’s known since he served in the legislature in the early 1990s. “He’s a steady man of prayer, and I greatly respect him,” she said.

Fitzgerald credits Hayes as a leader in opposing abortion and advocating abstinence-based sex education. As state party chair, she said, he was skilled at bringing factions together.


“He has led the conservative movement in this state to a great degree,” she said. “He’s been a man of integrity and I greatly appreciate how he conducts himself.”


When Hayes returned as state chair in 2016, replacing the ousted Hasan Harnett after a series of controversies, the GOP delivered 15 electoral votes for President Donald Trump and took six of nine Council of State seats.

In a Charlotte Observer op-ed following allegations of election fraud in the 9th Congressional District last December, Hayes railed against “paid political mercenaries” and called for their prosecution as “a scourge on our democracy.” He wrote that the state GOP had no knowledge of the absentee ballot harvesting under investigation.

“This is a national embarrassment that can never be allowed to repeat itself,” he wrote.
Voting is beautiful, be beautiful ~ vote.©

Wednesday, January 9, 2019

DEFANGO: Layer 2 Unlocked Live Dive - Thedarkoverlord Megaleak - LONG CUT - 911 Insurance Documents

The Twin Towers were overtly, heavily insured as a well orchestrated, legal operation to make money.

By, hey, what do I know?

I know Defango is going through the second layer of unlocked megaleaks from The Dark Overlord.



Voting is beautiful, be beautiful ~ vote.©

Wednesday, January 2, 2019

DEFANGO: Going Through The Dark Overlord 911 Insurance Documents & More

The best part of all of this is that it is public information through PACER and such actions like the paywall can actually trigger a FinCEN investigation when it comes to the corporate insurance payouts, like the payouts to those "Authorities" and other Corporate Shape Shifters.

Then, there is that pesky "Attorney-Client Privilege" that can be stripped in the commission of a crime, you know.

That would bring in all the former DOJ characters like Bill Barr, Janet Napolitano, and the U.S. District Attorneys like "Pretty" Preet Baharara and Terrorism Risk Insurance Act.

#cyberwars are real.




The hackers who stole Orange is the New Black are back, and they've hit a new low. The group known as TheDarkOverlord claims to have stolen 18,000 documents from Hiscox Syndicates, Lloyds of London and Silverstein Properties, and threatened to release files providing "answers" for 9/11 attack "conspiracies" unless it received a ransom. Saying it was “welcoming 2019 with open arms and a big announcement,” the Dark Overlord hacker group Monday threatened via a Pastebin post to release files it said were nicked from a law firm – believed to have advised insurer Hiscox Syndicares Ltd. – that handled September 11-related cases.

Dark Overlord: https://pastebin.com/36QuTJXc

Hackers Threaten to Dump Insurance Files Related to 9/11 Attacks

The Dark Overlord appears to be trying to capitalize on conspiracy theories about the September 11 attacks.

On Monday, New Year’s Eve, a hacker group announced it had breached a law firm handling cases related to the September 11 attacks, and threatened to publicly release a large cache of related internal files unless their ransom demands were met.

The news is the latest public extortion attempt from the group known as The Dark Overlord, which has previously targeted a production studio working for Netflix, as well as a host of medical centres and private businesses across the United States. The announcement also signals a slight evolution in The Dark Overlord’s strategy, which has expanded on leveraging the media to exert pressure on victims, to now distributing its threats and stolen data in a wider fashion.
In its announcement published on Pastebin, The Dark Overlord points to several different insurers and legal firms, claiming specifically that it hacked Hiscox Syndicates Ltd, Lloyds of London, and Silverstein Properties.
“Hiscox Syndicates Ltd and Lloyds of London are some of the biggest insurers on the planet insuring everything from the smallest policies to some of the largest policies on the planet, and who even insured structures such as the World Trade Centers,” the announcement reads.
It is unclear what exact files the group has stolen, but it is trying to capitalize on conspiracy theories around the 9/11 attacks.
“We'll be providing many answers about 9.11 conspiracies through our 18.000 secret documents leak,” the group tweeted on Monday.
Got a tip? You can contact this reporter securely on Signal on +44 20 8133 5190, OTR chat on jfcox@jabber.ccc.de, or email joseph.cox@vice.com.
A spokesperson for the Hiscox Group confirmed to Motherboard that the hackers had breached a law firm that advised the company, and likely stolen files related to litigation around the 9/11 attacks.
“The law firm’s systems are not connected to Hiscox’s IT infrastructure and Hiscox’s own systems were unaffected by this incident. One of the cases the law firm handled for Hiscox and other insurers related to litigation arising from the events of 9/11, and we believe that information relating to this was stolen during that breach,” the spokesperson wrote in an email.
“Once Hiscox was informed of the law firm’s data breach, it took action and informed policyholders as required. We will continue to work with law enforcement in both the UK and US on this matter,” they added. Lloyds of London did not respond to a request for comment.
The hacking group published a small set of letters, emails and other documents that mention various law firms, as well as the Transport Security Administration (TSA) and Federal Aviation Administration (The TSA could not provide a statement in time for publication, and the FAA told Motherboard in an email it was investigating.) Those documents themselves appear to be fairly innocuous, but the group says it may release more.
In its extortion note, The Dark Overlord included a link for a 10GB archive of files it allegedly stole. The group also provided a link to this archive to Motherboard before publishing its announcement. The cache is encrypted, but the hackers are threatening to release the relevant decryption keys, unlocking different sets of files at a time, unless the victims pay the hackers an undisclosed ransom fee in Bitcoin.
“Pay the fuck up, or we're going to bury you with this. If you continue to fail us, we'll escalate these releases by releasing the keys, each time a Layer is opened, a new wave of liability will fall upon you,” the extortion note reads.
The Dark Overlord is also claiming to be offering to sell the data on a dark web hacking forum, and is attempting to blackmail individuals who may be included in the documents themselves.
“If you're one of the dozens of solicitor firms who was involved in the litigation, a politician who was involved in the case, a law enforcement agency who was involved in the investigations, a property management firm, an investment bank, a client of a client, a reference of a reference, a global insurer, or whoever else, you're welcome to contact our e-mail below and make a request to formally have your documents and materials withdrawn from any eventual public release of the materials. However, you'll be paying us,” the group’s post reads.
As The Dark Overlord’s announcement notes, the breach itself was previously reported in vague terms by a specialist legal publication, and Hiscox Group pointed Motherboard to the firm’s own April 2018 announcement of a data breach.
“Hiscox recently learned of an information security incident affecting a specialist law firm in the US that provided advice to Hiscox or its policyholders on some of its US commercial liability insurance claims. The incident involved illegal access to information stored on the law firm’s server, which may have included information relating to up to 1,500 of Hiscox’s US-based commercial insurance policyholders,” that earlier announcement reads.
Voting is beautiful, be beautiful ~ vote.©

Thursday, May 3, 2018

AIG Exposed - The History For Detroit Land Bank Authority



Most people know "American International Group" as the recipient of the largest bailout in history, but there is much more to this giant insurance company than that. From ties to "Wild" Bill Donovan's OSS to Arkansas money laundering to 9/11 insider trading, today we explore the allegations and connections that continue to haunt the once impervious AIG.
Voting is beautiful, be beautiful ~ vote.©

Wednesday, February 9, 2011

States Cry Foul With Health Care Mandate

Ever wanted to know why there was so much opposition to the health care reform?  Well here it is.

It's called fraud.  Yes, contained within health care reform is also regulation.  Here is a great little rant from the State of Florida.  Why are they ranting?  It is because they are not compliant.

Florida is so bad, the U.S. Department of Justice teamed up with the U.S. Department of Health and Human Resources to establish the Health Care Fraud Enforcement Task Force (H.E.A.T.)  The worst part of the levels of health care fraud in these states that are crying the unconstitutional foul is that the levels of Medicaid fraud, once the federal moritoria on the suspension of the rules are lifted, will make Medicare pail in comparison to the ugly beast called Medicaid fraud.

U.S. DHHS OIG and DOJ Health Care Fraud Prevention Enforcement Team
The lack of Medicaid and Medicare regulation in the states will substantially cut the federal funding to their programs.  In essence, coming into federally funded, mandated compliance to end Medicaid and Medicare fraud will kill jobs because these fraud scheme, racketeering operations will be shut down.
Department of Justice and Department of Health and Human Services response to Senator Grassley's inquiry on...

Friday, February 4, 2011

Single Payer Health Care Pilot Program A Success

This is the look of the future of health insurance.  This is it.  This is a single payer program.

Congressman John Conyers, Jr. has been promoting a Single Payer Program for health care for everyone to be eligible with his United States National Health Care Act, HR 676.  This program deals with a single payer source, not specifically a "single individual" paying into the program with tax dollars.

The single payer is a financial term referring to a single funding source.  When there is a single funding source, in the instance of the CHIRPA Medicaid programs for children and families, the ability exists to provide transparency, accountability and oversight through its counter program, and that is the single audit.

In the United States, the Single Audit, also known as the OMB A-133 audit, is a rigorous, organization-wide auditor examination of an entity that expends $500,000 or more of Federal assistance (commonly known as Federal funds, Federal grants, or Federal awards) received for its operations.[1][2][3] Usually performed annually,[4] the Single Audit’s objective is to provide assurance to the US federal government as to the management and use of such funds by recipients such as states, cities, universities, and non-profit organizations. The audit is typically performed by an independent certified public accountant (CPA) and encompasses both financial and compliance components. The Single Audits must be submitted to the Federal Audit Clearinghouse along with a data collection form, Form SF-SAC.


OMB Circular A-133 Compliance Supplement 2009
The Single Audit ensures there is efficiency in the delivery of services, there is continuous quality improvement of programs and services, and enforces mandatory compliance with the terms of funding source, reducing fraud, waste and abuse.

With the Electronic Health Records  incentive programs, it is only with a click of the button that these single payer programs can be reviewed through auditing programs.

Even more so, there are other codified mechanisms to ensure accountability of single payer programs such as the Sarbanes-Oxley Act.

When there are such oversight mechanisms in place, there is always an improvement in program goals.  The goals of any program is to provide care for the health of society.  Through the investment in the best interests of the child, the national society profits when the program produces a future taxpaying citizen.  The child becomes a health adult.  A healthy adult becomes part of a healthy nation.  A healthy nation lessens the drain on its economical resources.

The Medicare model of the single payer will eventually be adopted.  When it does, there will already be a plan for implementation as its pilot program is dealing with children and families.

Two Year Anniversary of Children’s Health Insurance Law Sees Millions of Newly Insured Children, Families

Two years after President Obama signed the Children’s Health Insurance Program Reauthorization Act, HHS Secretary Kathleen Sebelius today announced that more than two million more children were served by Medicaid or the Children’s Health Insurance Program (CHIP) at some point over the past year.
Together, the two programs serve more than 42 million children who would otherwise not have access to regular medical care.
“The increase in the number of children served by these two vital programs is especially significant in the face of the recent economic downturn states are experiencing,” said Secretary Sebelius. “Even in times of hardship, states have demonstrated their commitment to the health of children by continuing efforts to identify and enroll them in coverage.”

To continue to advance coverage for children, Secretary Sebelius today also announced $40 million in new grants to states, community-based organizations, school systems and others to support their outreach and enrollment activities.  The grants will help states further modernize and streamline their administrative systems, as well as create and implement school-based outreach strategies and approaches for identifying children who have historically been hard to reach.
Today’s grant announcement builds on $206 million in enrollment bonuses earned by 15 states last year that increased enrollment above specific target levels.  The bonus funds help states cover the cost of enrolling additional children in Medicaid.
“As we mark the second anniversary of one of President Obama’s first actions as President, we can be confident that CHIPRA has proven to be a tremendous success,” said Sebelius. “Now we must build on our accomplishments. Today, I am again calling on leaders across the country – from federal, state and local officials to private sector leaders – to join our effort to insure more children. We all have a stake in America’s children and together, we will ensure millions more children get the care they need.”
States were able to increase enrollment in the two programs in part because of boosts in federal support provided by the American Recovery and Reinvestment Act (ARRA).  ARRA temporarily increased federal matching funds for state Medicaid programs during the recession.
While Medicaid and CHIP have helped bring the rate of uninsured children to the lowest level in more than two decades, an estimated five million uninsured children are thought to be eligible for one of these programs, yet not covered.
The Secretary’s Challenge: Connecting Kids to Coverage, launched last year, will continue support efforts to reach more children by providing leaders with critical information and support as they work to insure more children in their communities and by closely monitoring progress. 
“States’ continued progress toward enrolling all eligible children in coverage is a significant step in cushioning the recession’s impact on access to health insurance,” said Cindy Mann, director, Center for Medicaid, State and Survey and Certification Operations, within the Centers for Medicare & Medicaid Services (CMS). “As families lose employment or have their hours cut back they may lose the health coverage benefit that came with that job.  If not for these two programs, millions more children would go without critical health care services.”
In its second annual report on CHIP and Medicaid enrollment, CMS notes that:
  • More than 2 million children gained Medicaid or CHIP coverage during federal fiscal year 2010 (October 1, 2009 – September 30, 2010). In total, Medicaid and CHIP served more than 42 million children last year. This steady increase in enrollment is evidence of the important role that Medicaid and CHIP play for children, especially during economic downturns.  The uninsured rate for children continues to decline at a time with the rate for adults is climbing.  The increase in children’s enrollment demonstrates that Medicaid and CHIP are serving the purpose for which they were created – providing high quality health coverage for lower-income families.
  • Thirteen states implemented eligibility expansions in 2010 and many others simplified their enrollment and renewal procedures.  Forty-six states and the District of Columbia now cover children with incomes up to 200 percent of the federal poverty level (FPL) in Medicaid and CHIP; with 24 of those states and the District of Columbia covering children with incomes up to 250 percent of the FPL.  Twenty-one states now offer coverage to lawfully residing immigrant children and/or pregnant women, enabling states to receive federal funding for this coverage.
  •  CHIPRA Performance Bonuses have encouraged states to adopt and augment simplification measures in Medicaid and CHIP. Fifteen states qualified for a total of $206 million in performance bonuses for FY 2010; this is a significant increase over 2009 where 10 states received bonuses totaling $75 million. These bonuses provide additional federal financial support each year to states that successfully boost enrollment above target levels among previously eligible but uninsured children in Medicaid.  To qualify, a state not only has to enroll more children, but must also have implemented program features that are designed to promote enrollment of eligible children. 
  • States are increasing their use of technology to facilitate children’s enrollment and retention.  Nearly two-thirds of states (32) have an on-line application that can be submitted electronically; 29 states allow electronic signatures on those applications.  Six states have received approval to enroll children through the “Express Lane Eligibility” option created by CHIPRA.  Express lane eligibility allows states to use data gathered for other programs such as housing assistance or food stamps to determine Medicaid or CHIP eligibility. And 33 states are utilizing the CHIPRA data matching process provided by the Social Security Administration to confirm U.S. citizenship for children.
  • Outreach and enrollment grants have advanced coverage and led to public-private partnerships throughout the country to enroll more children. Sixty-eight grantees across 41 States and the District of Columbia are working diligently to facilitate children’s enrollment in health coverage 


Children's Health Insurance Program Reauthorization Act (CHIPRA) 2010 Annual Report

Wednesday, October 13, 2010

Secretary Sebelius leads efforts to improve access to coverage for children with pre-existing conditions, urges states to take action

Secretary Sebelius leads efforts to improve access to coverage for children with pre-existing conditions, urges states to take action

HHS and states act to expand options for children; new agreements in Maryland likely to result in expanded options for children
In a letter to the National Association of Insurance Commissioners, Secretary Sebelius today outlined efforts by the U.S. Department of Health and Human Services, working with states, to ensure insurance companies keep their promise to “make pre-existing conditions exclusions a thing of the past” for children. The letter comes after insurance companies reneged on their commitment to provide coverage options for children with pre-existing conditions and refused to sell child only insurance policies.  The efforts by the Department of Health and Human Services are designed to increase options for children across America and are already having an impact. Today, the state of Maryland will announce a new agreement with Kaiser Permanente of the Mid-Atlantic and CareFirst BlueCross BlueShield that will ensure the two companies continue to sell child-only insurance policies.
The Affordable Care Act makes it illegal for insurance companies to deny coverage to children with pre-existing conditions and makes discrimination against all individuals with pre-existing conditions illegal in 2014—a trend that was rising at exceedingly high rates in recent years.  In fact, a recent report from the House Energy and Commerce Committee found that more than 651,000 people were denied coverage because of a pre-existing medical condition between 2007 and 2009.
In her letter, Secretary Sebelius further clarified the HHS regulation that implements a key early provision of the Affordable Care Act, signed into law on March 23, 2010 to prevent insurers from denying coverage to children based on a pre-existing condition.  This clarification outlines options available to insurers and states to offer child-only policies, but rejects the insurers’ idea of denying coverage to sick children outside the open enrollment period.  
“The Affordable Care Act was designed to ensure that Americans who need health insurance are no longer denied access to the care they need – and that includes the youngest and most vulnerable Americans,” said Sebelius.  “We have been working closely with the states in their role as insurance regulators and with insurance companies to find ways to improve access to coverage for America’s families.”
Today, the Maryland Insurance Administration will announce an agreement with Kaiser Permanente of the Mid-Atlantic and CareFirst BlueCross BlueShield for those companies to issue policies in the child-only insurance market, a new offering for Kaiser Permanente of the Mid-Atlantic.  This agreement, subject to approval by Maryland’s General Assembly, followed a decision by Acting Maryland Insurance Commissioner Beth Sammis to establish uniform open enrollment periods in the State for policies covering children under 19.
“Working with Maryland’s General Assembly, we will establish by regulation an open enrollment period to be sure Maryland families have more options in purchasing insurance for their children, and I commend Kaiser Permanente of the Mid-Atlantic and CareFirst BlueCross BlueShield for their decision to continue to offer this coverage once the regulations are enacted,” said Commissioner Sammis.  “We are committed to working to ensure children can get the health care they need, and are glad we have been able to find a solution where these insurers will sell new policies.”
In her letter to the NAIC, Secretary Sebelius outlined a range of steps that can be taken to help preserve coverage options for children, regardless of their health status.  This includes either states or insurance companies themselves creating open enrollment periods during which parents can purchase coverage for children who are without access to employer-based health plans.  Insurers may not enroll only healthy children in coverage outside those open enrollment periods.
Sebelius also encouraged states to take other actions, such seeking appropriate legislation to help preserve options for children with pre-existing conditions.  California, for example, recently required individual-market issuers that offer family coverage to also offer child-only policies.
A number of states, including Maine, Massachusetts, New Jersey, New York, and Vermont already have laws in place to prevent discrimination against children and others with pre-existing conditions.  About a dozen states offer unsubsidized buy-in to the Children’s Health Insurance Program (CHIP) for children so that middle income families can purchase child-only coverage at a full but fair premium.  And the new Pre-Existing Condition Insurance Plan created by the Affordable Care Act offers additional options for families to access insurance for their children with pre-existing conditions.
Full Letter Follows:
                                                            October 13, 2010
Jane L. Cline
President and West Virginia Insurance Commissioner
National Association of Insurance Commissioners
1124 Smith Street
Charleston, West Virginia 25301
Dear Jane:
I want to thank the NAIC and its members for the productive September 22 meeting with President Obama and me on the implementation of the Affordable Care Act.  It was fitting that our meeting was held so close to the six-month anniversary of the passage of the Affordable Care Act and the effective date for many of its important consumer protections.  I have been gratified by our collaborative efforts and look forward to our continuing partnership as we work to make the provisions of the Affordable Care Act a reality for all Americans.
One issue we discussed at the meeting, that I know is important to both the states and to our Administration, is ensuring there are health coverage options for all children under the age of 19, regardless of their health status.  One goal of the Affordable Care Act is prevent insurers from denying coverage to those who need it most – starting with children with pre-existing health conditions.  Without access to insurance, many sick children will not get the care they need to lead healthy lives.  The inability to obtain affordable coverage can also create significant financial challenges for the parents of these children. 
Unfortunately, as we discussed, some insurers have decided to stop writing new business in the “child-only” insurance market – reneging on a previous commitment made in a March letter to “make pre-existing condition exclusions a thing of the past.”  Although this is a small market and children currently insured by such policies will not be affected, the decision of some health insurance companies to stop selling new polices for children is extremely disappointing.  Nothing in the Affordable Care Act, or any other existing federal law, allows us to require insurance companies to offer a particular type of policy at this time. 
We have been trying to work with the insurance industry to resolve this situation.  Some insurers have said they would sell new child-only policies if they could accept year-round those applicants who are healthy, while restricting access for children with pre-existing conditions to a time-limited open enrollment period.  We have carefully considered these insurers’ legal and policy arguments, and have concluded that the approach they advocate is legally infirm, and inconsistent with the language and intent of the Affordable Care Act.  Nor would it be lawful for a state to allow denials of coverage for children based on pre-existing conditions outside of an open enrollment period.  We will continue to reach out to insurers in our effort to encourage them to sell new “child-only” policies between now and 2014 – when the new health insurance exchanges will begin to offer affordable options to children and families, banning all discrimination against all Americans based on health status. 
While we recognize industry concerns about adverse selection, we believe that there are options other than abandoning families who seek this coverage, as evidenced in states with similar laws already in place.  In response to questions we have received, we have clarified that a range of practices related to “child-only” policies are not prohibited by the Affordable Care Act, such as allowing:
  • Issuers in the individual market to determine the number and length of open enrollment periods for children under 19 (as well as those for families and adults), consistent with state law;
  • Rates to be adjusted for health status as permitted by state law (note: the Affordable Care Act prohibits health status rating for all new insurance plans starting in 2014);
  • The imposition of a surcharge for dropping coverage and subsequently reapplying for it if permitted by state law;
  • The implementation of rules, consistent with state law, to help prevent employers from encouraging workers to enroll children in child-only policies instead of employer-sponsored insurance; and
  • The sale of “child-only” policies that are self-sustaining and separate from closed “child-only” books of business if permitted by state law.
Enclosed with this letter are additional answers to frequently asked questions that address more recent inquiries.
In addition to these efforts by HHS, many states have in place existing laws to prevent discrimination against children and others with pre-existing conditions.  For example, in Maine, Massachusetts, New Jersey, New York, and Vermont, all individual market insurers are required to “guarantee issue” all their policies – meaning that all children must be offered health insurance, irrespective of their health status.  In addition, New Hampshire requires individual market carriers to guarantee issue all their policies to applicants under 19 years old.  Parents of children with pre-existing conditions in these states therefore have a right to purchase child-only policies throughout the year.  And in Michigan and Pennsylvania, so-called “insurers of last resort” are required to offer coverage on a guaranteed issue basis either periodically or continuously throughout the year to qualified applicants, including children under age 19. 
The threat of insurers’ no longer selling child-only policies has prompted additional state action as well.  Recently, Governor Schwarzenegger signed legislation that bans insurers in California from offering policies in the individual market for five years if they fail to offer child-only coverage.  A number of states, including California, Colorado, Ohio, Oregon, and Washington, have established uniform open enrollment periods, and others, such as Minnesota, have been considering doing so.  This creates a level playing field by preventing families from signing up for coverage for children only when their costs are high, and it ensures that no insurer will receive a disproportionate share of children with pre-existing conditions, since all insurers must accept such children during the same period.
States have also looked to existing programs for options for health insurance for children.  Some states offer an unsubsidized buy-in to the Children’s Health Insurance Program (CHIP).  Roughly a dozen states now allow middle-income families to purchase child-only coverage at a full but fair premium.  For example, Oregon both has required a consistent annual open enrollment period through an emergency regulation and is marketing its CHIP buy-in program to ensure that families have private and public options for insuring their children.  No federal approval is required for this type of buy-in, and the Centers for Medicare and Medicaid Services stands ready to work with states interested in adopting this option.
The new Pre-Existing Condition Insurance Plan (PCIP) program created by the Affordable Care Act also offers options for families to access insurance for their children with pre-existing conditions.  The PCIP program is available for eligible children with pre-existing conditions who have been uninsured for at least six months.  The PCIP program includes coverage of pediatric benefits, prescription drugs, and inpatient, outpatient, and mental health services.  Coverage is provided at standard premium rates charged in the commercial individual market, with no pre-existing condition exclusions.  PCIPs normally require an applicant to produce a denial letter from an insurer to be eligible for PCIP coverage.  However, uninsured children with pre-existing conditions can qualify if they have a letter from their doctor or are charged a high rate, depending on the state program’s rules.  The Administration is working to ensure that PCIPs in all states offer coverage for children at a premium based on the standard rate for children. 
Further, prior to the enactment of the Affordable Care Act, 34 states established high-risk pools for all residents with pre-existing conditions whom private insurers declined to insure.  These pools are an additional option in those states for children with pre-existing conditions, and some states, including Mississippi, are planning to open their pools to all uninsured children.  Finally, every state has coverage available to children without regard to pre-existing conditions through their Medicaid and CHIP programs; in most states, these programs are available to families with incomes below $88,000 (twice the poverty level).  
I encourage all states to take whatever actions they can, whether issuing bulletins under existing law to establish uniform open enrollment periods or seeking appropriate legislation to preserve options for children to obtain coverage regardless of their health status.
I want to underscore my personal appreciation for the outstanding work of the NAIC and all state officials as we work together to implement the Affordable Care Act.  I look forward to continuing to work in partnership with the NAIC and with state insurance regulators to implement the Affordable Care Act, and to maintain and strengthen state insurance regulation and the improved access and consumer protection that it yields.

                                                           Sincerely,
                                                         
                                                           Kathleen Sebelius

Saturday, September 18, 2010

Social Worker Indemnity Insurance

This may be the United Kingdom, but it says worlds to what is going on in the field of social work.


In the United States, localizing it to Michigan, child protective workers, foster care/adoption case managers and supervisors are not classified as social workers.  They are case managers, meaning, there is no regulatory agency overseeing the case managers.  You cannot file a complaint against a child protective service worker because there is no place in state government to take it.


So what do you do?


You file in the courts.  


When you file in the courts, according to non-profit corporation law, the organization must, in the case of a case worker being sued, have a quorum vote on indemnification of the worker.  This translates to the organization voting to pay for the worker's legal defense.


This indemnification is usually done, just in case qualified immunity does not kick in, leaving the organization liable for the worker.


Of course, these are legal arguments only the court can decide, but the entire issue of social worker insurance opens new doors to accountability in child welfare.


As for public employees, the Attorney General handles the torts.


Social Worker Insurance



Products available through

Social Workers Insurance 

Scheme include Professional Indemnity Insurance, Public & Employers Liability Insurance, Business Equipment Insurance, IR35 Tax Protection Insurance, Personal Accident & Sickness Insurance & Health & Safety Insurance.

Skills Areas Covered For Social Workers Insurance;



Wednesday, August 25, 2010

New York County Settles With Insurance Company On Abused Foster Kids

For all the law students and venturous attorneys who are seeking to break new ground in the field of law, allow me to introduce you, once again, to the emerging market of child welfare law.
The child welfare industry was designed with such pervasively administrative structures riddled with fraudulent financial incentives, uncapped funding and revenue-maximizing schemes handing out cost reimbursements to child placing agencies like crack rocks to a crackhead.  Not to mention thechild abuse propaganda and it becomes an industry of indifference.

Who cares when there are insurance polices and no federal financial penalties.

It is always so easy to complain, yet so rare to find a compliment. I would like to take the time to honor the brilliant attorneys in this New York case who had the courage to stand up and approach the issue from a different direction by empowering the whistleblower...the children.

Unlike Children's Rights, it looks like the ones who were harmed will actually be compensated.

If anyone has access to the filings, please, by all means, send them my way.  tranbeverly@gmail.com

County settles insurance claims in foster child abuse case

Social Services was accused of negligence
By Colin DeVries
Hudson-Catskill Newspapers
Published: Wednesday, August 25, 2010 2:15 AM EDT
CATSKILL — County lawmakers have approved a settlement with a Virginia-based insurance company over claims of sexual and physical abuse of children in a foster care home.

The claims originate from alleged abuses committed by foster father Jose Serrano of Cairo, which are currently being civilly litigated in Greene County Supreme Court.

In three suits filed with the supreme court, seven foster children claimed to have been physically and sexually abused, molested and sodomized while under the care of Serrano. The alleged abuse occurred between 1997 and 2000, according to the lawsuits. Most of the children were teenagers when the abuse occurred, according to court documents.

The suits cited Greene County and the county’s Department of Social Services as defendants in the case, claiming DSS was negligent in hiring, training and evaluating Serrano as a foster care provider. The first suit, filed in July 2001, states that two employees of DSS — identified as Jane Doe and John Doe — “failed in their duty to place infant plaintiff in a safe and stable foster home, due to the fact that the defendants knew, and/or reasonably should have known the defendant Jose Serrano was abusing, sodomizing and/or molesting the children within his care.”

*
While the cases against Serrano and DSS are still pending in Greene County Supreme Court, county lawmakers approved a settlement with Colony Insurance Company, one of two insurance agencies that covered sexual and physical abuse claims during that time period.

Though the insurance company claims it is not responsible for the majority of incidences of abuse due to contractual lapses in time — the county had also contracted with Selective Way Insurance Company of New Jersey during a portion of the period of abuse — the second insurance company believes they are responsible for coverage of at least four victims.

The resulting coverage from Colony would cover up to $250,000 for each sexual abuse claim, meaning up to $1 million.

Selective Way issued commercial general liability coverage with a limit of $1 million and an aggregate of $2 million during a period of the abuse, according to court filings.

The true value of the case may not shake out in court, however, after a settlement agreement is reached, according to Greene County Attorney Carol Stevens.

In response to the declaratory judgment action filed by Colony Insurance in the U.S. District Court for the Northern District of New York, Stevens thought it would be in the county’s best interest to reach a settlement agreement instead of fighting it out in court.

“In order to avoid the expense, inconvenience and uncertainty of litigating the declaratory judgment action,” the resolution stated, “(Colony, Greene County and Selective) desire and intend to settle fully and finally all matters in controversy between them.”

During an interview with Stevens last week, she did not know the monetary value that would be agreed to.

To reach reporter Colin DeVries please called 518-943-2100 ext. 3325, or e-mail cdevries@thedailymail.net.