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Luigi Mangione defense shared same records they claimed constituted privacy violation: prosecutors

Luigi Mangione defense shared same records they claimed constituted privacy violation: prosecutors

Fox News3 days ago
He is accused of killing the CEO of a major U.S. health insurer in order to terrorize the industry, according to prosecutors — but now details of his own personal insurance plan have become a flashpoint in the case against him.
Luigi Mangione, a 27-year-old alumnus of the Ivy League's University of Pennsylvania, took his business to Aetna, which may have inadvertently given too much information to New York prosecutors in response to a subpoena following the alleged assassination of 51-year-old UnitedHealthcare CEO Brian Thompson.
Mangione allegedly shot the father of two from behind outside a shareholder conference in New York City last fall.
Manhattan prosecutors in a court filing Friday denied that they violated a federal law protecting private healthcare information when they subpoenaed information from his health insurance provider.
Mangione's defense last month accused the Manhattan District Attorney's Office, led by Alvin Bragg, of flagrantly violating the Health Insurance Portability and Accountability Act, better known as HIPAA, with a "false and fraudulent" subpoena and asked for prosecutors to face sanctions and for the judge to toss the case.
Prosecutors denied all allegations that "something secretive or nefarious" was afoot and countered that they made a "lawful" request for basic information.
Read the latest court filing:
They asked for his account number and the time period he received coverage, but unexpectedly received extra materials that they turned over to the court, according to the latest filing.
"The defense...seeks to punish the People for the administrative mistakes of others, claiming that the People have perpetrated a 'lie and a fraud' against defendant—an inflammatory and dubious accusation without any basis," prosecutors wrote in a letter to the judge.
In fact, prosecutors argued, it wasn't just Aetna that inadvertently sent additional information to Bragg's office. The defense did too when one of the former Ivy Leaguer's lawyers sent a copy of the same healthcare information to prosecutors in an email.
Bragg's office also notified Aetna, which re-submitted its subpoena response without the additional, unrequested details.
When asked about the legal back-and-forth, Aetna provided a brief statement:
"Aetna received a subpoena for certain medical records, and we provided them," a spokesperson told Fox News Digital.
Prosecutors said they initially learned of his Aetna coverage from a search warrant served on his Apple iCloud account. The filing does not make clear why they were seeking information from the insurer, but the requested details could be used to establish a timeline or build out the apparent motive.
Investigators recovered writings from Mangione where he blasted the healthcare industry and allegedly referenced both UnitedHealthcare and the 2024 shareholder conference that was supposed to begin hours after the murder of Thompson. He also allegedly wrote messages on bullet casings found at the scene.
Mangione allegedly stalked Thompson and shot him in the back outside the hotel where the conference was taking place.
Surveillance video from the hotel shows a masked man sneak behind Thompson and fire multiple shots. At least one eyewitness ran off the opposite direction of the suspect.
Mangione has pleaded not guilty to a slew of charges in connection with the slaying, including murder and terrorism charges in New York and murder through use of a firearm in federal court. He is being held without bail at a federal jail in Brooklyn.
He is also facing prosecution in Pennsylvania, where police arrested him, allegedly in possession of a "ghost gun" and 3D-printed silencer.
He could face life imprisonment at the state level or the federal death penalty if convicted of the most serious charges.
His next appearance in the New York Supreme Criminal Court in Manhattan is scheduled for Sept. 16.
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Why a Michigan man waited over a month in the hospital for stroke rehab
Why a Michigan man waited over a month in the hospital for stroke rehab

Yahoo

time5 hours ago

  • Yahoo

Why a Michigan man waited over a month in the hospital for stroke rehab

When John Karadell was admitted to the hospital after a stroke, his doctors quickly pushed for him to begin an intensive form of rehabilitation — the sooner the better. 'Almost immediately they started telling me that the No. 1 most important thing now is to as quickly as possible get me into what they call acute rehab,' said Karadell, 58, of Howell, Michigan. 'They used words like, 'This is crucial. This is essential to your recovery.'' But after 11 days in a hospital bed with no word on when he'd be transferred to the facility, Karadell said he learned his health insurer, Aetna, had denied coverage for what's known as acute post-stroke rehabilitation. What followed was a weekslong back-and-forth between Aetna and the hospital, University Hospital in Ann Arbor — including phone calls, bureaucratic delays and miscommunication, according to a Michigan Medicine spokesperson, an Aetna spokesperson and hospital case notes reviewed by NBC News. More than a month after Karadell's stroke, he said he essentially gave up and left the hospital to go to a less-intensive rehab program, a downgrade from what his care team consistently recommended throughout his hospital stay. 'I'm left with what I believe is permanent damage,' Karadell said. 'And I'm left to wonder: Could it have been different if they would have approved what they should have done?' In a statement, an Aetna spokesperson said the circumstances surrounding Karadell's denied claim are 'complex' and the insurer's ability to process claims and appeals is 'dependent on the timeliness and comprehensiveness of the information we receive from the provider.' 'We understand the frustration whenever there is a health care process that is complicated or does not meet a member's expectations,' the spokesperson said. 'Even though the vast majority of experiences are managed smoothly, our company strives to partner with healthcare providers to make sure each member receives what's expected every time.' The spokesperson added, 'as we are not in the hospital with this patient, we expect our providers to partner with us and play an active role in conveying important clinical information to us that we would not otherwise have.' Karadell's experience, however, is far from unique: A nationwide survey of more than 1,300 insured adults found over a third — 36% — had had at least one claim denial, said Miranda Yaver, an assistant professor in the department of health policy and management at the University of Pittsburgh who conducted the survey. Almost 60% of those patients, she said, went on to have the same claim denied multiple times. Half of the people who were denied ended up postponing their care. If you are dealing with bills that seem to be out of line or a denial of coverage, care or repairs, whether for health, home or auto, please email us at Costofdenial@ What appears to have happened to Karadell can be best described as 'rationing care by inconvenience,' said Yaver, who wasn't involved with Karadell's case. It's a tactic, she believes, that health insurers use to limit spending. By making the process of getting coverage difficult — either through paperwork, repeated denials or a complex appeal process — they count on doctors and patients giving up. 'It's not that you're never going to get the approval, but it ends up being this endurance contest and administrative burden,' she said. 'And it's really overwhelming, especially because when we're navigating these things, it's not on our best day, it's on our worst.' 'Discharge has been delayed' Some form of rehab is recommended for all patients after a stroke, according to the American Stroke Association. The program recommended for Karadell — known as acute post-stroke rehabilitation — is typically for patients who still have significant difficulties, such as trouble walking, feeding themselves or bathing but are medically stable enough to tolerate therapy, said Dr. Nneka Ifejika, chief scientific officer at Ochsner Health System in New Orleans and an ASA national volunteer expert. Ifejika was not involved in Karadell's care. In a hospital note dated June 8, 2024, two days after he was admitted, Karadell was described as still having significant difficulty getting dressed, bathing, brushing his teeth and using the bathroom on his own. He also required some help eating meals. He had dizziness and intense pain in his neck. His wife, Emily Steiner, also said he had vision and speech problems. The note said he was doing well with the therapy he was getting at the hospital but recommended a more intensive program. 'Progressing well in therapy, will greatly benefit from multidisciplinary rehab at IPR [inpatient post-acute rehabilitation] to facilitate maximal independence in ADLs [activities of daily living] and functional mobility prior to return home,' the note said. Ifejika said that it's critically important for stroke patients to start rehab as early as possible because delays can lead to worse health outcomes, including long-term disability. The longer a stroke patient is bedridden, the more their physical ability and mobility decline, she said. Extensive stays in the hospital can also lead to increased risk of falls or getting an infection, she said. (In Karadell's case, his wife said, it also took a mental toll, as he had trouble sleeping due to noise and patients sharing the room.) Ifejika said she typically starts patients in rehab within two to three days of a stroke. 'They go directly from the hospital to the rehab facility, whether it be a freestanding rehab facility or a hospital-based rehab facility,' she said. The hospital spokesperson said the hospital's admissions coordination submitted a prior authorization request for Karadell's intensive rehab on June 12. On June 17, Aetna denied the coverage, saying that clinical documentation hadn't been submitted, the hospital spokesperson said. The spokesperson added that the insurer did not offer an opportunity for a hospital physician to speak to a doctor from the insurance company about the request, a process known as a peer-to-peer review. An Aetna spokesperson said it would have provided a peer-to-peer review if the hospital had requested it. The hospital submitted an expedited appeal that day, the hospital spokesperson and Steiner said. An Aetna spokesperson said the hospital's appeal was not submitted as 'expedited.' That same day, a hospital note said that Karadell was 'significantly below baseline of function,' adding: 'Recommend IPR to progress independence in ADLs.' In a second note also dated June 17, a doctor wrote: 'Today, discussed with patient will continue to work on IPR admission. He states he is frustrated with how long it has taken but hoping to begin therapies soon.' One week later, however, Karadell was still in the hospital. 'Discharge has been delayed by rejected insurance authorization despite our strong medical recommendation for discharge to IPR,' a doctor wrote in a June 24 note. Two days later, on June 26, a hospital note said: 'He and wife continue to voice their frustration regarding the insurance-related delays.' In the days that followed, the hospital said Aetna denied the approval for a second time. Subacute care On June 30, nearly 30 days after Karadell's stroke, Aetna said it approved the intensive rehab, but the hospital spokesperson said they didn't receive the approval until July 5, a Friday. That Monday, the hospital said it contacted Aetna to confirm the approval but learned it had expired the day before. At that point, Karadell gave up and opted to get less intensive rehab closer to home — an option that his care team had been considering as a backup and had already been authorized. (Aetna said it had canceled the intensive rehab approval because of the hospital's request to send Karadell to a less-intensive program, as the two requests were mutually exclusive.) Ifejika said that so-called subacute care, which is often provided at an outside facility, such as a nursing home or assisted living facility, is easier to get insurance approval for because it's less expensive. However, she added, studies show it comes with a higher risk of hospital readmission compared to acute rehab. 'Sending them to a skilled nursing facility is actually doing them a disservice,' she said. Steiner said the assisted living facility Karadell went to only had a part-time physical therapist, and he was doing less rehab than he had been doing at the hospital. At one point, he said, he needed help getting up to use the bathroom but couldn't get assistance and ended up falling. 'That was quite frankly awful,' Steiner said. 'None of this I knew at the time, really how significant of a difference it was going to be.' Karadell left the facility after about two weeks. Though he could have stayed longer, 'I wanted to go home so desperately,' he said. Karadell was also left with a bill for more than $150,000 marked 'pending' in his hospital file, the result of his extended stay. When NBC News recently asked the hospital about the bill, a spokesperson said it had been going back and forth with Aetna over how much would be covered. Aetna paid around $37,000 and the hospital wrote off the rest. Prior authorization Health insurers have pledged to take steps to streamline the often-criticized prior authorization process for approving claims. In June, Health and Human Services Secretary Robert F. Kennedy Jr. said the country's largest health insurers had promised to take steps to reform prior authorization, including quicker approvals and reducing the number of medical services subject to the rule. Health insurers have made similar commitments in the past, including in 2018 and again in 2023. Many failed to implement such reforms. Dr. Adam Gaffney, a critical care physician and assistant professor at Harvard Medical School, said more fundamental reform, likely from Congress, will be needed to address the health care barriers imposed by insurance companies. Yaver, of the University of Pittsburgh, said many doctors — and patients — agree that reform is needed. In more than 100 interviews with doctors, Yaver said many had stated that the prior authorization process had gotten more difficult over the years, not easier. 'On the physician side, this requires a lot of time and staffing,' she said. 'Some of them attribute this to contributing to burnout.' On the patient side it 'destabilizes their health and economic lives,' she added. Karadell — who says he still has numbness in his legs, back, face and feet and struggles with simple tasks, like climbing stairs and reaching for the remote — said the experience 'changed my life forever.' 'I always have to watch my step,' he said. 'When I leave the house and I go to the store or to go get something to eat, I have to watch the ground because I'm scared of falling.' This article was originally published on Solve the daily Crossword

Veriheal Expands Patient Support Services With State-Compliant Medical Cannabis Letters
Veriheal Expands Patient Support Services With State-Compliant Medical Cannabis Letters

Business Wire

time7 hours ago

  • Business Wire

Veriheal Expands Patient Support Services With State-Compliant Medical Cannabis Letters

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Millions of Californians could see higher health insurance premiums in 2026
Millions of Californians could see higher health insurance premiums in 2026

San Francisco Chronicle​

time7 hours ago

  • San Francisco Chronicle​

Millions of Californians could see higher health insurance premiums in 2026

Health insurance premiums for Californians buying coverage through Covered California will rise by an average of 10.3% in 2026, the state marketplace announced Thursday. Officials warned that costs could climb even higher if Congress allows enhanced federal subsidies to expire at the end of next year. The projected increase — up from a 7.9% hike in 2025 — is driven largely by rising medical and prescription drug costs. But the looming expiration of enhanced premium tax credits, which have lowered costs for millions of Americans since 2021, could trigger a far steeper jump in what consumers pay. If lawmakers fail to act, the average Covered California enrollee could see monthly premiums rise by 66% from the loss of federal aid alone, affecting 1.7 million people statewide. 'Skyrocketing health insurance premiums are the last thing Americans need right now,' said Jessica Altman, Covered California's executive director, in a statement. 'There is still time for Congress to act and protect the health care of millions.' Covered California is the state's Affordable Care Act marketplace, where residents can compare and purchase health plans, often with financial assistance. California is taking steps to soften the impact, allocating $190 million in state subsidies for 2026 to help its lowest-income residents. Still, officials say that will cover only a fraction of the $2.1 billion gap left by expiring federal assistance. Despite the uncertainty, Covered California says its marketplace remains strong, with 11 insurers offering plans statewide and most residents having multiple carrier options. Aetna will exit in 2026, affecting about 21,000 enrollees who will need to switch plans. The state's 10.3% average increase is about half the projected national average of 20%, which officials credit to aggressive rate negotiations and a healthier risk pool.

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