Latest news with #reimbursement
Daily Mail
2 days ago
- Business
- Daily Mail
Shock update after Aussie family lost 15 years of savings when their $250,000 house deposit was stolen in sophisticated email scam
A Gold Coast family scammed out of their $250,000 house deposit has received a major lifeline after ANZ agreed to fully reimburse the stolen funds. Sarah and Laine Robinson unknowingly transferred their entire life savings to scammers posing as their conveyancer just days before settlement on their dream rural home in Mount Nathan. 'We honestly can't believe it,' Sarah told A Current Affair. 'We've had a phone call from ANZ, and they agreed to reimburse the money.' The couple had spent 15 years saving for their dream property and were packed up and ready to move with their three children when the scam unfolded. The nightmare began when, as settlement approached, the conveyancing firm the couple had been working with suddenly went silent. Unknown to the Robinsons, scammers had intercepted the email chain and began impersonating the firm. The fraudulent emails looked nearly identical to legitimate correspondence, but had one subtle red flag, the sender's email was missing a simple '.au' at the end. 'I was talking to the scammers for a week-and-a-half without knowing,' Sarah said. Trusting the instructions, the Robinsons visited an ANZ branch to make the payment. There, the teller failed to notice that the account name didn't match the details. 'They can see that they were at fault on that day,' Sarah said. 'Their staff member failed to do appropriate checks and failed to protect us.' The scam was only uncovered the day before settlement, when the real conveyancer contacted them. While the firm had received the first $60,000, the second and much larger payment of $252,000 was missing. ANZ was initially able to recover around $80,000, but the remaining $170,000 was gone. The bank has now stepped in and reimbursed the full amount. The heartwarming update comes after Australian Financial Complaints Authority had previously cleared the ANZ of wrongdoing, a finding the couple have criticised. Despite this, ANZ made the decision to cover the full loss. The couple are now urging other scam victims not to give up hope. 'If you can see you can see you've done the right thing, keep fighting. You can have a positive outcome, we are living proof that can happen,' they said. The family is now back on the market, hoping to finally find a new dream home. ANZ said it would take action to help protect its customers against scams and fraud, including business email compromise and invoice scams like this one. 'We invest in ongoing education, detection systems, and recovery efforts to support our customers. The extent and pace of change in the scams landscape has evolved significantly, as perpetrators become increasingly sophisticated,' a statement said. 'We will continue to adapt our protective measures and encourage customers to stay alert, stay informed, and act swiftly on anything suspicious.'
Associated Press
4 days ago
- Business
- Associated Press
SeaStar Medical Announces CMS Coverage for Medicare and Medicaid Eligible Patients with Cardiorenal Syndrome Awaiting LVAD in Investigational Trial of SCD Therapy
Coverage marks SeaStar Medical's second award by CMS for reimbursement of medical expenses for Medicare and Medicaid patients in a clinical trial Stands out as rare award with less than 100 clinical trials covered annually DENVER, May 28, 2025 (GLOBE NEWSWIRE) -- SeaStar Medical Holding Corporation (Nasdaq: ICU), a commercial-stage healthcare company focused on transforming treatments for critically ill patients facing organ failure and potential loss of life, announced today that the U.S. Centers for Medicare & Medicaid Services (CMS) has agreed to pay for certain expenses incurred by medical centers treating patients covered by Medicare or Medicaid who are enrolled in the NEUTRALIZE-CRS investigational clinical trial. This follows the company's first award for reimbursement by the CMS that was granted in July 2024 for qualified patients treated in the ongoing NEUTRALIZE-AKI pivotal clinical trial. 'To receive CMS coverage of certain expenses for patients in a clinical trial is rare, with less than 100 per year, and we believe reflects the life-saving potential of our technology,' said Eric Schlorff, SeaStar Medical CEO. 'We fulfilled multiple criteria set forth by the CMS for this award, including ten study criteria elements that included assessment of how we could improve health outcomes, how generalizable the Selective Cytopheretic Device (SCD) therapy would be to the Medicare population, and how the study results would not duplicate existing knowledge.' Mr. Schlorff continued, 'As we initiate our pre-commercialization efforts for our SCD therapy in patients with Acute Kidney Injury (AKI), we recognize that CMS coverage in the commercial setting will be a key element to bringing our potential organ-sparing and life-saving therapies to more patients. We have already engaged a third-party reimbursement policy expert to analyze the feasibility of obtaining reimbursement coverage upon a potential FDA approval for our SCD therapy in adult patients with AKI. Based on the results of the analysis, the high unmet need, and Healthcare Economics and Outcomes Research (HEOR) data supporting reduced healthcare costs, we are building a compelling case that should enable CMS and private payers to understand the value of the SCD therapy in adult patients with AKI.' The NEUTRALIZE-AKI pivotal clinical trial and NEUTRALIZE-CRS investigational clinical trial are evaluating the ability of SeaStar Medical's SCD therapy to neutralize destructive hyperinflammation to improve health outcomes. The SCD therapy is designed as a disease-modifying device that neutralizes over-active immune cells and stops the cytokine storm that yields destructive hyperinflammation and creates a cascade of events that wreak havoc in the patient's body. The NEUTRALIZE-AKI pivotal trial was granted CMS coverage in July 2024 for qualified patients. The trial is evaluating the safety and efficacy of the SCD therapy in 200 adults with AKI in the ICU receiving CRRT. It is currently 50% enrolled, with full enrollment anticipated near the end of 2025. The trial's primary endpoint is a composite of 90-day mortality or dialysis dependency of patients treated with the SCD therapy in addition to CRRT as the standard of care, compared with the control group receiving only CRRT standard of care. The FDA has granted Breakthrough Device Designation for the SCD therapy in adult patients with AKI and CRRT. The NEUTRALIZE-CRS trial is designed to evaluate the safety and initial efficacy of the SCD therapy in reducing destructive hyperinflammation in adult patients with acute heart failure with worsening renal function due to cardiorenal syndrome or severe right ventricular failure awaiting a left ventricular assist device (LVAD) implantation. The trial is expected to enroll 20 patients at up to five clinical sites and will be funded by a previously announced $ 3.6 million National Institutes of Health (NIH) grant awarded to Innovative BioTherapies (IBT), which is led by SCD inventor H. David Humes, MD, Professor, Division of Nephrology, Internal Medicine, University of Michigan and SeaStar Medical Scientific Advisor. Dr. Humes will serve as lead investigator for the study and SeaStar Medical will act as clinical research organization (CRO). The FDA has granted Breakthrough Device Designation for the SCD in cardiorenal syndrome awaiting LVAD implantation. About SeaStar Medical SeaStar Medical is a commercial-stage healthcare company focused on transforming treatments for critically ill patients facing organ failure and potential loss of life. SeaStar's first commercial product, QUELIMMUNE (SCD-PED), was approved in 2024 by the U.S. Food and Drug Administration (FDA). It is the only FDA approved product for the ultra-rare condition of life-threatening acute kidney injury (AKI) due to sepsis or a septic condition in critically ill pediatric patients. SeaStar's Selective Cytopheretic Device (SCD) therapy has been awarded Breakthrough Device Designation for six therapeutic indications by the FDA, enabling the potential for a speedier pathway to approval and preferable reimbursement dynamics at commercial launch. The company is currently conducting a pivotal trial of its SCD therapy in adult patients with AKI requiring continuous renal replacement therapy (CRRT), a life-threatening condition with no effective treatment options that impacts over 200,000 adults in the U.S. annually. Forward-Looking Statements This press release contains certain forward-looking statements within the meaning of the 'safe harbor' provisions of the Private Securities Litigation Reform Act of 1955. These forward-looking statements include, without limitation, SeaStar Medical's expectations with respect to anticipated patient benefits and cost savings from our products; the expected regulatory approval process and timeline for our products; and the ability of SeaStar Medical to meet the expected timeline. Words such as 'believe,' 'project,' 'expect,' 'anticipate,' 'estimate,' 'intend,' 'strategy,' 'future,' 'opportunity,' 'plan,' 'may,' 'should,' 'will,' 'would,' 'will be,' 'will continue,' 'will likely result,' and similar expressions are intended to identify such forward-looking statements. Forward-looking statements are predictions, projections and other statements about future events that are based on current expectations and assumptions and, as a result, are subject to significant risks and uncertainties that could cause the actual results to differ materially from the expected results. Most of these factors are outside SeaStar Medical's control and are difficult to predict. Factors that may cause actual future events to differ materially from the expected results include, but are not limited to: (i) the risk that SeaStar Medical may not be able to obtain regulatory approval of its SCD product candidates; (ii) the risk that SeaStar Medical may not be able to raise sufficient capital to fund its operations, including current or future clinical trials; (iii) the risk that SeaStar Medical and its current and future collaborators are unable to successfully develop and commercialize its products or services, or experience significant delays in doing so, including failure to achieve approval of its products by applicable federal and state regulators, (iv) the risk that SeaStar Medical may never achieve or sustain profitability; (v) the risk that SeaStar Medical may not be able to secure additional financing on acceptable terms; (vi) the risk that third-party suppliers and manufacturers are not able to fully and timely meet their obligations, (vii) the risk of product liability or regulatory lawsuits or proceedings relating to SeaStar Medical's products and services, (viii) the risk that SeaStar Medical is unable to secure or protect its intellectual property, and (ix) other risks and uncertainties indicated from time to time in SeaStar Medical's Annual Report on Form 10-K, including those under the 'Risk Factors' section therein and in SeaStar Medical's other filings with the SEC. The foregoing list of factors is not exhaustive. Forward-looking statements speak only as of the date they are made. Readers are cautioned not to put undue reliance on forward-looking statements, and SeaStar Medical assumes no obligation and do not intend to update or revise these forward-looking statements, whether as a result of new information, future events, or otherwise. For more information visit or visit us on LinkedIn or X. Contact: SeaStar Investor Relations: [email protected]
RNZ News
24-05-2025
- Health
- RNZ News
Modifications, Uber, not reading the terms: Common reasons why your insurance claim might be declined
A woman cancelled an overseas holiday when her mother became ill and was shocked to discover she was not eligible for reimbursement. Photo: 123RF Insurers can pay billions of claims each year, but many people are still disappointed, when they have a claim turned down or receive less than they expected. Insurance and Financial Services Ombudsman Karen Stevens says her office is dealing with more complaints than ever before from people for whom the process has not gone as expected. "For years and years, we would do around 3000 complaints a year and 300 investigations," she said. "By the end of this financial year, we'll be over 500 investigations - it's gone way up. "Last year, we had just on 5000 complaints into the office." She said part of the rise was due to increasing public awareness about what the scheme offered, but there were also misunderstandings about what insurance could be expected to provide. "The biggest consumer issue that we've got most of the time is a lack of understanding on scope of cover. Because they pay their premiums, they think that they're covered for basically every contingency." Here are some of the things that might seem small, but could affect your ability to make a claim. Stevens said insurance policy exclusions were something that caught people out frequently. Many policies include things that will not be covered and it's important to check what these are, so you know what to expect. "One that immediately springs to mind that I was looking at last night was in a travel context, where a woman and her husband and family were going on holiday. "They had travel insurance. She found out that her mother was very unwell and not likely to last the time that they were going to be away, so she cancelled her trip. "The problem was that there was an exclusion in the policy that quite clearly said that they wouldn't have unlimited cover, if the person who was unwell had been in a rest home of any sort in the 12 months prior to becoming seriously unwell or dying." That meant they had limited cover of up to $1000 per adult, which did not cover the costs of the trip. "She said, 'Oh, but there was nothing wrong with her, until she got pneumonia in hospital'. Well, that's fine, but the policy had an exclusion that actually had nothing to do with her wellness or anything else at the time." Stevens said modifications made to cars could be a problem. "If an insurer is unaware of the modifications, there's a specific exclusion, if they haven't been told about them and priced accordingly. They're likely to find out, when they go to claim, that not only are they not covered, but of course, our draconian laws on non-disclosure, which still stand, mean that they probably won't have any cover going forward either. "You know, vehicle modifications are still a big one in New Zealand." Consumer NZ insurance specialist Rebecca Styles said insurers could have a broad definition of what would count as modification. Styles said, if someone had been given lower premiums or a lower excess based on where a car would be parked, and then parked elsewhere, that could be a problem. "The insurer will have the ability, under the policy, to say, 'Well, terribly sorry, but we're either not paying your claim, because you're in breach of a condition or will avoid the policy', again, depending on the policy wording." Styles said State, for example, had a list of broad examples of when someone should notify it about a change to where a car was kept. "Where you park your car is considered a 'risk factor', so that would be taken into account, when pricing your policy - you usually park in a garage, but moved house and now park on the street. "While I haven't come across instances of an insurer declining a claim because of this, in the policy, there is a requirement to let the insurer know." If you're paying your insurance on a monthly basis and miss some, you could find your policy is cancelled. Styles pointed to a State policy that said people who missed a payment would get a notice and, if it remained unpaid, the policy could be cancelled. Insurers want to be notified before you start using your car for something like Uber or DeliverEasy, and some don't offer cover for these activities. Taking "reasonable care" is a standard requirement for most insurance policies. That means, if you leave your car unlocked with the keys in it, you might not have cover if someone steals it. This can be an issue in situations, such as where people leave their keys on the beach, while they go for a swim. Stevens' office said many travel insurance policies also had a requirement that people not leave items unattended, even for very short periods of time. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday. h] Related
CBS News
22-05-2025
- Business
- CBS News
Texas may be closer to being reimbursed for border security efforts
Texas is one step closer to reimbursement for border costs Texas is one step closer to reimbursement for border costs Texas is one step closer to reimbursement for border costs The state of Texas may be getting one step closer to being reimbursed by Congress for the billions of dollars it spent to secure the border during the Biden administration. An amendment to the House reconciliation bill provides a total of $12 billion through 2029 to reimburse states for their efforts to reduce illegal immigration since Biden took office in January 2021. The Department of Homeland Security would set up a process for states like Texas to apply for reimbursement. CBS News Texas was on Capitol Hill in February when Gov. Greg Abbott met with Texas Republicans to push for this type of reimbursement. Abbott said the state spent more than $11 billion during the Biden administration securing the border. The reconciliation bill consists of President Trump's priorities, including spending and tax cuts. Both the House and Senate will have to pass it. Texas Gov. @GregAbbott_TX has said the state spent $11 billion securing the border during the Biden administration. @CBSNewsTexas — Jack Fink (@cbs11jack) May 22, 2025
CBS News
22-05-2025
- Business
- CBS News
Texas nears reimbursement for border security as House bill allocates $12 billion
The state of Texas may be getting one step closer to being reimbursed by Congress for the billions of dollars it spent to secure the border during the Biden administration. An amendment to the House reconciliation bill provides a total of $12 billion through 2029 to reimburse states for their efforts to reduce illegal immigration since Biden took office in January 2021. The Department of Homeland Security would set up a process for states like Texas to apply for reimbursement. CBS News Texas was on Capitol Hill in February when Gov. Greg Abbott met with Texas Republicans to push for this type of reimbursement. Abbott said the state spent more than $11 billion during the Biden administration securing the border. The reconciliation bill consists of President Trump's priorities, including spending and tax cuts. Both the House and Senate will have to pass it. Texas Gov. @GregAbbott_TX has said the state spent $11 billion securing the border during the Biden administration. @CBSNewsTexas — Jack Fink (@cbs11jack) May 22, 2025
