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Cigna health giant accused of improperly rejecting thousands of patient claims using an algorithm

Published Tue, 05 Nov 2024 11:42:22 GMT

SACRAMENTO, Calif. (AP) — A federal lawsuit alleges that health insurance giant Cigna used a computer algorithm to automatically reject hundreds of thousands of patient claims without examining them individually as required by California law.The class-action lawsuit, filed Monday in federal court in Sacramento, says Cigna Corp. and Cigna Health and Life Insurance Co. rejected more than 300,000 payment claims in just two months last year.The company used an algorithm called PXDX, shorthand for ”procedure-to-diagnosis,” to identify whether claims met certain requirements, spending an average of just 1.2 seconds on each review, according to the lawsuit. Huge batches of claims were then sent on to doctors who signed off on the denials, the lawsuit said.“Relying on the PXDX system, Cigna’s doctors instantly reject claims on medical grounds without ever opening patient files, leaving thousands of patients effectively without coverage and with unexpected bills,” according to th...

Nearly 100 pilot whales strand themselves on an Australian beach. Half have died despite efforts

Published Tue, 05 Nov 2024 11:42:22 GMT

PERTH, Australia (AP) — Nearly 100 pilot whales stranded themselves on a beach in western Australia Tuesday, and about half had died by Wednesday morning, despite the efforts of wildlife experts and volunteers to save them.The pod of long-finned pilot whales was first spotted swimming near Cheynes Beach east of Albany on Tuesday morning. As the day progressed, the pod began moving closer to the beach, sparking the concern of conservation officers. By 4 p.m., a large stretch of the shoreline was covered in beached whales. Western Australia state’s Department of Biodiversity, Conservation and Attractions set up an overnight camp to monitor the whales. Peter Hartley, a manager from the department, said they had counted 51 whales that had died overnight. “We still have 46 whales still alive, and that will be our focus today — to get them back into the water and encourage them to head off into deeper water,” he told the Australian Broadcasting Corp. “We are optimistic that we will save a...

Lawsuit filed against father, son and car wash after Jeep into Hinsdale sub shop crash

Published Tue, 05 Nov 2024 11:42:22 GMT

HINSDALE, Ill. — A lawsuit has been filed on behalf of the three people who were injured in an incident where a Jeep crashed into a Hinsdale sub shop.According to attorney Louis C. Cairo, the plaintiffs in the case — Sophia N. Ricciardi, Michal Lizler and Connor J. Sullivan — sustained physical and emotional injuries when they were dining at Fontano's Sub Shop, and a Jeep came crashing through the façade of the building, coming to a stop on top of two of the three plaintiffs. PREVIOUS COVERAGE: Teen in critical condition after car crashes into Hinsdale sub shop The legal complaint, filed by GWC Lawyers, LLC, alleges six counts of negligence against Fuller Car Wash and Martin Contreras as father, guardian and next friend of Martin Contreras Jr (a minor). Cairo claims Contreras Jr was an employee of the car wash at the time of the crash, and operated the Jeep that crashed into Fontano's Sub Shop in a negligent manner, leading to the physical and emotional injuries suffered by his cl...

Tourist awarded $375K after staying in bedbug-infested Los Angeles vacation rental

Published Tue, 05 Nov 2024 11:42:22 GMT

(KTLA) - The owners of a vacation rental property in Hollywood Hills have been ordered to pay $375,000 to a British vacationer who said he was bit hundreds of times by bedbugs while staying at the property in 2015.Meshak Moore had planned on staying at a property on the 2300 block of Vasanta Way from Aug. 24, 2015, through Oct. 22, 2015, but left four weeks into his stay after repeatedly being bitten across the entirety of his body by bedbugs that had infested the property, according to court documents provided by his lawyer. He initially believed mosquitos were responsible, but after several sleepless nights and painful bites, he tore apart the bed and found a large infestation of bedbugs on the mattress, headboard, and bed frame. Man suffers concussion after being hit by phone while riding Cedar Point roller coaster Moore suffered hundreds of bites on his back, arms, neck, and groin, causing him serious discomfort, permanent scarring, and emotional distress, the complaint allege...

Wildfire in northeast Burnet County approximately 33 acres, 85% contained

Published Tue, 05 Nov 2024 11:42:22 GMT

BURNET COUNTY, Texas (KXAN) -- Crews are fighting a wildfire in northeast Burnet County, near the Bell County line, according to the Texas A&M Forest Service website.The reported size of the fire is 33 acres with 85% containment as of 8 p.m. Tuesday, the agency said. Named the Happy Ridge Fire, it's burning an area between Oakalla and Briggs near Farm-to-Market Road 2657.Officials first reported the fire shortly after 4 p.m., according to the forest service.As of right now, the cause of the fire is undetermined, officials said.This is a developing story. Check back for updates.

Orioles lose to Phillies on walk-off hit, 4-3, as Yennier Cano uncharacteristically allows two runs in ninth

Published Tue, 05 Nov 2024 11:42:22 GMT

The Orioles entered Tuesday night 19-9 in one-run games this season. They came one out away from improving that figure once again.With All-Star Yennier Cano on the mound and the Orioles leading 3-2 with two outs in the ninth inning, Philadelphia’s Bryson Stott doubled in Bryce Harper to tie the game at 3. Then, after Jorge Mateo couldn’t throw J.T. Realmuto out at first base on a slow grounder, Alec Bohm ended the game with a single to left field.The result: a walk-off Phillies win and a one-run loss for the Orioles.Baltimore avoided a loss Monday night, but couldn’t do the same Tuesday as the tense game concluded with Phillies players celebrating their victory in right field and an announced crowd of 37,200 celebrating.Before the ninth, it was an auspicious night for the Orioles. Kyle Gibson pitched well against his former team and newcomer Shintaro Fujinami provided reason for optimism with two shutout innings. Ryan O’Hearn, who entered Tuesday a .171 hitte...

John Shipley: Twins batters must keep their feet on the gas

Published Tue, 05 Nov 2024 11:42:22 GMT

The Twins seem to have recalibrated.Winners in nine of their past 11 games and four up on Cleveland in the American League Central before Tuesday’s game against Seattle at Target Field, this team more resembles, finally, the one that roared out of the gates with a 10-4 record than the one that staggered into the all-star break by getting swept by the Baltimore Orioles.This is all good news for the local 9 and their fans, and certainly makes for a better product on the field. The Twins entered Tuesday with a four-game winning streak — matching a season high — and consecutive walk-off victories at home. The Twins didn’t just come out of the break 9-2; they battled for just about all nine of those victories.Furthermore, they were competitive in all but one of those games, encouraging news for those who watched the Twins finish the unofficial first half of the season with a lackluster, if not downright depressing, 15-3 loss to the Baltimore Orioles.Since the break ended, it’s been a muc...

Twins officially sign first-rounder Walker Jenkins to deal

Published Tue, 05 Nov 2024 11:42:22 GMT

Scott Boras had seen Walker Jenkins play in high school games. He had seen him play in tournaments. But on a visit to his home in North Carolina two years ago, the storied baseball agent was hoping to see him take batting practice and hear the sound of the ball leaving his bat.The problem?It was 11 p.m.And raining.Well, it turns out that wasn’t a problem for Jenkins at all.“He says, ‘Let’s go,’” Boras recalled.And so they did. Clay Jenkins, his father, threw. Walker hit. By the time they were done, Walker was soaking wet, and Boras had heard what he was hoping to hear.“I really got to know a lot about his character and who he is,” Boras said. “He’s way ahead of his years, age-wise, because he’s a very disciplined guy and knows what he wants. It says a lot about his character.”That’s the guy who the Twins added to their organization on Tuesday, officially inking the first-round pick to a deal. Jenkins, whom the Twins selected fifth overall earlier this month, received a $7.1 million ...

Police arrest driver connected to fatal crash on May 11

Published Tue, 05 Nov 2024 11:42:22 GMT

BETHLEHEM, N.Y. (NEWS10) -- On Tuesday, Thomas F. McGrath, 71, of Slingerlands, was arrested for charges stemming from a fatal crash on May 11. Michael J. Kleinke, 17, of Colonie, died in the crash. Get the latest news, weather, sports and entertainment delivered right to your inbox! McGrath was charged with aggravated vehicular homicide, second-degree manslaughter, driving while impaired by drugs, and several vehicle and traffic law violations. He was arraigned in the Town of Bethlehem Court.McGrath posted bail and was released under the supervision of the Albany County Probation. McGrath's driver's license was suspended pending probation. He is due back in court on August 15.

Rotterdam researching legal actions for migrant situation

Published Tue, 05 Nov 2024 11:42:22 GMT

ROTTERDAM, N.Y. (NEWS10) — The Rotterdam Town Council passed a resolution to call on Schenectady County to stop accepting any more asylum seekers. Even though there are residents who want to help the new arrivals become Rotterdam residents, not everyone agrees.“The migrants should stay in New York City until they have a real home for them,” Rashad Rahim said. Get the latest news, weather, sports and entertainment delivered right to your inbox! Other residents still feel upset that the owner of Super 8 suddenly kicked out guests and long-term residents to make room for the asylum seekers.“I feel it was really wrong what happened to those people. I don’t think it was fair at all,” Gail Ristau said. “They didn’t have any notice. They had been staying there because they needed a place to go.”The Town Council is now working with a lawyer to research the next steps for possible legal actions.“We’re all just, you know, very frustrated,” Joe Mastroianni, Rotterdam Town Councilman, said. “...