Latest news with #reimbursement
Bloomberg
3 days ago
- General
- Bloomberg
Homes With Toxic Smoke Damage Deepen Insurance Nightmare in LA
Months after fire tore through Los Angeles' Pacific Palisades neighborhood, homeowners are struggling to get reimbursed — not for houses reduced to rubble, but for the damage of smoke and toxins in the properties that remain. For residents such as Keri Homolka, fighting for a payout has become a full-time job. The Jan. 7 blaze caused the window frames of her home to buckle and crack. Paint on the walls bubbled. While the residence was spared from total destruction, its insides were tarnished by ash and soot, residue from the burned-out houses on either side.
Yahoo
4 days ago
- Business
- Yahoo
Summit Health Advisors Receives $98,000 Grant to Enhance Pharmacist Reimbursement Models
SCOTTSDALE, Ariz., June 24, 2025 /PRNewswire/ -- Summit Health Advisors, LLC has been awarded a $98,000 grant from the NCPDP Foundation to explore and develop innovative business models for reimbursing pharmacists for clinical care services. The project will focus on community settings, where pharmacists can play a crucial role in providing direct patient care, especially in rural areas facing a shortage of primary care physicians. By analyzing existing business models and NCPDP standards, the team will develop comprehensive reimbursement strategies that empower pharmacists and improve healthcare outcomes. "A viable business model that supports pharmacists practicing at the top of their license isn't just about expanding scope — it's about preserving the role of pharmacies as trusted, accessible healthcare touchpoints in communities across the country. Maintaining face-to-face connections matters in an increasingly digital world," said Seth Joseph, Managing Director of Summit Health Advisors. "We're grateful to the NCPDP Foundation for supporting this work. We're proud to partner with Point-of-Care Partners, whose deep understanding of the pharmacy landscape and strong relationships throughout the industry are key reasons we're confident this project will deliver insights that can lead to real, lasting and positive change." The project is set to be completed within 12 months, with key milestones including a comprehensive literature review, expert interviews, and the publication of a white paper. John W. Hill, MBAHCM, Executive Director of the NCPDP Foundation, added, "We are thrilled to support Summit Health Advisors in their innovative project to enhance pharmacist reimbursement models. We believe this project will have a profound impact on the healthcare ecosystem, and we are excited to see the positive outcomes it will bring." This grant was made possible through the NCPDP Foundation General Grant Fund. The project aligns with one of the NCPDP Foundation's strategic initiatives: expanding the role and value of the pharmacist. About the NCPDP Foundation The NCPDP Foundation collaborates with organizations and individuals to support research initiatives that improve data sharing throughout the healthcare ecosystem, removing obstacles to quality care for patients, with a focus on pharmacy interoperability. The NCPDP Foundation is a 501(c)(3) nonprofit charitable organization headquartered in Scottsdale, Arizona. View original content to download multimedia: SOURCE NCPDP Foundation
Telegraph
18-06-2025
- Telegraph
‘We ended up stranded in Spain after a Booking.com error'
Do you have a legal question to put to Gary? Email askalawyer@ or use the form at the bottom of the page. Hello Gary, I would like some advice regarding My wife and I recently booked a holiday through the site. However, when we arrived, the accommodation was not available, leaving us stranded in a small town in Spain. I contacted and spent a lot of time on the phone with their team. They said they were trying to find alternative accommodation, and this went on for a couple of hours to no avail. We booked into a nearby hotel for the night, and I advised that I would expect to be reimbursed for the cost. Now we are back home, the site has reimbursed me for the difference in cost for the alternative apartment that I booked the next day. But not for the first night hotel. I sent receipts for the hotel and for the restaurant for our meal that evening – though we had booked self-catering, we had no alternative but to eat out. I also asked for repayment for the taxi to the hotel which was €20 (£17) and telephone costs which amounted to about £40 from having to contact as they never rang me back as promised. I also asked for consideration of the stress that had been caused, bearing in mind my wife and I are 76 years old, and I was carrying a quantity of medication that required refrigeration. The response from them was for us to send them the receipts, which was positive. But now they are just ignoring any contact. – Tom, by email Dear Tom I completely understand you feel very much let down by It must have been dreadful to arrive in Spain and find there was no room at the inn, as it were. And then it is very stressful to scramble to find somewhere else to stay, never mind having the worry of your medication and keeping it refrigerated. In fairness to the company, it is good they quickly offered to cover some of your losses. The precise legal status of your relationship with and their legal responsibilities towards you are relatively complex to understand. You say you booked a 'holiday' with but in a strict legal sense you did not do that. You simply booked accommodation through the website. In legal terms, a so-called 'package holiday' is an entirely different entity from what you did. A package holiday has enhanced consumer protection when any part of the different elements of the package goes wrong. But you and your wife were independent travellers arranging the different elements of the trip yourselves. In that sense, is what I would describe as a 'third party booking site'. It is a business through which consumers like you book a travel service, but the site you are booking through is not providing the service. This can lead to confusion about the precise legal duties which the third party booking site has towards the consumers who use the site. Central to this is the law of agency. An agent is a party that is authorised in law to act on behalf of another party, often authorised to create a contract. Here, acted as agent with the party that owned the accommodation you booked in Spain. This means your legal contract for the accommodation was with the owner. Hence, would no doubt say any legal claim arising from the failure of the contract is a claim between you and the owner of the accommodation. For instance, if you had stayed in the accommodation you booked with and were injured because of a fault with the accommodation, your personal injury claim would be against the owner of the accommodation. That's the basic law, and hence why might feel they have gone beyond their legal duty in stepping in to tidy up the mess created by the accommodation you booked not being available. However, I would say that where the legal status of your relationship with becomes more of a grey area – and where the law of agency is not relevant – is in relation to the actual booking process. is a third party site, so I would say if the booking process itself has gone wrong, they do have a duty to you to sort it out because you are a direct customer of their booking service. To put it another way, might not be responsible to you for the quality of the holiday accommodation, but they are responsible to you for the actual booking process. And in this case, it seems the booking process went wrong because the accommodation you booked was not available. And that failure in the booking process led to you suffering financial losses. A package holiday contract is a rare example of a contractual claim for loss suffered that can include a claim for loss of enjoyment because an essential part of a holiday is to enjoy it! In this case, you did not book your 'holiday' through so you cannot claim from them for loss of enjoyment and the stress you suffered. But for the reasons I have explained, because of the problems you encountered arising from the failure of the actual booking process, you can claim for losses arising under that contract. Readers will be pleased to hear that after I sent you my initial thoughts on this situation, have said they will reimburse the financial losses you incurred for which you are able to produce receipts. So, a good result, and I am glad have in that sense acknowledged their limited responsibility to you. A spokesman said: 'We apologise for the delay in processing the refund for the price difference of the alternative hotel booked by the customer. This refund is now being processed, along with reimbursements for the meal and phone charges.'
Yahoo
08-06-2025
- Yahoo
Couple Feels 'Taken For Granted' When Family Member Won't Reimburse Flights to Babysit Nephew
A man on Reddit is seeking advice after he and his partner feel "taken for granted" over a favor they'd agreed to The couple agreed to fly to babysit a nephew while the parents went on vacation, but were later told they wouldn't be reimbursed for the flights Now they feel awkward that they even askedA man is seeking support from the Reddit community after a family favor turned unexpectedly awkward. He and his partner had agreed to fly out and watch his partner's nephew for a week while his parents traveled internationally. 'We wouldn't be making this trip if it weren't for babysitting,' the poster explains in his post, highlighting that the trip was solely for the purpose of helping out family. The couple, currently in 'saving mode,' hadn't planned on traveling and assumed the parents would offer to cover their flights. Instead, the arrangement quickly became complicated when the topic of reimbursement came up. 'So we assumed (maybe incorrectly) that the parents would offer to cover our flights, since we're using our PTO and giving up a week to help them out,' he writes. When his partner raised the issue with her sister, the response was less than enthusiastic. The sister replied that she 'wished she'd known sooner' and explained that they were broke after paying for their own vacation. This left the couple feeling uneasy about the situation and questioning whether their request was out of line. 'Now there's this underlying tension, like we were out of line for even asking,' the poster admits. He clarified that all communication about the matter had been between his partner and his partner's sister, though he was supporting his partner throughout. 'I've stayed out of the conversation myself—this has all been between my partner and her sister—but I'm supporting her, and we're both starting to feel taken for granted,' he writes. Never miss a story — sign up for to stay up-to-date on the best of what PEOPLE has to offer, from celebrity news to compelling human interest stories. The couple emphasized that their request wasn't about profiting from the arrangement. 'It's not about trying to make money off the situation,' he says, but adds that it was hard not to feel 'a little used' when they were doing such a big favor and expected to pay their own way. Now, the couple is left feeling awkward and questioning whether their request was unreasonable, or if they were simply being taken for granted by family. Since sharing their post, many Reddit users suggested that they shouldn't have agreed if communication wasn't completely clear. 'Lesson learned: don't agree with anything before it's clear what the conditions are,' writes one user. Another one suggests, 'If you are still going to fly out to babysit make sure that you're clear that they need to go grocery shopping before they leave so the fridge and cupboards are stocked for the week.' Read the original article on People
Telegraph
07-06-2025
- Business
- Telegraph
Why banks may no longer refund fraud victims
Lenders are lobbying for new fraud reimbursement rules to be watered down over fears scam victims are being told to lie to their banks. Since last October, companies which handle payments have been required to give victims of 'Authorised Push Payment' (APP) fraud their money back, up to a limit of £85,000. In the first three months, 86pc of money lost to the scams – approximately £27m – was reimbursed to consumers by 60 firms. The current rules mean that, other than a £100 'excess' which firms can remove from payments, the only reasons that customers can be denied a payout are if they've ignored warnings, failed to quickly notify their bank of the fraud, refused to share information about the scam or do not consent to a police report being made. But in meetings in May, banks demanded that requirements for victims to act reasonably – and not to lie to their bank – were made stronger. This would mean that customers could be denied refunds in more cases. The Payment Systems Regulator (PSR) will hold an independent review of the mandatory scheme in October, and will then recommend changes. Problems raised include the high reimbursement limit, compliance monitoring by which administers the scheme, and the limited number of exemptions for refusing payouts. Lenders also said they should be able to give clear warnings about lying to them, as victims are often guided to do by fraudsters. One bank told industry magazine The Banker that: 'The [consumer negligence] bar is set so high that in almost all these cases a customer can be incredibly reckless, can lie to their bank, can ignore warnings and still get their money back.' Riccardo Tordera, director of policy and government relations at The Payments Association (TPA), said: 'The PSR says just 2pc of claims are rejected on this basis yet acknowledges no clear shift in consumer behaviour. 'Meanwhile, the Financial Ombudsman Service and the PSR both apply a stricter definition of gross negligence than common law, which could make enforcement of reimbursement policies challenging in a British court.' Under the previous voluntary code – called the Contingent Reimbursement Model (CRM) – customers could be refused for ignoring warnings or failing to verify the payee. Now the test is much stricter. Reimbursement numbers never jumped above 75pc under the old scheme – compared to 86pc for the mandatory payouts. APP scams see victims convinced to move their money themselves, eventually into a 'safe' account controlled by the fraudsters, at which point it is lost. Ticket sale scams, such as those experienced by Oasis and Taylor Swift fans, are also considered APP frauds. At first glance, the implementation has gone well. The amount lost in APP frauds dropped by 2pc between 2023 and 2024, according to UK Finance, and the number of cases fell by a fifth. But £450.7m was still lost to fraudsters last year. But the scheme has not been without its critics. Before the scheme was implemented, some parts of the industry warned of the potential problems of moral hazard – which is when consumers are incentivised to lie – and that fraudsters would pose as victims. This, it was claimed, would drive a significant spike in claims. But these fears have not materialised. Originally, the reimbursement limit was set to £415,000 – with firms expected to pay out just days after claims were made. But lobbying saw the limit dropped to £85,000, the same as the Financial Services Compensation Scheme (FSCS), which protects money deposited with banks. Smaller and medium-sized payment companies had said that one large claim could wipe them out. David Geale, managing director of the Payment Services Regulator (PSR), which is responsible for the scheme, said in May that: 'While it is too early to draw firm conclusions based on the period covered by this data, we have not seen evidence of spikes in claim volumes that some had feared would occur under the policy.' Before the scheme was introduced, there was a voluntary code which most of the major banks were signed up to, run by the Lending Standards Board. Sources at the LSB said last year, before reimbursement was mandatory, that they had not seen fraudulent claims. Rocio Concha, director of policy and advocacy at Which?, said: 'Based on the available data from the PSR, the new mandatory scheme appears to be performing well, with more fraud victims getting their money back. 'Sections of the industry had tried – without producing any evidence – to claim that mandatory reimbursement would lead to consumers acting irresponsibly or even teaming up with criminals to con banks out of cash. This seemed ludicrous at the time and initial insights have borne that out.' Ms Concha added that while the number of cases were down, there was another worrying trend. She said: 'Latest industry figures suggest more victims are being tricked into sending money to bank accounts overseas controlled by fraudsters. That is concerning as these transfers aren't covered by the new mandatory reimbursement rules.' A spokesman for the PSR said: 'We have always been clear that we would have an independent review following the implementation of the policy. 'If we think there are key learnings or adjustments to make to our policy, we will consider those carefully before making any changes.'
