The stocks for pharmaceutical companies dropped in price on July 5 after President Donald Trump said his administration is working on an executive order which would require drug companies to price their medicines based on the lowest amount paid for the same drug by another nation.

SPDR S&P Pharmaceuticals, an exchange-traded fund tracking the stocks of major pharmaceutical companies, was down 1.5 percent at 1:10 p.m. on July 5. The index began declining immediately after Trump told reporters on the White House lawn about preparations for the executive order.

“We’re going to be announcing something very shortly, a favored nations clause. As you know, for years and years other nations paid less for drugs than we do. Sometimes by 60-70 percent. We’re working on it right now, we’re working on a favored nations clause, where we pay whatever the lowest nation’s price is. Why should other nations—like Canada—but why should other nations pay much less than us. They’ve taken advantage of the system for a long time, pharma,” Trump said.

“But we’re working on right now a favored nations clause, so that whatever the lowest nation is anywhere in the world, or company, but the lowest nation or company, then what happens is, we will pay that amount. And that’s being worked on right now. We’re gonna do it in the form of an executive order,” the president added.

In October last year, Trump announced a new rule that would bring the prices Medicare pays closer to what other countries pay and save taxpayers an estimated $17.5 billion over the next five years. The president unveiled the rule after the Department of Health and Human Services released a report on drug prices under Medicare Part B, which estimated the United States is paying on average almost two times what other countries are paying.

Trump has taken a number of other steps to lower drug prices. In January, the administration proposed a rule to cut out the middlemen and require drug companies to pay rebates directly to consumers. Every year, an estimated $150 billion is passed around the rebate system to middlemen like pharmacy benefit managers with consumers left entirely in the dark.

Another administration rule will require drug companies to list the prices for their medicine in television advertisements. Earlier this month, the president issued an executive order which, once implemented, would require hospitals to display prices for services upfront.

“When prices are transparent and competition is encouraged, consumers win. We believe that can prove true in health care as it has in every other area of the American economy,” Alex Azar, the secretary of Health and Human Services, wrote in an op-ed in February.

The California Labor Commissioner’s Office has cited a Daly City senior care facility for multiple wage theft violations affecting 48 workers. The workers are owed more than $639,000 for underpaid minimum wage, overtime and contract wages as well as other penalties.

The Labor Commissioner’s Office opened an investigation at Amore Retirement Living last June after receiving a complaint that the employer did not have workers’ compensation insurance. Investigators found that the 53-bed facility lacked coverage for the previous five years, and uncovered many other labor law violations.

Investigators at the Labor Commissioner’s Office learned that Amore Retirement Living over a 28-month period ending in October 2017 did not provide overtime or meal periods for their employees who worked an average of 58 hours a week. An audit of payroll and time records also showed that 29 employees worked split shifts without being paid the one-hour premium required in order to provide around-the-clock care to the residents.

The citations against Amore Retirement Living, which total $708,521 including civil penalties, name both the care home’s licensee Krysella Trismeo Corporation and its chief executive officer, Sheryll Miranda-Sunga, as jointly liable for the wage theft.

The investigation determined that the employer owes workers $623,871 in unpaid minimum wages and overtime, liquidated damages, meal period and wage statement violations, split shift premiums and waiting time penalties, with an additional $7,766 for contract wages due for 40 of the workers. The citations also include $84,650 in civil penalties due to the state for minimum wage, overtime, split shift premium, meal period and itemized wage statement violations. Krysella Trismeo Corporation was cited $469,103 on June 20, 2018 for failure to obtain and maintain workers’ compensation insurance coverage.

When workers are paid less than minimum wage, they are entitled to liquidated damages that equal the amount of underpaid wages plus interest. Waiting time penalties are imposed when the employer intentionally fails to pay all wages due to the employee at the time of separation. This penalty is calculated by taking the employee’s daily rate of pay and multiplying it by the number of days the employee was not paid, up to a maximum of 30 days.

The Monterey County District Attorney reported that Angel Musones, a 51-year-old resident of Salinas, and Navid Homami, a 45-year-old resident of Monterey, pled no contest to operating their private security guard business – Mile High Security – without having workers’ compensation insurance.

Judge Thomas Wills sentenced both men to 3 years’ court probation and ordered them to each pay $10,000 in criminal penalties.

The District Attorney’’ Workers’ Compensation Fraud Unit opened an investigation of Mile High Security in December 2018.

It was determined that Mile High Security, LLC, started doing business in September 2018. The company advertised and operated itself as a private patrol operator without having a valid license to do so.

Interviews with Homami and Musones confirmed that they did had as many as 8 employed security guards but did not have workers’ compensation insurance  – a misdemeanor violation of Labor Code section 3700.5.

The District Attorney filed criminal charges on May 14, 2019. The case was investigated by District Attorney Investigator George Costa.

Are health insurance policies creating nightmares for physicians and hazards for their patients? A new study finds that nearly nine in ten doctors believe barriers set by insurance plans have led to worsened conditions for patients in need of care.

Researchers with Aimed Alliance, a non-profit that seeks to protect and enhance the rights of health care consumers and providers, say that doctors are so fed up with the constant headaches caused by insurers, two-thirds would recommend against pursuing a career in medicine, and nearly half (48%) are considering a career change altogether.

For the study, the organization polled 600 physicians in the U.S. practicing either family medicine, internal medicine, pediatrics, or obstetrics/gynecology. The group sought to understand the extent to which insurance policies impact primary care physicians, their practices, and their patients on a day-to-day basis. They also wanted to get a better understanding of mental health issues among providers, as well as the causes behind the national provider shortage.

Researchers found that physicians don’t think very highly of health insurance companies, and believe they’re putting patients at risk with policies such as prior authorizations ahead of filling prescriptions. In fact, 87% of doctors say patients’ conditions have grown worse because of such red-tape regulations, and 83% worry the patients will suffer prolonged pain as a result.

Prior authorizations are especially bothersome for doctors. More than nine in ten (91%) of those surveyed think the policy delays necessary care for patients. Similarly, the same number of doctors agree insurers engage in “non-medical switching,” which forces patients to take less costly – but potentially less effective – medicines.

Such policies are stressing many physicians out. Thirty-seven percent say half or more of their daily stress is caused by insurance issues, and 65% feel they’re facing greater legal risks because of decisions made by insurers. The vast majority (85%) are left frustrated by such issues, and many admit to taking their anger and emotions out on their staff and even family members.

“I can understand why many of the respondents reported that they would not recommend this career to anyone else,” Dr. Shannon Ginnan, medical director of Aimed Alliance, tells StudyFinds. “As practitioners, much of our time is spent on burdensome paperwork required from health insurers for our services to be paid for. This prevents us from spending as much time on patient care as we would like, and it doesn’t take much for all this paperwork to interfere with the services that we provide.”

To Ginnan’s point, the survey showed that 77% of doctors have had to hire more staffers to handle the heavier administrative load from insurance work. Ninety-percent say they have less time to spend with patients because of the burden.

As for the aspect of insurers’ policies that doctors would like to see changed most, the majority (55%) agreed on an insurers’ ability to override the professional judgment of physicians. About nine out of ten (87%) respondents felt that insurer personnel interfere with their ability to provide individualized treatments for each patient.

Beyond the harm that doctors say insurance policies cause patients in need of care, they also agree that patients are taking a hit in their bank accounts too. Doctors believe that insurers are contributing to the rising cost of healthcare more than anything else, including pharmaceutical companies, government policies, lawsuits, or hospitals.

A few weeks ago, the Insurance Journal reported a possible sale of workers’ compensation specialist Applied Underwriters.. The California Department of Insurance was reviewing an application for the sale of the Calif.-based Berkshire Hathaway subsidiary.

However, the buyer was not identified.”Once the application is determined complete, portions of the file will be public and available to be shared,” said CDI spokeswoman Nancy Goldberg.

Friday, the New York Post reported that Berkshire Hathaway agreed to sell Applied Underwriters, to Bahamas-based United Insurance Co., which was recently part-owned by Aon, according to a filing late Thursday with the California Department of Insurance.

The New York Post claims that UIC is acquiring Berkshire’s 81-percent stake in the insurer, as well as the stakes owned by two other executives, according to the filing. Financial terms of the deal weren’t disclosed.

One of the largest sellers of workers’ compensation insurance in the US, Applied Underwriters has been accused of being a “reverse Ponzi scheme” in a pending civil suit filed in 2016 by ex-clients – an accusation the company has denied.

Regulators also are probing the company over allegations of bait-and-switch tactics. The company is under investigation by New York and New Jersey regulators for selling unregistered insurance products. The company has denied any wrongdoing.

While Berkshire has never disclosed exactly how much it paid for Applied, a 2007 report from SNL financial put the deal price at $339 million.

That deal was apparently so expensive that Deloitte, in a 2015 report, excluded it from insurance deals because it would “skew” the data.

Nevertheless, “It’s probably been a successful investment,” Meyer Shields, analyst at KBW, told The Post, estimating it could now be worth between $1 billion and $1.2 billion.

In 2015, Berkshire told the Omaha World-Herald that Applied Underwriters had assets of $2.7 billion. But getting sold off by Berkshire – and losing Buffett’s sterling reputation – could negatively affect the value, too, Shields added.

A consortium of insurers and hedge funds was previously reported to be interested in the company, according to a February report in Reuters. Berkshire confirmed later that month it was divesting from Applied — a rare instance of Buffett walking away from an investment.

But, Applied Underwriters spokesman Mark Veverka said.”The story published today in the NY Post regarding Applied Underwriters is grossly inaccurate and incomplete.” He declined to elaborate