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HMSA members faced with delays, billing issues in seeking new COVID booster

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HMSA members faced with delays, billing issues in seeking new COVID booster


HONOLULU (HawaiiNewsNow) – HMSA members seeking the new COVID booster this week were left confused and frustrated after billing issues prevented them from getting the shot for free.

The state’s largest health insurer Thursday afternoon it’s fixed the problem and is now covering the vaccines. But earlier, members say they were being turned away or asked to pay upfront, as much as $200.

HMSA blames the problems on delays in entering new billing codes into its system.

Maui resident Martin Zorn said as soon as the new COVID vaccine was available at the Long’s Drugs in Pukalani, he booked an appointment.

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But he never got a shot.

“Long’s told me (HMSA is) not covering it. It’s not in the formulary,” Zorn said.

Booking a COVID-19 vaccine? Some are reporting canceled appointments or insurance issues

“And I said, ‘as long as it’s scheduled, can I come in and pay it out of pocket and then submit it for reimbursement to HMSA?’ And they said, ‘you have to call HMSA.’”

He did that.

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“The person I talked to had no idea, it’s like, ‘we’re working on it.’”

Zorn said the delay is frustrating.

“We all knew this was coming,” Zorn said. “What other issues do they have with their computer system? It’s not like it’s a surprise.”

But HMSA said it was surprised at how quickly the shots hit the market.

Prior vaccines were fast-tracked because the federal government foot the bill. This one requires new codes for the commercial market ― and HMSA says it’s a steep learning curve.

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“It happened so much quicker than we thought, for better or for worse,” said Dr. Stefanie Park, HMSA vice president and chief medical officer.

“The vaccines were approved last week Monday, and then CMS, the federal government, released the rates on Thursday. It was a really quick turnaround for us to set all of these things and get them into our systems.”

Patients say the insurer dropped the ball.

Zorn says HMSA was still not covering shots at the Long’s near him on Thursday morning.

“My wife has some immune deficiency, and I wanted to get it because I don’t want to take the risk of bringing something home into the house either,” he said.

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HMSA members who paid upfront for a COVID vaccine are advised to go back to the pharmacy and request a refund.



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Hawaii

Pharmaceuticals Ordered To Pay Hawaii Nearly $1 Billion For Deceptive Business Practices

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Pharmaceuticals Ordered To Pay Hawaii Nearly $1 Billion For Deceptive Business Practices


The drug companies hid information from doctors who prescribed Plavix, which can have outsized negative effects on Asians and Pacific Islanders.

A Hawaii state judge on Tuesday awarded the state more than $900 million after he found two major pharmaceutical companies had employed unfair and deceptive business practices in marketing the blood thinner drug Plavix.

Bristol-Myers Squibb Co. and U.S. subsidiaries of Sanofi, a French drug company, were each ordered to pay $458 million by First Circuit Judge James Ashford.

The companies failed to disclose the efficacy and safety profile of Plavix, Hawaii Attorney General Anne Lopez said in a press release.

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Ashford found that the companies knew some patients, particularly non-Caucasian races, might not do as well on the drug but deliberately suppressed research and allowed Hawaii doctors to prescribe the medication without having the necessary information.

According to the AG’s press release, the judge found that the defendants “deliberately turned a blind eye toward the diminished response problem because of Defendants’ concern that addressing that problem might adversely affect Plavix sales and Defendants’ profits.”

In enforcing Hawaii’s consumer protection statute, the court concluded that Hawaii had a heightened interest in this case because “the omission of warning information raises a serious risk of harm to all consumers, but a particularly high risk to patients of East Asian and Pacific Island descent, who represent a significant portion of Hawaii’s population,” the release said.

The case was initially filed in 2014 by then-Attorney General David Louie. You can read Ashford’s order findings, conclusions and order here.



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Authorities identify man killed in Hawaii Island motorcycle crash

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Authorities identify man killed in Hawaii Island motorcycle crash


HONOLULU (HawaiiNewsNow) – Hawaii Island police have identified the 59-year-old man who died in a motorcycle crash in Ka’u last Thursday.

The victim was identified as Andre Joseph Fournier Sr. from Ocean View.

According to police, at about 5:37 p.m., Fournier was riding a motorcycle south on Mamalahoa Highway (Route 11) and had overtaken several vehicles near the Manuka State Park entrance.

Officials say after passing the vehicles, Fournier allegedly crossed double solid yellow lines and struck a rock embankment on the Mauka side of the highway.

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He was ejected from the motorcycle and was taken to Kona Community Hospital, where he was pronounced dead at 10:30 p.m.

Officials say the crash is being investigated as a coroner’s inquest.

Anyone who may have witnessed the collision is asked to contact Officer Adam Roberg at (808) 326-4646 ext. 229 or call Crime Stoppers at (808) 961-8300.

Fournier’s death is the 18th traffic fatality this year compared to 8 at the same time last year.

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Iran moves to project stability after crash kills key leaders

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Iran moves to project stability after crash kills key leaders


Iran sought to project a sense of order and control Monday by quickly naming an acting president and foreign minister a day after a helicopter crash killed both leaders. The change in leadership came at a time of heightened tensions in the Middle East and domestic discontent in Iran, where many residents have called for an end to decades of repressive clerical rule.

Iran’s supreme leader, Ayatollah Ali Khamenei, announced five days of mourning for the president, Ebrahim Raisi, 63, and the foreign minister, Hossein Amirabdollahian, 60, who died when their helicopter plunged into a mountainous area near the Iranian city of Jolfa. The men had been returning from Iran’s border with Azerbaijan after inaugurating a joint dam project.

Iran’s armed forces said they had created a committee to investigate the crash, which state media attributed to a “technical failure.”

Raisi, a hard-line cleric who came of age during the country’s Islamic Revolution, oversaw a deadly crackdown on protesters as the head of the judiciary in 2019 and as president in 2022. He had been widely viewed as a possible successor to Khamenei, 85.

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On Monday, Khamenei named Iran’s first vice president, Mohammad Mokhber, acting president and announced that Mokhber would organize elections for a new president within 50 days. A conservative political operative, Mokhber has a long history of involvement in large business conglomerates closely tied to Khamenei.

Iran’s Cabinet appointed Ali Bagheri Kani, a deputy foreign minister, as the ministry’s “caretaker,” the IRNA state news agency reported. Bagheri Kani has served as Iran’s chief nuclear negotiator and was involved in a deal last year that freed imprisoned Americans in exchange for several jailed Iranians and eventual access to about $6 billion in Iranian funds.

Iranian officials said there would be a public procession in Tabriz, the closest big city to the site of the crash, on Tuesday and that the bodies would then be brought to Tehran for a state funeral.

“Raisi was tireless,” Khamenei said in a statement. “In this very sad incident, the people of Iran have lost a valuable and loyal public servant.”

Analysts in Iran said that while there was speculation about who might be elected as the next president, there was little question about the overall stability of the country or the government. They pointed out that Khamenei will remain supreme leader with power over major state policies.

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Despite the official calls for mourning, many Iranians welcomed Raisi’s death, seeing him as one of the key figures in a corrupt regime who oversaw the execution of dissidents, used brutal violence to suppress and kill.





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