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When he was diagnosed with two autoimmune diseases, Joel Hechler knew he’d be in for a battle. He didn’t realize maybe his toughest one would be with his insurance company.“I think they put the dollars ahead of a patient’s health,” Hechler said. “I don’t think they fully understand the impact the medicine will have on my long-term health and well-being."Hechler suffers from Crohn’s disease and ulcerative colitis, diseases that attack the lining of his digestive tract. Autoimmune conditions like his can’t be cured but, with the right medication, the symptoms can be controlled.  Finding the right medicine can be hard for those suffering from autoimmune diseases. Even if there are scores of drugs on the market, some patients might only respond to one. In Joel’s case, his doctor thought he’d have a better chance trying a drug called Remicade.“I received a letter from my insurance company that denied the Remicade on the basis that I have to try a different drug before I can get to Remicade," Hechler said.Hechler's insurance company, Premera Blue Cross, wouldn’t approve the drug his doctor prescribed because they wanted him to try a cheaper one first.It’s part of a program that health insurers nationwide use called step therapy, requiring that patients try less-costly drugs before “stepping up” to more expensive ones — even if doctors believes the cheaper drug won’t work.Dr. Larry Adler is president of Huron Gastro in Ypsilanti, Michigan and says he spends virtually every day battling insurance companies over step therapy drugs.“They have to fail this medicine first before they get the new drug,” Adler said. “That doesn’t make any sense.”Adler says it's common for patients to get sicker while waiting for step therapy to run its course.In Hechler's case, it took six weeks of fighting with his insurer to convince them that the cheaper drug wouldn’t be effective. As he was waiting, he was getting worse.“It got to the point where I had to be admitted to the hospital,” Hechler said. "I was very, very sick.”Step therapies are used by insurers to try to control skyrocketing prescription medicine costs, says Glen Perry, Director of Pharmacy Contracting and Sales for Blue Cross Blue Shield of Michigan.“These drugs can cost up to 0,000 per year. These are not cheap medications,” Perry said.“It seems like you’re telling patients that, in many cases, your insurer knows what’s best for you, rather than your doctor,” Jones said.“We are trying to provide the most cost effective and safe medication use,” Perry said, adding that when a doctor and insurer disagree over a drug, they can usually resolve the case within a few days without putting a patient at serious risk.“A delay of one or two days I don’t think is really going to make that much of a difference for the medical outcome of the patient," he said.But for many patients, like Phyllis Toole, the delay is longer than a few days.Phyllis suffers from rheumatoid arthritis, a condition where her body attacks her joints. When her doctor wanted to put her on Orencia, her insurance company HAP said she needed to first try a less expensive drug, Humira.But Phyllis’ doctor was worried about possible side effects and thought Humira could be risky.After battling for months, Phyllis says the whole thing made her feel more like a number than a patient. With her doctor and insurer in a standoff, she was forced to rely on samples of the drug she got from her doctor. HAP never approved her prescription.“They’re playing doctor, is what it feels like,” Toole said. “They’re saying this is what you can have for the symptoms you have. It may make you sicker, but this is what you can have.”HAP issued the following statement to Scripps station WXYZ in Detroit: 3800

West Virginia is a red state, and not just in presidential politics.Just take a look at the "School Closings - At a Glance" map put out by the state Department of Education on its website.The map -- which sports different colors for delayed opens, early dismissals and closings -- is a solid red (for closings) since all 680 public schools in the state's 55 counties are closed because of the ongoing teachers' strike there.West Virginia employs nearly 20,000 classroom teachers in its public schools and has more than 277,000 students enrolled.Teachers hit the picket lines last week, demanding higher wages and better benefits. In 2016, West Virginia ranked 48th in the nation for average teacher salary, according to the National Education Association.Gov. Jim Justice signed legislation Wednesday giving teachers a pay raise, but educators said it wasn't enough and it didn't address other areas of concern like insurance and health care costs, so they went on strike. 990

When he was a US attorney in Florida, Labor Secretary Alexander Acosta gave accused pedophile Jeffrey Epstein the "deal of a lifetime," the Miami Herald reported Wednesday.In a sweeping review of the politically connected multimillionaire's case, the Herald explained how Acosta made an agreement with Epstein to avoid major repercussions for the hedge fund manager, even though a federal investigation identified 36 underage victims.The report said Acosta forged a deal with one of Epstein's attorneys where he pleaded to two state prostitution charges, ultimately serving only 13 months and avoiding a federal trial. The agreement, the Herald said, "essentially shut down an ongoing FBI probe" and further granted immunity to "any potential co-conspirators" in the case.Epstein also registered as a sex offender and paid restitution to the victims identified by the FBI.The paper said it learned that Epstein provided information to federal investigators, but did not detail what the information was. It did note, however, that the Epstein case occurred around the same time as the economic crisis of 2008 and that records showed Epstein was a witness in the prosecution of executives at the failed investment bank Bear Stearns.The Herald said neither Epstein nor his attorney Jack Goldberger responded to its requests for comment. CNN has also reached out to Goldberger for comment.Eric Holland, a spokesperson for the Department of Labor, said in an emailed response to the report that "this matter has been publicly addressed previously, including during confirmation hearings.""The US Attorney's Office for the Southern District of Florida has defended the actions in this case across three administrations, and the US Attorney's Office for the Southern District of Florida is the appropriate office for your inquiry," Holland said.Sarah Schall, a spokesperson for the Southern District of Florida, told CNN the office declined to comment.The Herald said it found about 80 women Epstein allegedly molested or sexually abused over a five-year period, and the report charged that even Epstein's state prison time was lax, being housed in a private wing at the Palm Beach County jail and allowed work release privileges.Epstein was friends with President Donald Trump and former President Bill Clinton, and his legal team included Alan Dershowitz and Kenneth Starr, the report noted.Trump nominated Acosta to lead the Department of Labor last year after his first choice, Andrew Puzder, withdrew himself from contention.Acosta defended his handling of the Epstein case during his confirmation hearing."At the end of the day, based on the evidence, professionals within a prosecutor's office decide that a plea -- that guarantees that someone goes to jail, that guarantees that someone register generally and that guarantees other outcomes -- is a good thing," he said last year.The report noted a pair of lawsuits await further action in the courts, and in one, the Herald said, women argue Acosta and other federal prosecutors broke the law in their handling of the case.The-CNN-Wire 3095

With America’s student loan crisis reaching .5 trillion, it’s not just college graduates who are paying off the loans. Parents are now getting sucked in to pay.One man says he has a warning for other parents, before they try to help their children.Victor Turner, who is a veteran, took out Parent PLUS loans in order to send his daughter to college.  "Out of all the loans, I think the highest one is about 0 a month, but there are 7 of them."  Now, back in school himself and caring for his new son, Turner is not the only parent risking their financial future for their child’s future.  In 2016, an average parent owed about ,000 on loans to help pay for their child's education.   734

When exploring mortgage options, it’s likely you’ll hear about Federal Housing Administration and conventional loans. Let’s see, FHA loans are for first-time home buyers and conventional mortgages are for more established buyers — is that it?Not necessarily.Actually, the differences between FHA loans and conventional mortgages have narrowed in the past few years. Since 1934, loans guaranteed by the FHAn have been a go-to option for first-time home buyers because they feature low down payments and relaxed credit requirements.But conventional loans — which are not insured by a government agency like the FHA, the Department of Veterans Affairs or the U.S. Department of Agriculture — have gotten more competitive lately.Both types of loans have their advantages. Here are the factors to consider when deciding between an FHA and a conventional mortgage. 886