by Mitti Hicks

November 13, 2024

Inside Look: The Companies Helping Insurance Companies Deny Pre-Authorization Claims

There's a hidden industry is making money by turning down doctors’ requests for payments, known as prior authorizations.

A KFF survey found that roughly 6 in 10 insured adults have experienced problems when using their insurance. The issues range from denied claims to network adequacy, preauthorization delays, and denials. According to a ProPublica investigation, this comes as no surprise. A hidden industry makes money by rejecting doctors’ payment requests, known as prior authorizations.

According to ProPublica’s investigation, one key player in this scheme is a company called EviCore by Evernorth. ProPublica’s investigation found that EviCore is owned by a major insurance company, Cigna. Major American insurance companies hire EviCore and provide coverage to 100 million consumers.

EviCore reportedly uses an algorithm backed by artificial intelligence that insurance insiders call “the dial.” The algorithm system can be adjusted, ultimately leading to higher denials of preauthorization claims.

Even more bizarre is that EviCore reportedly has some contracts that allow it to get paid more the more it cuts back on health spending for insurance companies.

EviCore is not alone. Another big player is Carelon Medical Benefits Management, an Elevance Health subsidiary formerly Anthem. While the company is being accused in court of wrongfully denying legitimate requests for coverage, it denies all charges.

How The Companies Are Responding

EviCore claims that the approval process ensures that procedures are safe, necessary, and cost-effective.

“We are improving the quality of health care, the safety of health care and, by very happy coincidence, we’re also decreasing a significant amount of unnecessary costs,” an EviCore medical officer said during the company’s webinar series.

Yet, according to the investigation, EviCore’s approach is far more sinister than it’s leading on. EviCore reportedly promises a 3-to-1 return on investment, meaning the insurer would pay $3 less on medical care and other costs.

For some perspective, EviCore turned down prior authorization requests nearly 20% of the time in Arkansas in 2021. According to ProPublica’s data analysis, Medicare Advantage plans turned down prior authorization requests about 7% of the time in 2022.

A Cigna spokesperson said on behalf of EviCore, “Simply put, EviCore uses the latest evidence-based medicine to ensure that patients receive the care they need and avoid the services they do not.”

The spokesperson added that the company uses algorithms for some clinical programs “only to accelerate approval of appropriate care and reduce the administrative burden on providers.”

Keke Palmer, Real Estate, Mother, Nope, Wills, financial planning, finances, Tru Jackson VP,birthday, pregnant, Creme of Nature

by Jeroslyn JoVonn

November 13, 2024

Keke Palmer Recalls Co-Star’s ‘Weighted’ Racist Comment On ‘Scream Queens’ Set

Keke Palmer is getting candid about the racism and microaggressions she experienced on the Scream Queens set.

Keke Palmer is gearing up to release a new memoir, where she opens up about everything—including the racist incident she experienced on the set of Scream Queens.

In her new memoir, Master of Me: The Secret to Controlling Your Narrative, the Emmy-winning actress and TV star opens up about the sacrifices and self-control it took to reach her success. Reflecting on pivotal moments with The LA Times, Palmer shares an incident from her time on Scream Queens, where she kept her composure after a white co-star made a racist remark while she attempted to calm them down.

“Keke, literally, just don’t. Who do you think you are? Martin F— Luther King?” the co-star, whom she refers to as “Brenda” shouted out.

Palmer writes that Brenda became frustrated after a clash with a colleague. The Akeelah and the Bee star attempted to ease tensions by encouraging everyone to “have fun and show respect for one another.” That’s when Brenda lashed out at Palmer in a racist rage and spewed the MLK remark.

“It was such a weighted thing that she said, but I didn’t allow that weight to be projected on me because I know who I am,” Palmer says. “I’m not no victim. That’s not my storyline, sweetie. I don’t care what her ass said. If I allow what she said to cripple me, then she would.”

Palmer chose not to name the person involved, explaining that she wanted to remove the power from their words and keep the focus off them. However, while she refused to name the actress, social media has started doing their investigating to determine who the racist culprit is.

Many are convinced that the co-star is actress Lea Michele, whom many noted is the only Scream Queens alum Palmer doesn’t follow on Instagram.

“Considering she doesn’t follow Lea Michele, it was probably her,” one person tweeted.

considering she doesn’t follow Lea Michele it was probably her
— will (@neversbeme) November 11, 2024

Palmer delves into her challenging experiences during her two seasons on Ryan Murphy’s Scream Queens, including a tense call from the director reprimanding her for not showing up on her scheduled day off.

“It was kind of like I was in the dean’s office,” she says now, reflecting on the interaction. “He was like, ‘I’ve never seen you behave like this. I can’t believe that you, out of all people, would do something like this.’”

She recounts being given her shooting schedule and planning another business commitment for a scheduled day off. However, when that day arrived, production informed her she was actually needed on set. Instead, Palmer chose to honor her prior commitment, prompting Murphy’s angry call. Murphy “ripped” into her, accusing her of being unprofessional.

Palmer apologized and assumed things were smoothed over—until a few days later, a Scream Queens co-star visited her trailer and told her the situation was “bad.”

The veteran actress felt like the co-star was “trying to make me scared or something, which was a little irritating,” she writes.

While she hoped to become a recurring face in Murphy’s many productions, she feels she ended her working relationship with the American Horror Story creator by standing up for herself.

“I’m still not sure Ryan cared or got it, and that’s okay because he was just centering his business, which isn’t a problem to me,” she writes in the book. “But what I do know is even if he didn’t care, and even if I never work with him again, he knows that I, too, see myself as a business.”

Keke Palmer’s “Master of Me” memoir will be released on Nov. 19, 2024, in print and as an ebook.

by Jeroslyn JoVonn

November 13, 2024

Oprah Winfrey Denies Being ‘Paid A Personal Fee’ By Kamala Harris Campaign, ‘My Time And Energy Were My Way Of Supporting’

Oprah Winfrey says she was never paid to support the Kamala Harris campaign.

Oprah Winfrey is shutting down speculation that she received a $1 million payment for her campaign event for Vice President Kamala Harris.

A report from the Washington Examiner, released three days after the election, ties billionaire media mogul Oprah Winfrey to rumors surrounding the Harris campaign’s $1 billion raised funds and its alleged spending of “over $15 million on event production,” per federal filings. The report claims Winfrey’s Harpo Productions received $1 million for the “Unite for America” livestream event with VP Harris.

However, according to her production banner Harpo Productions, Winfrey was never “paid a personal fee,” Variety reports.

“The campaign paid for the production costs of ‘Unite for America,’ a live-streaming event that took place Sept. 19 outside Detroit, Mich.,” a spokesperson for Harpo said. “Oprah Winfrey was at no point during the campaign paid a personal fee, nor did she receive a fee from Harpo.”

TMZ approached the OWN founder after the rumors surfaced and asked if it was “true that they paid you a million dollars for the endorsement for Kamala.”

“Not true,” Winfrey said. “I did not get paid a penny. Ever.”

Oprah says people in her production company were paid to set up a Kamala Harris campaign event, but she never received a “personal fee”:

“For the live-streaming event in September, my production company Harpo was asked to bring in set design, lights, cameras, microphones, crew,… pic.twitter.com/kMjuHQRPCk
— Pop Crave (@PopCrave) November 12, 2024

She reiterated these claims in a lengthy Instagram response to one user who defended her against claims she only supported Harris’s campaign for a hefty financial payout.

“I was not paid a dime. My time and energy was my way of supporting the campaign,” Winfrey explained in a post captured by Pop Crave.

She confirmed the payments to her Harpo Productions staff, who brought in “set design, lights, cameras, crew producers, and every other item necessary (including the benches and chairs we sat on) to put on a live production.”

“I did not take a personal fee,” she clarified. “However, the people who worked on that production needed to be paid. And were. End of story.”

Winfrey interviewed Harris during the “United for America” event, where the VP discussed key issues like abortion rights and immigration. The virtual town hall, promoted as a star-studded gathering, also included appearances by Meryl Streep, Chris Rock, Ben Stiller, Tracee Ellis Ross, and Julia Roberts.

by Mitti Hicks

November 13, 2024

Average Homebuyers In America Are Now The Oldest and Wealthiest In History

The median buyer age has increased to a peak of 56, up from 49 in 2023.

A new report details a grim reality as America continues to deal with a housing shortage and financial hurdles for people looking to own a home. According to the National Association of Realtors, homebuyers are now older and wealthier than ever, as the average age of homebuyers has reached an all-time high.

The median buyer age has increased to a peak of 56, up from 49 in 2023. The median first-time buyer age increased to 38, up from 35 in 2023, and the repeat buyer age increased to 61, up from 58 in 2023.

“Underscoring the hurdles to entering the housing market, first-time homebuyers’ median age reached an all-time high of 38 years old. In the 1980s, the typical first-time homebuyer was in their late 20s,” the report reads.

But age isn’t the only factor that has increased. It’s also the median income of those who are buying.

“In the last two years, first-time homebuyer household income has grown by $26,000. This year’s report shows that the median household income of first-time homebuyers was $97,000,” the report states.

The Race Gap For Homebuyers Is Increasing

Unfortunately, there is still a race gap between white homeowners and Black homeowners.

“Overall, 83% of buyers were White/Caucasian, up from 81 percent last year,” the report reads. Only 7% of recent buyers identified as Black/African-American.

According to a report from Fast Company, mortgages for Black Americans fell by 16% in 2022. Mortgage denial rates, however, increased by 2.6 percentage points.

Another dramatic change was revealed in the report: buyers with children are not purchasing homes as much.

Among all homebuyers, 62% are married couples, 20% are single women, and 8% are single men. The share of buyers with children under 18 dropped to the lowest level at 27% of all buyers.

Multigenerational living remains popular, with an all-time high of 17% of all buyers purchasing a home that will house different generations, the report reads. The most common reasons are cost savings, elder care, and young adults moving back.

by Sharelle Burt

November 13, 2024

Donald Trump Promises Reparations To White Americans, Labeling Them As Racial Discrimination ‘Victims’

You heard him correctly.

In a video posted across social media platforms, President-elect Donald Trump announced reparations to White Americans, labeling them as “victims” of racial discrimination in correlation to education polices.

In video, posted days after Trump was elected the 47th President of the United States, claimed he will pursue federal civil rights cases against schools that “continue to engage in racial discrimination” and persist in “unlawful discrimination under the guise of equity.”

Trump also threatened the budgets of colleges and universities, saying he will tax their endowments and issue fines.

“A portion of the seized funds will then be used as restitution for victims of these illegal and unjust policies, policies that hurt our country so badly,” Trump said. “Colleges have gotten hundreds of billions of dollars from hardworking taxpayers, and now we are going to get this anti-American insanity out of our institutions once and for all. We are going to have real education in America.”

Trump announces reparations for white people. He says he will ask the Justice Department to penalize colleges that consider diversity, equity, and inclusion (DEI) and fine them so he can pay “restitution” to white people who he considers the real victims of racial discrimination. pic.twitter.com/69sFbAz3rF
— Keith Boykin (@keithboykin) November 12, 2024

Social media users reacted to Trump’s rhetoric. “The second season of this reality show just scares me minute by minute,” @onestpress said.

The second season of this reality show just scares me minute by minute
— Olga Nesterova (@onestpress) November 12, 2024

“Biden’s investments in HBCUs will be gone. Pell grants, gone, grants to schools to fund special need services, gone,” @msgrumpybunny wrote. “And white people are stupid if they think they’ll get reparations – money will be going into Trump’s pockets.”

https://twitter.com/msgrumpybunny/status/1856427224540557424

@HarkemJ11 blamed the Black voters who elected Trump.

https://twitter.com/HarlemJ11/status/1856417611208097832

The video correlates to Trump’s idea of eliminating the Department of Education, which he discussed heavily on the campaign trail. According to the Washington Post, the President-elect continuously promised to “return” the education responsibility to the states. State and local governments have been responsible for providing nearly 90% of school funding.

Also, the DOE does not identify curriculum or have a hand in most school policies. It administers federal grant programs such as the $18.4 billion Title I program that gives funding to high-poverty K-12 schools and the $15.5 billion program that assists with the cost of education for students with disabilities. The $1.6 trillion federal student loan program is also supported by the department and sets rules for what colleges must do to participate.

However, to close the department, which was established in 1979, Trump would need congressional approval, which is unlikely.

Josh Reynolds, Denver Broncos,Wide Receiver, Strip Club, Shooting

by Cedric 'BIG CED' Thornton

November 13, 2024

7-Year-Old Girl Shot In Harlem; 2 Teenagers Arrested, Charged with Attempted Murder

Two alleged gang members were charged with attempted murder.

A 7-year-old girl was shot in the stomach after reputed gang members started shooting in the middle of the day on a Harlem street, ABC 7 NY reports. The incident occurred around 3 p.m. on Nov. 11. The girl was riding a pink scooter near West 145th Street and Bradhurst Street; her father was walking alongside her.

Police arrested 19-year-old Daniel Idowu and an unidentified 17-year-old. They have been charged with attempted murder.

The little girl, identified by police as Fatou Keita, was taken to nearby Harlem Hospital in a police vehicle, and officials stated that she arrived there in stable condition. A video reveals Keita’s father picking her up after she was struck by gunfire as the shots continued to fly.

“She was just in total shock looking down at her wound, it was just crazy,” witness Angel Casanova told ABC 7. “Her dad was inconsolable, he was saying that he wished it was him who was shot.”

Authorities said that nine rounds were fired but did not hit their intended target. The shooting was between rival gang members. The suspects came out from behind a parked car and started firing into the street.

CBS News reported that Idowu was also charged with four counts of criminal possession of a weapon. A gun was recovered at the scene.

“It is never a good thing when a child is a victim of a shooting,” New York City Mayor Eric Adams said. “It’s never good when any innocent bystander is a victim. But, again, I want to commend the quick response from the 30th and 32nd precincts.”

Community leader Dr. Iiesha Sekou said the girl was OK.

“They were distraught, very upset,” Sekou said. “She’s out of surgery. She’s stabilized. It’s not a perfect situation, but she’s doing well … to have endured the kind of trauma to a body that a bullet brings to a child.”

Medi-Cal, program, California, healthcare, insurance, coverage, undocumented, Senator, Alexis Donald

by BLACK ENTERPRISE Editors

November 13, 2024

Alexis Donald Becomes The First Medical Doctor And Published Author In Her Family

'Mommy, I Want to be a Doctor,' a children's book, is out now.

Alexis Donald, M.D., a trailblazing African American medical doctor and advocate for empowering young minds, is thrilled to announce the release of her highly anticipated children’s book, Mommy I Want to be a Doctor. Based on her own remarkable journey, this captivating story encourages children to dream big, believe in themselves, and fearlessly pursue their aspirations.

As the first medical doctor in her family, Dr. Alexis has always been driven by a passion for medicine and a desire to make a difference in the world. Her inspiring tale begins with her childhood dreams and takes readers on a heartfelt journey of determination, resilience, and triumph.

Mommy I Want to be a Doctor is a beautifully illustrated book that captures the essence of Dr. Alexis Donald’s true-life story. Through relatable characters and engaging storytelling, young readers will be inspired to embrace their own dreams, no matter how big or audacious they may seem.

This enchanting book not only highlights Dr. Donald’s personal achievements but showcases her exceptional academic accomplishments. As the valedictorian of her high school, she became the first person in her high school’s history to be awarded the prestigious Bill Gates Millennium Scholarship. Undeterred by challenges, she continued her educational journey, graduating fromJackson State University for undergrad and Meharry Medical College for both her master’s and medical degrees.

Now a successful family medicine physician, Dr. Donald is on a mission to inspire the next generation to dream big, believe in themselves, and fearlessly pursue their passions. Through Mommy I Want to be a Doctor, she hopes to instill in young minds the importance of perseverance, self-belief, and the limitless possibilities that await them.

With its powerful message and captivating illustrations, Mommy I Want to Be a Doctor is poised to become an instant favorite among children, parents, and educators alike. This heartwarming tale serves as a reminder that dreams can come true with dedication, hard work, and unwavering determination.

Dr. Donald invites readers of all ages to join her in celebrating the release of her children’s book. This extraordinary book is now available for purchase at leading bookstores and online retailers.

For more information about Dr. Alexis, her inspiring journey, and her mission to empower young minds, please visit AuthorAlexisMD.com

Her book is available on Amazon.

This story was first reported on BlackNews.com

by BLACK ENTERPRISE Editors

November 13, 2024

Hollywood And The Ongoing Battle For Black Narratives In Film

Contemporary sources paint a complicated picture.

Written by Julianne Malveaux

When former NBA player and longtime civil rights activist Craig Hodges signed a deal with a Hollywood production company called Wayfarer Studios to document his life story—which involves fervent activism for Black rights and eventual ostracization from the league—he surely could not have expected to find himself blackballed yet again. But that’s exactly what’s happened.

As is often the case, the past shapes the future –- and this new dispute, while seemingly minor, betrays how racial identity, principled politics, and outspoken activism can still create a toxic cocktail for Black Americans in Hollywood.

Hodges and Wayfarer originally signed a deal in 2021 to turn Hodges’ book –- Long Shot: The Triumphs and Struggles of an NBA Freedom Fighter -– into a documentary. The book provides an alternative and complicated look at the same era of Chicago Bulls basketball that ESPN’s pandemic smash hit The Last Dance covered. The success of that series prompted a new wave of sports documentary fever in America.

Wayfarer smartly wanted to join the cause, but it appears that they misunderstood the story Hodges wished to tell.

Hodges, a former Chicago Bull who helped the team win two of its six NBA titles in the 1990s, has long been a controversial figure who unsuccessfully encouraged his more famous teammates like Michael Jordan to speak up on political issues, including the Gulf War and the beating of Rodney King. After the Bulls won the 1992 NBA Finals, Hodges wore a dashiki to the White House and handed President George H.W. Bush a letter that “asked him to do more to end injustice toward the African American community.”

The Bulls waived Hodges that same year, and he never played in the NBA again. Despite his efforts and those of his agent, who collectively “called every team in the NBA,” he never received another workout. As such, Hodges sued the NBA in 1996 for “blackballing” him from the league as a result of his activism and association with the Nation of Islam.

Contemporary sources paint a complicated picture. A Cleveland Cavaliers executive noted at the time that “he never heard of any conspiracy” against Hodges and that “in a league with about 80% Black players, it’s hard to charge racism.”

Buck Williams, a Knicks player and, at the time, head of the Players’ Association, however, had a different view. “It is well known through the league that there may be repercussions if you speak out too strongly on some sensitive issues,” Williams told The New York Times, and “it is a burden when you carry the militant label he has.”

From this alone, it’s clear that this is a story worth telling, particularly as the NBA’s place in modern society continues to evolve and become associated with activism and Black civil rights. Hodges is a historical antecedent to a modern trend in one of the country’s biggest sports leagues. It is also clear that Hodges is a deeply principled man who will not betray his morals or instincts to tell a story different from the one he envisions.

And that, it seems, is the trouble. Problems arose with Hodges and Wayfarer butting heads over who was best fitted to tell the basketball player’s story. Hodges wanted British-Indian producer Jivi Singh to be the one to tell his story, but Wayfarer’s Justin Baldoni and Jamey Heath disagreed.

Wayfarer allegedly demanded that a Black director be used to cover “blind spots” that Singh would have related to telling a story about Black Americans. Hodges and Singh disagreed, and the project stalled and is now in limbo.

There is a valuable discussion to be had here about representation in Hollywood and who should tell certain stories. It is my hope that this dispute will elevate this conversation and cause some reflection on both sides.

At the same time, though, it is sadly ironic that Wayfarer –- and Justin Baldoni –- find themselves mired in this dispute. Baldoni, an actor-director most famous for Jane the Virgin and his recent fight with Blake Lively –- founded Wayfarer in 2019 to “disrupt for good” and “champion inspirational stories which unite as true agents for social change.” Baldoni himself has written a book surveying traditional masculinity that includes a chapter on white privilege and allyship. He has also frequently painted himself as an anti-racist, particularly in 2020 and on social media.

However, it has become apparent that much of this is mere lip service and rhetoric intended to sound good—it is all bark, no bite.

By insisting that a Black director tell a story that a Black man wrote, lived, and experienced—against the subject’s wishes—Wayfarer and Baldoni have used empty talking points to effectively silence a remarkably timely story about political activism in the NBA. It’s yet another example of how empty politics hold back Black storytelling—and when that happens, we all suffer.

Dr. Julianne Malveaux is an economist, author, and educator.

by Cedric 'BIG CED' Thornton

November 13, 2024

Here Are Some Entry-Level New York City Jobs That Pay $75K And Over

Looking for work in NYC?

There are new job listings in New York City that show entry-level positions with starting salaries of $75,000 and above, according to WPIX.

The media outlet stated the jobs were listed on the JobsNYC website, and some of the available positions do not require a civil service exam: for example, a Value Engineering Project Manager that was listed by the Office of Management and Budget. Job duties include monitoring capital construction plans and providing technical support to OMB and other City agencies.

A bachelor’s degree is required for this position.

The Office of Management and Budget is looking to hire a network analyst based in Manhattan. The job entails administering and maintaining server hardware and software and operating as the agency’s cybersecurity liaison. The listed salary range is $74,893 and $84,257. Again, a bachelor’s degree from an accredited institution is warranted, although no civil service exam is required.

The New York City Department of Transportation has placed an opening for a security analyst for the IT & Telecom division. The salary range is $78,795 to $113,300. Job requirements include performing application and systems vulnerability scans, and also installing, configuring, and updating security software applications. It is an entry-level cybersecurity role that is based in Manhattan. This position may require a civil service exam.

WPIX previously reported that more than 80% of jobs in city government require applicants to take a civil service exam, according to the Department of Citywide Administrative Services. There are typically more than 110,000 candidates who take the exam annually. People interested in taking a test can access the Online Application System website to apply. If you choose to do so in person, you can go to one in any of the five boroughs.

The testing centers are located at:

Bronx CTAC: 1932 Arthur Ave., 2nd floor
Brooklyn CTAC: 210 Joralemon St., 4th floor
Manhattan CTAC: 2 Lafayette St., 17th floor
Queens CTAC: 118-35 Queens Blvd., 5th floor
Staten Island CTAC: 135 Canal St., 3rd floor

by BLACK ENTERPRISE Editors

November 13, 2024

Honour Sithole Came To U.S. With $100, Now He’s An Award-Winning Mental Health Expert Helping Thousands

Honour Sithole's remarkable American story began less than 25 years ago.

Meet Honour Sithole, a renowned Black mental health advocate and Licensed Professional Counselor-Supervisor, who immigrated to the United States in 2000 with only $100 in his pocket. Now, he has released a compelling new book entitled Dare to Be, chronicling his remarkable journey as an immigrant from Zimbabwe to becoming one of America’s most influential mental health professionals.

Sithole, founder and CEO of Inside Fitness 360 Professional Counseling and Life Coaching, has had his own practice for more than 10 years and has transformed over 30,000 lives through counseling sessions and established himself as a leading voice in mental health advocacy. His practice was recognized as the Face of Mental Health in 2018 for its innovative approach and exceptional impact, and in 2022, he was a featured guest on the Dear Future Wifey podcast.

Dare to Be weaves together Sithole’s inspiring personal narrative with practical strategies for personal transformation. The book offers readers a comprehensive roadmap for success, focusing on self-discovery, mind-body-spirit harmony, and authentic living.

“My journey from arriving in America with just $100 to building a successful practice and receiving recognition from the Texas State Senate taught me invaluable lessons about perseverance and personal growth,” says Sithole. “Through Dare to Be, I’m sharing these insights to help others overcome their own challenges and achieve their dreams.”

Sithole’s expertise has earned him numerous accolades, including:

• 2023 Professional Excellence Immigrant Award

• Named among the top 100 Black therapists by the Boris Lawrence Henson Foundation (2022)

• Texas State Senate Proclamation for supporting men’s mental health

• 2020 Richard E. Hopkins “Torch” Award

Corporate Impact and Leadership Development

Dare to Be extends beyond personal development to address crucial workplace wellness strategies. Sithole’s corporate training programs have helped organizations create psychologically safe environments, resulting in:

• Enhanced employee satisfaction and retention

• Improved team communication and collaboration

• Reduced workplace stress and burnout

• Development of emotionally intelligent leadership

As a trusted advisor to government entities, professional athletes, and corporations, Sithole brings over 20 years of executive leadership experience to his work in mental health advocacy. His approach to corporate wellness and leadership development has revolutionized how organizations address employee mental health, creating psychologically safe workplaces where teams can thrive.

The book is available on Amazon.

This story was originally reported by Blacknews.com