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MIAMI (AP) —
The Bahamas is bracing for a brush with Hurricane Joaquin, which is on a projected track that would take it near the East Coast of the U.S.
Forecasters with the Bahamas Meteorology Office say the Category 1 storm is expected to pass near small islands in the eastern part of the island chain. Senior Meteorological Officer Geoffrey Greene said Wednesday the storm should be close enough to San Salvador, Cat Island and Eleuthera to bring tropical-storm-force winds and heavy rains.
The storm is expected to bring smaller amounts of rain to the central Bahamas and the capital of Nassau.
Joaquin strengthened to a hurricane Wednesday morning, with maximum sustained winds near 75 mph (120 kph). The U.S. National Hurricane Center says additional strengthening is expected over the next two days.
LOS ANGELES (AP) —
Two 22-year-old men fatally stabbed a University of California, Los Angeles student before setting her apartment on fire, prosecutors said Tuesday.
The two men pleaded not guilty in the death of Andrea Del Vesco, 21, whose body was discovered in the fire in her Westwood apartment last week. Authorities had not previously said whether she died in the fire or was killed first.
Del Vesco, who went by "Andy," was a fourth-year psychology major and sorority member from Austin, Texas, who was going to UCLA.
Prosecutors say Alberto Hinojosa Medina of Fresno burglarized an apartment on Sept. 21, then entered another apartment and fatally stabbed Del Vesco before setting the fire. He's charged with capital murder, arson and burglary. A judge ordered him held without bail. Prosecutors said they would decide later whether to seek the death penalty for him.
Another UCLA student, Eric Marquez, is charged with murder and burglary. He was ordered held on $1.1 million bail and faces a maximum sentence of life in prison.
Deputy District Attorney Victor Avila said in court that Medina was captured on surveillance video "covering up blood on his shirt" with a blanket belonging to Del Vesco, the Los Angeles Times reported. He said Del Vesco's property was later recovered from Medina's home in Fresno.
Prosecutors said Marquez's car, recognizable by the Greek lettering on the back, was the "getaway vehicle."
Marquez's attorney argued that he should be granted bail as a student with no prior record who is accused of aiding and abetting rather than actually carrying out the killing.
"He is someone who has never been in trouble before," Cron said.
Police Chief Charlie Beck said his detectives had not established any relationship between the victim and the suspects.
WASHINGTON (AP) —
Medicare paid $30 million for ambulance rides for which no record exists that patients got medical care at their destination, the place where they were picked up or anywhere else.
The mystery ambulance rides are part of a bigger problem with Medicare payments for transporting patients, according to a federal audit being released Tuesday.
The Department of Health and Human Services' inspector general's office also found that some urban ambulance services got paid for an average distance of more than 100 miles per ride. That contrasts with a national average of just 10 miles for urban ambulance rides.
Four major metro areas seemed to be breeding grounds for ambulance schemes. Philadelphia, Los Angeles, New York and Houston accounted for about half of the questionable rides and payments. Medicare has barred new ambulance companies from joining the program in Houston and Philadelphia, and the report recommends a similar approach in certain other places.
Across the country, 1 in 5 ambulance companies had at least some questionable billings.
"Medicare payments for ambulance transports have increased in recent years, and investigators have uncovered a variety of fraud schemes involving ambulance suppliers," the report said.
The audit involves medical claims dating to the first six months of 2012, but the inspector general's office said it believes the findings reflect continuing weaknesses in Medicare's efforts against fraud. A Medicare spokesman says the agency has taken action since the auditors privately shared their findings last year.
Investigators went to great lengths to try to explain the $30 million in mystery ambulance rides.
The report said they did not count any cases in which the patient died within a day of being transported by ambulance. On the chance that some billers might have incorrectly reported pickup and drop-off locations, auditors checked if the patient might have gotten care related to their ambulance ride at another location. They scrutinized Medicare's inpatient, outpatient, nursing home, hospice, and physician claims databases. To account for tardy bills, they kept watch for a whole year.
In the end, they were stumped. "The transports may not have occurred," the report said. For 46 ambulance companies, there was no record that patients got medical services in more than 9 out of 10 of the rides they billed for.
Medicare has a longstanding problem with ambulance fraud, investigators said. Over the past decade or so the total cost of ambulance rides has risen sharply. Medicare's Part B, which covers outpatient care, paid $5.8 billion for ambulance rides in 2012, almost double the amount paid in 2003.
The audit scrutinized 7.3 million ambulance rides in the first half of 2012. In addition to the mystery transports, investigators found that Medicare paid $24 million for ambulance rides that didn't meet program requirements for payment.
In its formal response, Medicare said it has developed a comprehensive strategy to combat ambulance fraud and abuse.
A spokesman said separately that Medicare is now requiring prior approval for repeat non-emergency ambulance rides in New Jersey, Pennsylvania and South Carolina. Next year that requirement will be extended to Delaware, Maryland, North Carolina, Virginia and West Virginia, plus Washington, D.C.
Medicare is also considering barring new ambulance companies from joining the program in fraud-prone areas.
Fraud costs the health care system tens of billions of dollars a year. Medicare is especially vulnerable because Congress requires the program to pay claims promptly in most cases. That has given rise to the frustrating condition that law enforcement officials call "pay and chase."
The inspector general recommended that Medicare use its existing legal authority to require more documentation from ambulance companies and to give its billing contractors additional options to hold off paying claims that don't seem to meet basic requirements.