text:
Migraine Headaches
Topic Overview
Is this topic for you?
This topic is about migraine headaches. If you are looking for information about tension headaches, see Tension Headaches.
If you are looking for information about headaches in children, see Headaches in Children.
What are migraine headaches?
Migraines are painful, throbbing headaches that last from 4 to 72 hours. When you have a migraine, it may be so painful that you are not able to do your usual activities. But even though migraines make you feel bad, they don't cause long-term damage.
Migraines are a health problem that can be treated. Talk to your doctor about your migraines.
What causes migraines?
Experts are not sure what causes migraines.
Migraines run in families, but it isn't clear why some people get migraines and others don't.
Some things can cause a migraine to start. These are called triggers. Your triggers may be different from someone else's. Some common triggers include:
- Stress.
- Not eating.
- Poor sleep habits.
- A change from your normal routine.
- Red wine.
- Monosodium glutamate (MSG).
- Strong odours.
- Chocolate.
What are the symptoms?
The main symptom of a migraine is a throbbing headache on one side of your head. You also may feel sick to your stomach and vomit. Activity, light, noise, or odours may make the migraine worse. The pain may move from one side of your head to the other, or you may feel it on both sides at the same time. Different people have different symptoms.
Some people have an aura before the migraine begins. When you have an aura, you may first see spots, wavy lines, or flashing lights. Your hands, arms, or face may tingle or feel numb. The aura usually starts about 30 minutes before the headache. But most people don't have auras.
How are migraines diagnosed?
A doctor can usually tell if you have a migraine by asking about your symptoms and examining you. You probably will not need lab tests, but your doctor may order some if he or she thinks your symptoms are caused by another disease.
How are they treated?
You can't cure migraines. But medicines and other treatments may help you feel better and limit how often you get migraines.
At first, your doctor may want you to try an over-the-counter pain medicine, such as acetaminophen, aspirin, ibuprofen, or naproxen. Brand names include Advil, Aleve, Aspirin, and Tylenol. Be safe with medicines. Read and follow all instructions on the label.
If these medicines don't work, your doctor can prescribe stronger medicine to stop the migraine. Your doctor also may prescribe medicine to prevent migraines.
You may not be able to use some medicines if you are pregnant or have other health problems, such as heart problems.
If the first medicine doesn't work, ask your doctor if you can try something else. It may take time to find what works best for you.
Some people also use other kinds of treatments, such as acupuncture. These may help reduce the pain or the number of migraines you have.
When you feel a migraine coming on:
- Stop what you are doing, and take your medicine. Don't wait for the migraine to get worse. Take your medicine exactly as your doctor told you to.
- Rest in a quiet, dark room. Close your eyes, and try to relax or go to sleep. Don't watch TV or read. Put a cold pack or cool cloth on the painful area.
Be careful when you use your migraine medicines. Taking them too often can cause you to get another headache when you stop taking the medicine. This is called a rebound headache. If you are taking headache medicine more than 2 days a week, or if you get more than 3 headaches a month, talk to your doctor.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
- Anxiety: Stop Negative Thoughts
- Depression: Stop Negative Thoughts
- Headaches: Managing a Headache
- Migraines: Finding and Avoiding Triggers
- Stop Negative Thoughts: Getting Started
- Stress Management: Breathing Exercises for Relaxation
- Stress Management: Doing Guided Imagery to Relax
- Stress Management: Doing Meditation
- Stress Management: Doing Progressive Muscle Relaxation
- Stress Management: Managing Your Time
- Stress Management: Practicing Yoga to Relax
Experts aren't sure what causes migraines.
They run in families, and experts have found a genetic link. But it isn't clear why some people get migraines and others don't.
Certain things can bring on a migraine. These are called triggers. Your triggers may be different from someone else's. Having several triggers increases the chance you will get migraines.
Some common triggers include:
- Stress.
- Not eating.
- Poor sleep habits.
- A change from your normal routine.
- Red wine.
- Monosodium glutamate (MSG).
- Strong odours.
- Chocolate.
The most common symptom of a migraine headache is a throbbing pain on one side of your head. You also may have other symptoms before, during, and after a migraine. Different people have different symptoms.
Symptoms before the migraine begins
A day or two before a migraine starts, you may feel:
- Depressed or cranky.
- Very happy, very awake, or full of energy.
- Restless or nervous.
- Very sleepy.
- Thirsty or hungry, or you may crave certain foods. Or you may not feel like eating.
Symptoms of an aura
About 1 out of 5 people has a warning sign of a migraine called an aura. It usually starts about 30 minutes before the headache starts. During an aura, you may:
- See spots, wavy lines, or flashing lights.
- Have numbness or a "pins-and-needles" feeling in your hands, arms, or face.
Symptoms when the headache starts
Symptoms can include:
- Throbbing pain on one side of the head. But you can have pain on both sides.
- Pain behind one of your eyes.
- Moderate to very bad pain. The pain may be so bad that you can't do any of your usual activities.
- Pain that gets worse with routine physical activity.
- Nausea, vomiting, or both.
- Pain that gets worse when you're around light, noise, and sometimes smells.
Less common symptoms include:
- Problems speaking.
- Tingling in your face, arms, and shoulders.
- Short-term weakness on one side of your body.
If you have these less-common symptoms and have not had them before, call your doctor right away so that he or she can make sure you aren't having a transient ischemic attack (TIA), stroke, or other serious problem.
Without treatment, a migraine headache can last from 4 to 72 hours.
Symptoms after the headache
After the headache stops, you may have muscle aches or feel very tired. These symptoms may last up to a day after your migraine ends.
Types of migraines and their symptoms
You may have one or more types of migraine headache. Each type has its own features. For example, some people get migraines with an aura. Some get them without an aura. Some women get menstrual migraines, which happen before, during, or shortly after their menstrual period.
It can be hard to tell the difference between a migraine and another type of headache, such as a tension or sinus headache. You may think that you have sinus headaches. But it's more likely that they are migraine headaches if they happen often and interfere with your daily life.
Migraines can occur along with many other health problems, such as asthma or depression. More serious conditions, such as tumours or infections, can also cause migraine symptoms. But most headaches are not caused by serious health problems.
What Increases Your Risk
You may be more likely to get migraines if you:
- Have a family history of migraines.
- Are female. Women are 3 times more likely than men to get migraines.
- Are a teenager or young adult. Migraines often begin during these years.
- Have depression, anxiety, asthma, or epilepsy.
When to Call a Doctor
Call 9-1-1 or other emergency services if:
- You have a sudden, severe headache that is different from past headaches.
- You have symptoms of a stroke, such as:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
Call your doctor now or go to the emergency room if:
- You have a fever and a stiff neck.
- You have new nausea and vomiting, or you cannot keep food or liquids down.
Watch closely for changes in your health, and be sure to contact your doctor if:
- Your headache does not get better within 24 hours.
- Your headache wakes you up at night.
- Your headaches get worse or happen more often.
- You develop new symptoms.
- You have any problems with your medicine, or your medicine isn't helping your headaches.
- You have new, different, or more frequent headaches.
- Your headaches occur after physical exercise, sexual activity, coughing, or sneezing.
- Your life is disrupted by your headaches (for example, you often miss work or school).
Watchful waiting
Watchful waiting is a wait-and-see approach. Trying it may be fine if you have recently been diagnosed with migraines and over-the-counter medicines are controlling your pain.
Examinations and Tests
Your doctor will diagnose a migraine by examining you and asking questions about your health and lifestyle. There are no tests that can prove that you have migraines.
Migraines can be hard to diagnose, because their symptoms are like those of other types of headaches. For example, many people have been diagnosed with sinus headaches when they actually have migraines.
It's likely that you are having migraine headaches if they happen often and interfere with your daily life.
Symptoms used in diagnosis
Your doctor may use the International Headache Society's guidelines to diagnose migraines. You may be diagnosed if ALL of these are true:footnote 1
- You have 5 or more headaches without an aura (or 2 headaches with an aura).
- The headaches last from 4 to 72 hours without treatment.
- You have nausea, you vomit, or your headache gets worse when you're around light or noise.
Tests you might have
Your doctor will check your symptoms and decide if you need to have tests to find out if your headaches are caused by another health problem. Tests may include:
MRI or CT scan. These imaging tests may be used to look for tumours or bleeding in the brain. But most headaches aren't caused by anything serious, so you probably won't need to have imaging tests.
- Headaches: Should I Have Imaging Tests to Find Out What's Causing My Headaches?
- Lumbar puncture (also called a spinal tap). This may be done if your doctor thinks that you might have a problem such as meningitis or bleeding in the brain.
- Sedimentation rate (a blood test). This test can find out if another health problem is causing inflammation related to your headaches.
Treatment Overview
You can't cure migraines, but you can use medicines and other treatments to feel better.
The goal of treatment is to reduce how often you get migraines and to stop the headaches with the fewest drug side effects. Your doctor may have you try several types of medicines and may adjust the doses to manage your migraines.
Find and avoid migraine triggers
You can reduce how many migraines you have by finding your migraine triggers and avoiding them. For more information on triggers, see Prevention.
Keeping a headache diary is a good way to find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you did before the headache started. You look for patterns to your headaches. This information can help you know what to avoid to prevent a migraine.
Take medicines
You may take:
- Medicines to stop a migraine. These are sometimes called abortive medicines. These may be over-the-counter or prescription medicines. If you take the medicine at the first sign that you're about to get a migraine, you may keep the headache from starting or from getting bad.
- Medicines to prevent migraines. These drugs are often called preventive medicines. You get them with a prescription. You take these every day or whenever your doctor tells you to.
For mild to moderate migraines, you may first want to try over-the-counter pain relievers that have fewer side effects and cost less than other medicines. But if they don't help, you may need prescription medicines. Be safe with medicines. Read and follow all instructions on the label.
If medicines to stop a migraine don't give you enough relief, or if you're taking them more than 2 times a week, talk to your doctor about whether you should take medicines to prevent a migraine.
Try other treatments
You may want to try complementary treatments along with medicines. These may include:
- Acupuncture.
- Biofeedback.
- Herbs such as feverfew.
For more information, see Other Treatment.
If you decide to try one or more of these treatments, make sure your doctor knows. He or she may have advice on how to use other treatments safely.
Reduce stress
How you think can affect how you feel. So finding ways to relax and change your negative or worrisome thoughts may help prevent headaches.
You may want to try:
- Positive thinking techniques.
- Progressive muscle relaxation.
- Ways to manage your time.
- Breathing exercises.
- Guided imagery.
- Meditation.
- Yoga.
For more information, see Living With Migraine Headaches.
Treatment if your headaches get worse
If treatment doesn't stop your migraines, you and your doctor may make changes. You may try different medicines, a new mix of medicines, or different doses.
If you have already tried several types of medicine, your doctor may want you to have tests (such as an MRI or CT scan) to look for any other cause for your headaches.
It is possible to be diagnosed with migraines when you really have another type of headache. (But it's more common for a person to be diagnosed with another type of headache when he or she really has migraines.)
It can be hard to tell the difference between migraines and other types of headaches such as sinus, tension, or cluster headaches. The symptoms can be the same. And you may have more than one kind of headache. Different types of headaches need different treatment.
Other things to think about
- Even with treatment, you may still get migraines.
- It may take some time to find the right medicines to help you.
- Using medicines too often can cause rebound headaches. These are different from migraine headaches. They occur after pain medicine has worn off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine. Be sure to take your medicine only as your doctor prescribes.
- If you think your headaches could be caused by depression or anxiety, be sure to let your doctor know. Treatment for these health problems may get rid of your headaches or reduce how often you have them.
- If you think your headaches are related to stress, talk to your doctor about getting help to cope better with stress.
You may be able to have fewer migraines by finding out what brings on (or triggers) your headaches and then avoiding those triggers.
Migraine triggers include certain foods and stress. Some common triggers are:
- Stress.
- Not eating.
- Poor sleep habits.
- A change from your normal routine.
- Heat, high humidity, or changes in the weather.
- Red wine.
- Monosodium glutamate (MSG).
- Strong odours.
- Chocolate.
Keeping a headache diary can help you find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you did before the headache started. This information can help you find and avoid your triggers.
Having a daily routine is one of the best ways to avoid migraines. For example, try to eat at the same times every day, and go to sleep at a regular time. Changes from your routine, such as skipping meals or staying up really late, could lead to a migraine.
Triggers add up, so the fewer triggers you have at one time, the better your chance of preventing a migraine. That doesn't mean that you can't go outside if hot weather often triggers your migraines. But on a hot day, you might avoid red wine or chocolate if those also are triggers for your headaches.
Your doctor may also prescribe drugs to help prevent migraine headaches.
Living With Migraine Headaches
You may have fewer migraines—and less pain when you do get them—by trying to:
- Find and avoid triggers for your headaches.
- Keep a headache diary to find out what triggers your migraines.
- Take medicine as your doctor advises to prevent and stop migraines.
- Take your medicine right away when you think that you are getting a migraine.
- Reduce stress with relaxation and positive-thinking methods.
- Get help from your doctor and a counsellor if you think that your migraines may be linked to depression or anxiety. Treating these health problems may reduce how often you get migraines.
Find and avoid migraine triggers
You can reduce how many migraines you have by finding out what triggers your migraines and avoiding those things. Triggers may include food, alcohol, hot weather, and changes to your routine.
Keep a headache diary
Keep a headache diary to find your triggers. You write down when you have a headache and how bad it is, along with details such as what you ate and what you did before the headache started. This information can help you find and avoid the things that bring on your headaches.
The information you put in your headache diary can also help your doctor find the best treatment for you. Finding the right treatment can help you have fewer headaches. And the headaches you do get may not be as bad.
Take your medicines as directed
One Woman's Story:
Carole, 41
"I always used to wait too long to take my medicine. Now I take it as soon as I start to feel the twinges of pain."— Carole
Read more about how Carole changed the way she treated her migraines.
The best way to stop a migraine is to take your medicine at the first sign of a headache. You might think you can stop the migraine by lying down and being quiet or doing relaxation exercises. But if a migraine has started, it's probably too late for those other methods to work by themselves.
- Keep your medicine with you at all times so that you're ready when a headache starts.
- Don't take the medicine too often. Talk to your doctor if you're taking your medicine more than 2 days a week, or if you get more than 3 headaches a month. Too much medicine—over-the-counter or prescription—can lead to more headaches. These are called rebound headaches.
You may be able to have fewer headaches by taking prescription medicine to prevent migraines. But taking this medicine doesn't mean that you'll never get a migraine.
Reduce stress
Migraine headaches are more common during stressful times or right after a stressful time ends.
You can lower your stress with positive thinking and relaxation methods. Research shows that you can change how you think. And how you think affects how you feel. Try these techniques on your own or with help from a therapist or counsellor trained in muscle relaxation, meditation, biofeedback, or cognitive-behavioural therapy.
- Doing Progressive Muscle Relaxation
- Managing Your Time
- Reducing Stress by Being Assertive
- Breathing Exercises for Relaxation
- Doing Guided Imagery to Relax
- Doing Meditation
- Practicing Yoga to Relax
You also can learn to stop thinking all the time about things that bother you.
Get help from your doctor or counsellor
A doctor or counsellor, or both, can help you if a problem like depression or anxiety makes your migraines worse. Treating these health problems may reduce how many migraines you get.
Two kinds of medicines are used to treat migraines:
- Medicines to stop a migraine. These are sometimes called abortive medicines. These may be over-the-counter or prescription medicines. If you take the medicine at the first sign you're getting a migraine, you may stop the headache before it starts.
- Medicines to prevent migraines. These drugs are often called preventive medicines. You get them with a prescription. You take these every day or whenever your doctor tells you to.
Finding the right mix of medicines for you may take some time. So work closely with your doctor to try different medicines and doses.
In most cases, your doctor will first prescribe a drug that causes the fewest side effects. Drugs may be prescribed based on your type of migraine.
Medicine choices
Medicines can help you feel better. But they can also be dangerous, especially if you don't take them the right way. Be safe with medicines. Read and follow all instructions on the label.
Medicines to stop a migraine
If your migraines are mild to moderate, you may need only an over-the-counter drug to stop the pain. Most doctors recommend that you try these drugs first, because they may have fewer side effects than prescription drugs. If over-the-counter drugs don't stop your headaches, your doctor may prescribe other medicine.
Your doctor may suggest that you take a mix of medicines to stop a headache. For example, you may take acetaminophen or naproxen along with a prescription medicine, such as a triptan.
Drugs used to stop a migraine include:
- Over-the-counter medicines like acetaminophen (Tylenol, for example) and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Brand names for NSAIDs include Advil, Aleve, and Aspirin.
- Triptans (serotonin receptor agonists), such as sumatriptan (Imitrex) and zolmitriptan (Zomig).
- Ergotamine derivatives, such as Cafergot.
Medicines to prevent a migraine
Drugs used to prevent migraines include:
- Anticonvulsants, such as topiramate.
- Antidepressants, such as amitriptyline.
- Antihistamine, such as cyproheptadine.
- Beta-blockers, such as propranolol.
- Botulinum toxin , such as Botox.
- Calcium channel blockers, such as verapamil.
You may want to try medicine to prevent a headache if:
- You are using medicines to stop headaches more than twice a week.
- Medicines to stop migraines aren't working well for you.
- You have two or more headaches a month that keep you from doing your daily activities.
- You have uncommon migraine symptoms, such as a long period with aura or numbness during your headache.
Rebound headaches
Taking medicine too often to stop a migraine can cause more headaches. These rebound headaches are different from migraine headaches. They usually start after pain medicine wears off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the drug.
Talk to your doctor if you are taking headache medicine more than 2 days a week. Take your medicine as prescribed by your doctor.
Other things to think about
Depression and migraines. Many people who have migraines also have depression. Taking prescription medicine for both problems is common.
- Make sure all your doctors know about all the medicines that you take. In very rare cases, a serious condition called serotonin syndrome may happen when a person takes a triptan for migraines and an SSRI (selective serotonin reuptake inhibitor) or SNRI (selective serotonin/norepinephrine reuptake inhibitor) for depression. But most people have no problems when they take these medicines together. Talk to your doctor if you are concerned about this problem.
- Antinausea medicine. If you have nausea or vomiting during migraine attacks, your doctor also may prescribe medicine to help with these symptoms.
Other Treatment
Some people find that complementary treatments reduce how many migraines they have or how bad the migraines are.
If you are thinking about trying a complementary treatment, get the facts first. Discuss these questions with your doctor:
- Is it safe? Talk with your doctor about the safety and potential side effects of the treatment. This is especially important if you are taking medicines for migraines or another health condition. Some complementary treatments in combination with medicines can be quite dangerous.
- Does it work? You may find it hard to judge whether a particular treatment is really working. Keep in mind that if you get better after using a certain treatment, the treatment isn't always the reason for the improvement.
- How much does it cost? An expensive, unproven treatment that may or may not help you may not be worth its cost. Beware of therapy providers or products that require a large payment at the beginning of a series of treatments.
- Will it improve my general health? Even if they aren't effective in treating migraines, some complementary practices (such as acupuncture, massage, or yoga) may lead to healthy habits that improve your overall well-being. These might be worth trying.
Talk to your doctor if you decide to try:
- Acupuncture. This involves putting very thin needles into the skin at certain points on the body. Research shows that acupuncture can help prevent some headaches.footnote 2
- Biofeedback. This is a way to control a body function—such as muscle tension—that you don't normally control.
- Feverfew. This is an herb that—some small studies show—may help prevent migraines in some people.footnote 3
- Magnesium. Studies have found that some people with migraines have low levels of magnesium in the brain. Taking magnesium may help prevent migraines.footnote 3
- Menthol. There is some evidence that a menthol solution rubbed on the forehead can stop or reduce migraine headache pain.footnote 4
- Riboflavin (vitamin B2). This vitamin may help prevent migraines.footnote 3
- Coenzyme Q10. In a small study, this supplement worked to reduce the number of migraines for some people.footnote 3
For people who haven't been able to reduce the number of or control their headaches with medicine, stimulation of certain nerves in the head with mild electric current may help prevent migraines. For this treatment, electrodes are placed on your forehead for 20 minutes every day. If you have severe and frequent migraines and have not been able to control them with medicine, you may want to ask your doctor if this kind of treatment is available in your area.
Related Information
- Headache Classification Committee of the International Headache Society (2013). The international classification of headache disorders, 3rd ed. (beta version). Cephalalgia, 33(9): 629–808. DOI: 10.1177/0333102413485658. Accessed February 1, 2016.
- Linde K, et al. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews, (3). DOI: 10.1002/14651858.CD001218.pub3. Accessed July 22, 2016.
- Holland S, et al. (2012). Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78(17): 1346–1353.
- Haghighi AB, et al. (2010). Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura: A randomised, double-blind, placebo-controlled, crossed-over study. International Journal of Clinical Practice, 64(4): 451–456.
Current as of: December 13, 2021
Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Kathleen Romito MD - Family Medicine
Colin Chalk MD, CM, FRCPC - Neurology
Current as of: December 13, 2021
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Kathleen Romito MD - Family Medicine & Colin Chalk MD, CM, FRCPC - Neurology
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
HealthLinkBC Files
HealthLinkBC Files are easy-to-understand fact sheets on a range of public health and safety topics including disease prevention and immunizations.
Browse Disease Prevention HealthLinkBC Files
Find Services and Resources
If you are looking for health services in your community, you can use the HealthLinkBC Directory to find hospitals, clinics, and other resources.


text:
University of Detroit Mercy Textbooks > Bound Together
Bound Together 1th edition
Publisher:Yale University Press
Renting Options
Own it? Sell it back
REVIEW: 'The Monkey King' is a wild adventure
New course evaluation system debuts at Detroit Mercy
New name for Detroit Mercy's College of Liberal Arts and Education
Tutoring program offers students way to help with Detroit literacy
Titan Innovation Fund seeks campus proposals
Detroit Mercy School of Dentistry discovery has major impact
Publisher:Yale University Press
Own it? Sell it back
Employers can list job opportunities for studentsPost a Job
Housing Providers can list available housingPost Housing
Post your own housing listing on Uloop and have students reach out to you!

subset: commoncrawl


text:
Wife-Carrying World Championships competes for weirdest summer game
Part of the three-day Sonkajarvi Festival in Helsinki, Finland, this whimsical annual event resembles a 250-yard steeplechase, in which the "wife" rides upside down on the runner's back with her legs slung over his shoulders for maximum speed. Women must be at least 17 years old and weigh at least 108 pounds. Not hitched? Don't worry you don't need to be actually married to compete.


text:
set status_overwrite [<text>]
This variable sets the string displayed in the status bar when the client is in overwrite mode in the input line. If the client is not in overwrite mode (i.e. is in insert mode), nothing is displayed.
This string is represented as %O in the STATUS_FORMAT string. The expando is treated literally inside STATUS_OVERWRITE.
Customizing the string indicating the client is in overwrite mode:
/set status_overwrite (Overwrite)


text:
Music descriptionFOUR versions included!
A sentimental, mellow, warm glow surrounds this track featuring acoustic guitar and piano. This relaxing track is great for photo slideshows, family movies, wedding videos, commercials, or any project needing a relaxed and organic vibe.
For added flexibility, four versions are now included: a full version, one without piano, a 60-second version, and 3:26 extended version to accommodate the high demand for using this music as a soundtrack for photo slideshows.
To hear the no-piano version, please start the preview at 2:19. To hear the :60 version, please start the preview at 4:39. To listen to the extended version, please start the preview at 5:40.
Files included in the zip:
Warm Summer (2:19), WAV and mp3
Warm Summer – no piano (2:19), WAV and mp3
Warm Summer 60 (1:00), WAV and mp3
Warm Summer – extended version (3:26), WAV and mp3
Get more for your $$.
This track is included in the music pack: Beautiful Piano Music Pack 1


text:
Questions answered in this episode:
"If we did travel at 99.9% the speed if light what would it look like? And I read that we could create something like a warp drive to travel without breaking the laws of physics. Is this true? - Tyler Claudio
"... if you traveled over the speed of light you would go back in time? [If an] object or machine could go faster then the speed of light would it appear in the past?" - Cam Nelson
"Is there a timeless zone in the universe?" - Santy Arcusa
Submit your questions for the next round of Ask the Experts by clicking here and posting in the YouTube comments (Google account required). And while you're there be sure to subscribe to our Spacelab channel for weekly videos on space and astronomy.
The question with the most "likes" will be answered in the next video by a new guest expert. Previous episodes have featured astronomer Caleb Scharf, astrophysicist Neil deGrasse Tyson and Scientific American's own editor in chief, Mariette DiChristina.


text:
Special Price Responsive Premium WordPress themeThank you for choosing CosmoThemes and purchasing one of our Premium WordPress Themes – your choice is greatly appreciated!
Verticality is a responsive onepage creative photography theme aimed to power complex portfolio and image-related sites or blogs available for a very special price.
Verticality uses a framework that permits the site to be accessed on all mobile devices, including iPad and Android powered tablets.
Multiple slide-showsYou can create an unlimited number of slideshows containing any amount of items and assign them for your mainpage.
Slideshows can be composed from different resource types:
- Uploaded images or extracted featured images from posts
- Automated slideshows created from Latest or Featured posts and portfolios.
Drag and drop mainpage builderSet your blog mainpage to display any content type you wish: slideshows, posts from categories, tags, portfolios, latest or featured post, even individual posts or pages.
Multiple post formatsWith Post Formats, the new approach allows Verticality to define a Post Format and then the post format can be selected in the Publish meta box when saving the post.
- standard – text post
- gallery – a gallery of images
- image – a single image
- video – a single video
- audio – multiple audio file
Built-in "Like" systemEnable the "Like" feature to let users easily access faved posts and raise their rating. When a certain post reaches the limit of 50 likes it will become featured.
The like limit can be changed from backend while the number of likes for all posts can be randomly generated.
Facebook and default commentsYou can either enable the default comment system or opt for the Facebook comments.
Add your Facebook application ID so you can moderate comments.
Tooltip helpersEver wondered how to tell your users of a specific feature or important message on your site? You can now achieve this with theme's built-in tooltip manager. You can use it on every single page on your site being able to add an infinite number of such hints.
Sidebars and widgetsThe site uses unlimited sidebars for you to be able to insert as many widgets as you need to get the most of your theme: Categories with icons, Content tabber (hot posts, new, comments, tags), Flickr, Twitter, Latest posts, Social media, Top authors, Submit content.
Select a different layout for each of your posts: containing a left sidebar, a right sidebar or displayed full-width.
Social media readyAll posts have built-in social-media share buttons that users can click and promote any content of your web-site. Enable or Disable them for any particular post or page.
Powerful backendVerticality comes with a revised powerful back-end to let you control all sites option without the need to hack or customize your own features.
Translatable theme. Internationalization readyThe theme comes with a .PO file that allows you to translate the theme into your language. Follow the instructions from documentation.
Support:If you happen to face some difficulties with this theme, consider to use our support which is conducted through the CosmoThemes support ticketing system: http://cosmothemes.com/forums
Support for all the themes will be available only via tickets.
version 09 (Sept 14th, 2015)
-FIX: Fixed wp_widget with __construct
version 0.8 (June 26th, 2015)
– UPDATE: mobile menu background updated
– UPDATE: deleted Cosmo API deprecated function
– FIX: PrettyPhoto security update – UPDATE: deleted deprecated News function
– FIX: Twitter widget: multiple instances fatal error
– FIX: Tabs functionality updated
version 0.7 (February 14, 2015)
- Fixed shortcodes due to WP 4.0 update;
- Fixed color for external links;
- Fixed multiple slider next/previous buttons;
- Fixed multiple slider next/previous buttons;
- Added Instagram option for social networking;
version 0.6 (February 18, 2014)
– added style to logo on mobile devices;
– added logo on mobile devices;
– fixed mobile responsiveness issues;
– update to a new version of PHP;
– fixed some typos;
version 0.5 (August 21, 2013)
- Fixed scroll bar on simple post when colapse menu;
- fixed opening external resources in same window, for Chrome;
- WordPress 3.6 compatibility fixes;
- fixed password protected visibility for single posts;
version 0.4 (July 6, 2013)
- changed background size for menu items from 100% to cover
- fixed tabs shortcode for IE
- fixed featured image bug for video posts
- hide default post formats in wp 3.6
- fixed some jQuery Migrate deprecated functions
- updated twitter widget to be compatible with API 1.1
version 0.3 (January 4, 2013)
- Added option to show full story for list view
- updated jqueryScrollTo to be compatible with the latest jquery version
- added option to show collapsed menu from the start
- fixed translation for "click to collapse" label
- added min height for pages to fit viewport height, fixed single top control bar margins
- fixed single top control bar margins
- added option to open posts via ajax, reload page or open jut post's image.
- fixed gallery image width
- chrome frame compatibility update with IE 10
version 0.2 (December 29, 2012)
- added testimonials-quotes.png
- fixed background for widgets
- added metas.sprite.png
- fixed flickr photos -> 3 columns
- fixed testimonials widget bug
- added social-media.png
- fixed an error
- fixed tabber title padding
- fixed post meta
- fixed bug that appeared on archive pages


text: All our cases are made to order so theyre fresh off the press. We dont use stickers on our cases. All cases have been personally designed in our office to assure a sharp image. Our high resolution images are then printed using the latest printing technology and materials, leaving you with a high quality finish that wont fade, peel or scratch off. Makes for a great gift or just a stylish way to protect your phone. THERMOPLASTIC POLYURETHANE ( TPU ) CASE Light, Sleek and Durable. Our Soft Rubber Cases cover all sides of your phone and have a raised front lip for additional protection for your screen. Case has a snug fit and a great grip. Perfect for those looking for additional protection with minimal bulk. Ultra slim and thin profile Heat resisting, high flexibility, no deformation Clear image printed on aluminium metal insert with high-grade sublimation ink Finished with protective glossy coating for image clarity and durability Protect your phone from wear and tear Easy access to all buttons, functions, and ports Each item from your order may ship individually. Need more info please email or massage for any other questions. For the best experience, make sure you choose correct model for your phone and verify your address before placing orders. We always update our devices, so if your device is not available please Contact Us Happy Shopping and Thank You.


text: These FOX 2.0 Adventure Series shocks have been built specifically for Zone Offroad and valved to compliment your Zone lift kit. Utilizing FOX';s proven damping technology to provide a comfortable on-road ride and predictable off-road handling in a variety of conditions, they use a 2"; OD steel body construction with a large 5/8" heat treated hard chrome plated shaft for increased strength and durability. The monotube design uses an internal floating piston (IFP) to separate the shock oil from the high-pressure, nitrogen charged gas chamber. This eliminates oil aeration for fade-free performance from the vehicle specific valved shocks for in rough terrain. Get more out of your truck or Jeep with Zone Offroad and the FOX Adventure Series 2.0 shocks.


text:
I met Steven Kraus in Ohio at a political event held in March of this year where I purchased his book at that time. I decided to read the book as I flew back and forth from a wedding I attended that same month. Having completed the book on the way back from my trip, the following is my review of his book.
Some Background
Steven Kraus, born July 28, 1959, is a U.S. military veteran, a self-professed Christian and one who also served overseas with the military while working in the employment of a sub-contractor.
As stated on the back of his book, this is a "true story of one man's fight against greed, corruption, and insatiable ambition in small-town Ohio, Checkmate reveals why passion and integrity are rare in the corridors of swing-state politics."
Title: Checkmate: One Man's Fight against Political Corruption
Author: Steven W. Kraus
Published: February, 2018
Checkmate: One Man's Fight against Political Corruption is a detailed account of Steven Kraus life between November 2014 and February 2018 as it pertains to his political life that lead to his felony conviction in July of 2015, and the ongoing court battles to clear his name and integrity up to the writing of his book published in February 2018.
The book explains in a systematic manor from beginning to end, the account of how Mr. Kraus was framed, for political reasons, and placed on trial. However, in the end, Mr. Kraus believes God's hand is leading to the truth on this matter, as recorded through the Ohio courts and public records for all to see. These records show first hand, when placed in context, the corruption in Ohio's legal and political system, from the local prosecutor, through the court system of Ohio, to both sides of the political system.
This 276-page book took me about five hours to read as I followed the story line that unfolded over a period of about three years. Within the facts presented, they are not hard to believe in today's political environment. As names, dates, court documents and public records become known, an intriguing detailed story is revealed connecting all the dots from their beginning to their ending. As the story unfolds, the reader learns how corruption stems from a local prosecutor, while supported throughout the political and legal system in the State.
If you are interested in how politics becomes corrupted, and how it can filter through a legal system that can effect your life, let me encourage you to pickup this book. This is not something that can just happens in Ohio, but something that could happen anywhere in America as well.
This book provides one man's account to how the State of Ohio through a series of events unwittingly displayed through the public record its political and legal corruption for all to see as God's hand moved behind the scenes, just as it did through the life of a Jewish woman named Esther. This recorded for us in the Old Testament of the Holy Scriptures. Thus, the title of Mr. Kraus book—CHECKMATE.


text:
Carnival Valor deck 11 plan (Spa-Cabins-Sports)
Deck layout and review
Review of Carnival Valor deck 11 (Spa-Cabins-Sports)
The fore-located Spa Carnival and Fitness Center (open between 6 am – 10 pm) is the ship's wellness complex consisting of Gymnasium (complimentary, access via the lockers, floor-ceiling windows, equipped with free weights /TROY dumbbells, weight machines, treadmills, steppers, ellipticals, recumbent exercise cycles, Concept 2/indoor rowing machines, Kinesis wall), Fitness Studio (for classes /part of the gym, glass-enclosed), Spa Whirlpool (in the gym, glass-enclosed / glass-roof covered section), Beauty Salon (facials, manicure/pedicure, hair styling-cutting-coloring, eyebrow shaping, makeup, waxing, grooming-barbering, teeth whitening, Medi-Spa), Treatment Rooms (incl for acupuncture, couples massage, hot stone, Botox, body wraps /dry float bed), Spa Reception, separate male/female lockers (2 changing rooms, each with complimentary sauna/steam room/showers). The lockers' showers are glass-enclosed and multi-jet. Showerheads are massaging (1 rain head above, 4 side). During massages and wraps, guests should wear bathing suits. The ship has no Thermal Suites (Tepidarium with heated loungers). ZSPA (teen spa treatments for teenagers 12-17 yo) include facials, massages, scrubs, manicures/pedicures, hair styling-coloring-cutting. Daily, at the Eagles Lounge (aft on Promenade Deck) are scheduled complimentary health seminars (fitness-wellness-beauty) themed on aging, posture, detox, dieting, weight-loss, skincare, pro-collagen, acne attack /teens).
Some of the fitness classes are complimentary (aerobics, stretching, abs, body conditioning, Tai Chi) and some are at fee pp (Yoga, Pilates, spinning, boot camp, indoor cycling, personal training sessions). Follows the list of offered on Carnival cruises fitness classes (lead by professional trainers). In brackets are shown duration in minutes and cost (prices in USD pp) – Personal Training (30 min $45, 60 min $85, 180 min /3 courses $210), Nutritional Consultation (60 min $85), Metabolism Test (30 min $35), Boot Camp (4-day body sculpturing $120). Priced at $12 pp are Tour de Cycle (indoor cycling, 45 min), Pathway to Yoga (45 min) and Pathway to Pilates (45 min).
Carnival Spa menu of treatments (facials and massages using Elemis products) includes (duration in minutes, prices in USD pp) – Acupressure (50 min $150), Oxydermy Facial (50 min $150), Aroma Stone Therapy (75 min $175), Thai Herbal Poultice Massage (rhythmic, acupressure movements, 75 min $175), Bamboo Massage (50 min $145, 75 min $180), Absolute Spa Ritual (100 min $240), Reflexology (50 min $105), Couples Massage (full body Swedish or Elemis, 50 min $240), Deep Tissue Muscle Massage (50 min $115), Swedish Massage (50 min $110), Ionithermie Cellulite Reduction (50 min $145, 3 course $360), Ionithermie Cheek Lift (50 min $145), Exotic Lime and Ginger Salt Glow (half body 50 min $140, full body 75 min $180), Aroma Spa Seaweed Massage (heated mask, half body 75 min $175, full body 100 min $235), Fire and Ice (45 min, manicure $50, pedicure $70), Traditional (manicure 25 min $30, pedicure 45 min $45), Tooth Whitening (free consultation, 30 min /$150 pp, $260 couple), Waxing (prices range from $15 lip-chin, to $90 full leg), hairdresser services (prices range from $30 to $95), Pro-Collagen Grooming Treatment with Shave (facial, massage, double close shave /55 min $85), Express Shave (30 min $40), Skin IQ for Men Facial (50 min / $105), Urban Cleanse for Men Facial (50 min / $115).
Carnival Spa menu of Medi-Spa treatments includes – Acupuncture (by certified acupuncturist, first session 50 min $150, additional sessions up to 45 min $125, first facial session 75 min, additional facial sessions up to 60 min), Medi-Spa Cosmetic Treatments (free doctor consultation), Dermal Filler Treatments (Restylane, Perlane /30 min), BOTOX Cosmetic, DYSPORT Wrinkle Treatments (both are upper face, nonsurgical and FDA approved /30 min). All Medi-Spa treatments are administered on the ship by a dedicated physician (licensed medical doctor).
Carnival Spa menu of ZSPA treatments (for teenagers 12-17 yo). In brackets are shown duration (in minutes) and cost (prices in USD pp). The menu includes – Fabulously Fruity Facial (50 min $100), Acne Attack Facial (50 min $100), Heavenly Massage (aromatherapy oils, Swedish massage, 50 min $90), Paradise Massage (mother and daughter, 25 min $100, 50 min $195), Chill Out Massage (father and son, 25 min $100, 50 min $195), Surfers Scrub (25 min $65), Fitness Frenzy (3 boot camp classes, $55), Magical Manicure (25 min $30), Sole Mate (45 min $40). The list of Beauty Salon services for teens includes – boys (cut only 30 min $25), boys and girls (cut and color 120 min $120), girls (cut only 60 min $60), style only (30 min $45). ZSPA services are available between 8 am – 8 pm. Upon booking treatments, teens must be accompanied by an adult (parent/guardian) who completes and signs the ZSPA form.
The aft-located Sports Deck has a multi-sports court (full-size court for basketball, volleyball, football), Tennis Tables, Shuffleboard, Power Walking/Jogging Track (2-lane / 11 laps = 1 mi), SkyLight (glass-roof cover over the aft pool on deck 9).
Spa Deck cabins from 1101 to 1122, all of which are forward-located Balcony staterooms in category 8F.


text:
Houston Riverside General Hospital specialized in the kind of medicine its better-heeled brethren did their best to avoid. Like treating the poor, the mentally ill, the drug-addled.
So it's no surprise that the 95-year-old nonprofit — formerly known as Houston Negro Hospital — shared the same broken finances as the people it served. Most patients couldn't pay their own way, leaving Riverside to survive off the rock-bottom reimbursement rates of Medicare and Medicaid.
At one point, it was losing $10,000 a day. That's when executives decided to cauterize the wound with a hot poker of fraud.
In 1996 the State of Texas accused Riverside of padding fees and billing for drug rehabilitation services it never provided. Texas canceled $1 million in contracts and demanded that the hospital repay another $763,000. It also urged the feds to audit Riverside's Medicare and Medicaid payments.
Yet charges of fraud weren't enough for bureaucrats to fully close the spigot. The money continued to flow.
It would take another eight years before the state finally had enough. In 2004 it moved most of its drug-treatment contracts to more trusted providers, slashing Riverside's funding by 75 percent.
Unfortunately for the taxpayers, CEO Earnest Gibson III had friends in influential places.
Congresswoman Sheila Jackson Lee, a Democrat from Texas, demanded an investigation of the cuts, calling on Governor Rick Perry to restore the money. Perry, who had appointed Gibson to the Board of Regents at Texas Southern University, was happy to oblige.
By the time it was over, Riverside emerged with another $3 million.
It wasn't until 2011 — fifteen years after the initial accusations — that law enforcement got serious. That's when the feds nailed administrator Mohammad Khan, who confessed to enriching the hospital through a kickback scheme.
He had been paying "recruiters" $300 a head to bring Medicare patients to Riverside's six psychiatric clinics. They arrived by the van-load for daily therapy sessions they rarely qualified for or received. Medicare picked up the $116 million tab.
When the scheme was discovered, the Centers for Medicaid & Medicare Services (CMS) finally halted the hospital's payments.
But in the eyes of Jackson Lee, a meager $116 million theft was hardly cause to rush to judgment. Her husband, Elwyn Lee, once served on Riverside's board. So the good congresswoman again rode to the hospital's rescue.
"Even if more harmful acts prove to be true," she wrote to CMS, "an entire institution should not be penalized by the acts of one person."
In Riverside's case, that "one person" would abruptly multiply. Kahn ratted out CEO Earnest Gibson III as his co-conspirator. The feds also nabbed Gibson's 35-year-old son, Earnest IV. He ran one of the psychiatric clinics and was charged with billing nearly $700,000 for care that "was not medically necessary and, in some cases, not provided," according to prosecutors.
Investigators discovered that, since 2005, the hospital had been swindling the feds to the tune of $22 million a year. Kahn pleaded guilty. The two Gibsons and five others await trial on charges of fraud, conspiracy and money laundering.
By this time, Jackson Lee had no choice but to dial down her patron sainthood. She refused to comment for this story.
Yet, another member of Congress is happy to talk. Kevin Brady, a Texas Republican, has been trying to draw attention to health-care fraud in Houston since entering office in 2009. It seems that CMS, the agency charged with protecting Medicare dollars, failed to notice that the city's private ambulance services were robbing it blind.
That year companies in Harris County, Texas, billed Medicare $62 million for emergency shuttles. By comparison New York City received $7 million for the same services. Brady's concerns went ignored until 2011, when a Houston Chronicle series dragged the scam into the light.
Think of the Medicare program as a bank that never bothered to buy a safe. Everyone from HMOs to drug dealers have been caught robbing it time and time again, stealing the kind of money that makes the sequester look like pocket change.
While the credit-card industry uses data-mining techniques to flag fraud within minutes, CMS has allowed the most obvious schemes to run for years, rarely the wiser.
"Washington has long bragged that Medicare only has a 2 percent administrative overhead," Brady says. "But with that, we've paid a steep price in far too much fraud."
Given how often such blatant thievery goes undetected, no one's sure how much fraud there really is. Conservative estimates place the bill at $100 billion annually. The more adventurous peg the figure closer to $300 billion — three times what the feds spend on education.
It has left federal health care little more than an unlocked home, where street punks and gangsters, doctors and even states walk right in and help themselves to whatever's inside.
All You Need Is the Government and Your Imagination
The stealing has become so sweet that Medicare fraud threatens to overcome drug dealing as America's favorite quick-riches pastime. Street criminals can easily pull in $25,000 a day without carrying a gun. Throw in modest sentences for getting caught, and it's the criminal equivalent of saccharine.
Take Cuban expat Armando Gonzalez, who served five years for dealing crack. When he got out, he started several outpatient psychiatric clinics in Miami with a scheme similar to Riverside's.
Gonzalez paid assisted-living facilities kickbacks to bus in residents suffering from retardation and dementia. The clinics would then bill Medicare for services the "patients" weren't eligible for or didn't receive.
By the time the feds started sniffing around in 2008, Gonzalez had already made off with $28 million, enough to fund a personal fleet of seventeen luxury vehicles.
He closed shop in Miami, only to reopen in North Carolina. When he was finally arrested last year, Gonzalez was planning to expand into Tennessee.
Then there's Armen Kazarian, kingpin of Los Angeles' Armenian mob. The feds say his gang stole the identities of doctors and patients while setting up fake clinics across the country. They knew nothing of medicine, sending Medicare fake bills that showed eye doctors doing bladder tests, obstetricians testing for skin allergies and dermatologists billing for heart exams.
Medicare paid out $163 million before Kazarian and 73 henchmen were caught by the FBI. His sentence would prove how little risk there was to such grand aspirations. In February, Kazarian received just three years.
Not all schemes are this flamboyant. Some simply employ sleights of paperwork. A Detroit podiatrist billed Medicare $700,000 for performing toenail removals that amounted to little more than toenail clipping. Two Miami doctors billed back rubs as physical therapy, taking in $57 million.
Some are so brazen that they advertise on TV. Remember those late-night Scooter Store ads, promising to get you a motorized wheelchair "at little or no cost to you"?
In 2007 the San Antonio company agreed to pay $4 million in civil fines and forfeit another $43 million for advertising one scooter but delivering a more expensive model on Medicare's dime.
Executives didn't learn their lesson. The Scooter Store was soon caught again, this time for overcharging Medicare by as much as $87.7 million between 2009 and 2011, according to an audit. But CMS agreed to a spectacularly lenient settlement, allowing the company to repay just a quarter of that figure.
The feds would only get tough after CBS aired an investigation illustrating how the company browbeat doctors into writing unnecessary prescriptions for scooters. They raided Scooter Store headquarters in February. It finally appears the company has been barred from federal health programs.
Fraud Blossoms in the Sunshine and Heat
Warm weather attracts mold, mosquitoes and retirees with government benefits. So it's no surprise that Miami is the epicenter of health-care fraud.
It's not just the senior population conveniently warehoused in group homes and assisted-living facilities. There are also large immigrant communities that shield their own, and quick access to countries without extradition treaties.
Then there's the culture of fraud that stinks to the very head of Florida government.
During the 1990s, Republican governor Rick Scott was CEO of the hospital company Columbia/HCA. As the feds later discovered from the largest fraud case in Medicare history, the company seemed more organized-crime outfit than health-care provider.
Columbia billed for tests that weren't necessary or ordered, submitted false diagnoses to increase reimbursements, paid kickbacks to doctors for patient referrals and billed for home visits that people didn't qualify for or receive.
The smoking gun was the two sets of books Columbia kept. One detailed all Medicare submittals. The other noted which were fraudulent, allowing Columbia to keep enough reserves to pay penalties should it ever get caught.
A whistleblower estimated that fraud alone accounted for more than one-third of the company's profits.
When the whip came down in 2003, Columbia settled for $2 billion in fines for "systematically defrauding federal health-care programs." Scott claimed ignorance, though it's hard to believe that a self-described hands-on executive wouldn't know where a third of his company's profits came from.
He was eventually fired — but with the velvet landing accorded to disgraced CEOs. Scott walked away with nearly $10 million in severance, stocks worth $300 million and a $1 million-a-year consulting contract.
Only two lesser executives got jail time. Lead FBI agent Joe Ford would later regret allowing the company to simply pay away its sins: "People need to go to jail."
Still, fraud knows no party, race or gender. Indeed, the allegations against Miami's Democrat Representative Daphne Campbell's clan could script a health-fraud installment of The Klumps.
Campbell ran ten group homes until the state canceled her Medicaid contract in 2006. Four people died in her facilities that year, including one developmentally disabled female patient who had also been raped. Inspectors found rodent feces and general squalor.
Meanwhile, Campbell's ex-con husband, Hubert Campbell, has been accused by two former partners of defrauding the state's Medicaid program.
Not to be eclipsed, their 28-year-old son, Gregory Campbell, is accused of submitting nearly $300,000 in false Medicare billings while operating adult group homes. He has been charged with felony theft, organized fraud and Medicaid fraud.
But the feds never fully grasped the scope of all this stealing until 2007, when it stumbled upon the novel idea to scrutinize its bills, rather than merely paying them.
At the time, the U.S. Department of Justice was mostly tackling medical-equipment scams involving wheelchairs, hospital beds, respiratory devices and the like.
These were simply schemes. Providers don't need a license, and lax oversight allows them to pop up overnight, bill Medicare for hundreds of thousands of dollars then disappear just as quickly — only to reemerge elsewhere under a new name.
Hank Walther was a federal prosecutor at the time, soon to lead the feds' Medicare fraud task force. He feels they were allowing their adversaries to run scot-free.
"My four-year-old kid could prosecute these cases," he says of the equipment rackets. "They're really easy, and there are plenty of them. A lot of this other stuff — home health, the ambulatory cases, even the mental-health cases — each time we got into those new areas, there was a constant refrain from law enforcement and the U.S. Attorneys' Office saying, 'This is too complicated.'"
The feds started teaming prosecutors with detectives in the same approach used to break down organized crime. They began to hunt providers, whose fraud ran to the tens of millions compared with the $1 million to $2 million paydays from equipment scams.
Their discovery: Miami was the MIT of health-care schemes, the nation's unofficial laboratory for ripping off the government.
"When you look per capita, Miami has more people in community mental-health centers than New York and Los Angeles combined," says Walther. "Then you look at the profile of people going in there, and they don't really fit people that need these services."
In 2010 Walther helped take down American Therapeutic, the highest-billing mental-health center in the country. The company was cycling addicts, alcoholics and Alzheimer patients through its six clinics. Patients' diagnoses were changed so they would qualify for expensive group therapy. In the end, owner Lawrence Duran received an unheard-of 50 years, a sign that judges were finally acknowledging the magnitude of these swindles.
"It's like Whac-A-Mole," says Walther. "You knock one down, but now there's a bigger one somewhere else, and it's different. But once you figure it out, it rains on the back end with bad guys and money."
When the Check Arrives, Minnesota Gets Alligator Arms
For 29 years, David Feinwachs was general counsel to the Minnesota Hospital Association, a trade group for the state's hospitals.
Like many states, Minnesota pays HMOs to administer its Medicaid programs. But Feinwachs noticed something odd. While actual providers had seen their reimbursement rates frozen for more than a decade, the HMOs were hiking their management fees 10 percent a year just for playing middleman.
So Feinwachs started examining the HMOs' finances. "Because they're nonprofits, nobody ever looks at them," he says. "It's the perfect cover because everybody goes, 'They're nonprofits. What's the problem?'"
He soon found that they'd turned Medicaid into a cash cow, making it several times more profitable than their private insurance. But when Feinwachs asked for more data on their costs, the state blocked him, claiming it was proprietary information.
He was outraged. "You can't take tax-funded programs, turn them over to vendors and claim that what happened to the money is a trade secret."
Still, the HMOs were rattled. Their trade organization reached out to Feinwachs' boss in an attempt to silence him.
To soothe his concerns, Feinwachs was invited to sit in on a conference call in 2010 between the hospital association and Karen Peed, who oversaw the state's Medicaid contracts. "If you can't keep a secret, you have to leave the room," he claims Peed announced during the call. Then she proceeded to explain how Minnesota was rigging Medicaid reimbursement rates.
Think of Medicaid programs as akin to a restaurant bill, where states are supposed to split the tab with the federal government. But through creative accounting, Minnesota had figured out a way to only pay for the garlic bread, sticking the feds with the rest. (Peed's boss, Minnesota Department of Human Services commissioner Lucinda Jesson, declined our interview request.)
While it may be unseemly for one agency to fleece another, it's not illegal. When the state outsources its deceit to private insurers, however, it quickly tilts from bureaucracy to fraud.
Feinwachs warned his boss, who confronted Peed. She reportedly claimed it was no different than the cost-shifting used by hospitals, where people with insurance are charged more to compensate for patients on public assistance. The big difference, of course, is that you only pay hospitals when you use them. Every taxpayer in America was getting snipped by Minnesota's duplicity.
"It's like comparing panhandling to bank robbery — one's annoying, the other's a crime," Feinwachs says he told his boss. "After that, things got increasingly tense."
Feinwachs refused to back down. "My dad was in a place called Auschwitz," he says. "He used to always tell me, 'If you see something is wrong and you don't speak against it because you're worried you're going to lose something, eventually you're going to lose everything anyway. So you might as well fight.'"
Two months later, Feinwachs was fired for insubordination.
But he had already raised too much hell for the HMOs to feel safe. In 2011 UCare, one of the HMOs, chose to make amends. It dropped $30 million on the state's doorstep like an orphaned baby — with little explanation.
Minnesota claimed it was a donation. But the feds smelled a rat, believing it to be from Medicaid overpayments.
The move was so mysterious that Congress summoned UCare CEO Nancy Feldman to explain. She admitted that Minnesota was pumping up its Medicaid reimbursements to cover losses in a state program that Medicaid doesn't reach.
Worse, Republican governor Tim Pawlenty had canceled that program a year earlier. Neither the state nor the HMOs bothered to tell the feds they were still covering losses from a program that no longer existed.
"How do we know that other state, private and personal interests are not being funded through the federal Medicaid program?" Republican representative Michele Bachmann asked when testifying before Congress. "The answer is, we don't."
As multiple investigations continue, Feinwachs remains unemployed. He now spends his time agitating for reform.
"The interesting thing about health-care fraud is that our government always goes after low-hanging fruit," he says. "If they were storekeepers, we'd put in surveillance systems and armed guards to catch kids stealing gum from around the cash register. Meanwhile, we have people backed up to our warehouses with semitrailers loading the merchandise, and we're oblivious to that."
Well, not everyone is oblivious.
The Guys Who Showed Up
Housed in a featureless building north of Miami, the HEAT Task Force is a government anomaly: It actually turns a profit.
For every dollar it spends investigating, it uncovers another $8 in fraud.
From the moment you enter the office, you notice something's different. The cubicle plantation is eerily quiet. Most agents are on the street, working several blocks at a time.
HEAT is short for the windy governmentese of Health Care Fraud Prevention and Enforcement Action Team. It has branches in nine cities where the stealing is most prolific — places like Los Angeles, Houston, New York, Dallas and Baton Rouge. Agents and prosecutors work in small, aggressive teams, combining data analysis with traditional detective work.
Since 2007 they've charged 1,480 defendants with $4.8 billion in fraud. More than half of those indictments came out of the unit in Miami, a city special agent in-charge Christopher Dennis calls "the crown jewel of Medicare fraud. A lot of the schemes are typically started here — vetted, proven here — and farmed out to other parts of the country."
There's no shortage of targets.
Agent Reginald France, a first-generation Haitian American built like a linebacker, was out at 3 a.m. this morning raiding a medical office. His motivation comes from the guile of these crimes.
"You have some of the smartest people in law enforcement working here," he says. "In a lot of ways that drives us, because we want you to understand you can't pull the wool over our eyes."
France takes a reporter on a tour of the fraud hotbed of Hialeah. Strip malls line boulevards like concrete and metal kudzu. An agent who wishes to remain anonymous rides along, his square jaw and disarming manner reminiscent of The Rock. He offers a reporter $1 for every mall he can spot without a medical business.
It isn't easy.
There are doctors, physical therapists and mental-health clinics in every direction. Mom-and-pop pharmacies sit just doors down from Walgreens, yet still out-bill the national chain thanks to prescription fraud. Adult daycare centers specialize in physical therapy for Medicare beneficiaries.
"They bring in these zumba dancers," cracks The Rock. "These young girls are zumba-dancing away, and these old guys are looking at it, and, yeah, they're getting some kind of therapy."
Medicare recipients are crucial to these schemes. While it's possible to simply steal patients' information, those schemes are easier to detect.
"That's the bread and butter of the fraudster — the fact he can pay somebody to participate in the scheme," says Dennis. "If you have a willing participant, you then eliminate the ability to tie the fraud to you. That person is going to lie for you because they conspired with you."
Recruiters typically pay beneficiaries a combination of cigarettes, booze, pills and money to use their Medicare numbers. Cash payments can reach $2,000 quarterly. All recipients have to do is sign sheets confirming that care was received.
For the patient, it's a low-risk play. Nobody wants to put an 80-year-old mee-maw in front of a jury. Prosecutors wouldn't recoup much even if they did. And since Medicare can't be revoked by law, there's little downside to bartering your number away for a carton of Kools.
This makes the beneficiaries key to unraveling the plots, and necessitates a careful, respectful touch. Many of The Rock's tips come by way of recipients he's encountered in previous cases.
The Rock savors breaking down liars. He asks them seemingly innocuous questions about their family and upbringing. These are typically answered in a quick, sure tempo, while questions of fraud are littered with ums, wells and false starts.
"You keep them talking, and after a while, their house of cards starts to crumble," he says. "They're looking up and noticing that I'm not writing down anymore. You give them the look — 'I'm not stupid' — the same look their mother and my mother gave us."
He's been chasing fraud for more than a decade, and he's sure to be doing it a decade from now. That's the wonderful thing about the federal government being your mark: It always has new money to steal.
Dr. Oxy and Detroit's Fraud Beach
Imagine one of Martin Scorsese's overhead tracking shots. Only instead of zooming in on his favorite goodfella, the camera zeroes in on Michigan's Monroe Pain Center, near the Toledo, Ohio, border.
It pans the surrounding strip mall, parking lots filled with license plates from Kentucky, Tennessee and even Florida. That's how far people were willing to drive for a Las Vegas Cocktail.
The cocktail mixes Xanax, Soma and Vicodin for a powerful opiate high. Monroe was its unofficial retailer. It was led by Oscar Linares, a doctor from the Dominican Republic who also worked at the University of Toledo Medical Center. Sometime in 2008, he started leading a double life.
The office went from seeing 40 patients a day to as many as 250. Over two years, Linares prescribed 5 million doses of narcotics. Traffic grew so heavy that he hired a parking-lot attendant. Workers got bonuses when the patient count topped 200 in a day.
The cost to Medicare: $5.7 million.
Linares rarely examined his patients. One undercover cop didn't see the doctor until his tenth visit, and only then via a television monitor. Linares' workers simply gathered patients' information and had them sign blank forms that would be filled in later. Then a guy who used to work at Lowe's would hand out the scrips.
When the clinic was raided in 2011, police seized $214,000 in cash, a yacht and the 55-year-old doctor's fleet, which included a Ferrari Spider and a Bentley Continental.
Linares was charged with unlawful distribution of prescription drugs and Medicare fraud. He has pleaded not guilty and is awaiting trial.
Perhaps owing to his nationwide reputation, the doctor's scam was short-lived. But a more durable fraud thrives a half-hour north, in Detroit's Cass Corridor. Amid this stretch of poverty and ruin emblematic of the city's decay lies a peculiar oasis agents call "The Beach."
It's situated near several shelters, which provide a steady flow of beneficiaries. Recruiters drink beer and sit on beach chairs — hence the name — wrangling people into vans that shuttle "patients" to doctors, home-health agencies and mental-health clinics.
The doctors are the stars of this operation. They not only bill Medicare and Medicaid but use the power of prescriptions as currency to pay accomplices. It's a multi-ring circus with the doctor at its center, kickbacks flowing in all directions to pharmacies, patients and recruiters.
"A recruiter will identify a physician and work out a deal, saying, 'I'll bring you so many patients,' and the recruiter will pay a physician $10,000 to $15,000 to write scrips like crazy, pad after pad for a week," says one Detroit HEAT agent.
"When you have a dirty doctor writing 500 scrips for Oxycontin a month, you have to have a pharmacy that is going to fill them. If a pharmacy sees a Dr. ABC's scrip 500 times a month, they will call and ask, 'What's up, doc?' The recruiter plays a role here, too, and says, 'I'm taking care of the pharmacy.'"
The scheme's even spawned sub-specialties, such as "quality assurance" experts. They're typically former doctors from overseas who read through patient charts to flag anything that might prevent Medicare from paying.
And since fraudsters realize that red flags rise when there's a billing spike from one company, they'll incorporate seven or eight to spread the grift. Some even launch check-cashing businesses to launder their money.
"Now we're seeing people who aren't doctors open these clinics and hire other dirty real doctors to 'work' in the clinic," says the Detroit agent. "Almost every day there's a new thing."
The Bureaucracy That Didn't Work (Until Just Recently)
Much of the ease with which the treasury is raided can be blamed on CMS, which bleeds like a hemophiliac, thanks to a strategy known as pay-and-chase. Since its inception, Medicare has operated with a "pay claims, ask questions later" ethos.
This might have been appropriate in the idealistic '60s, when the program was formed and doctors served as its virtuous gatekeepers. Fraud was such a secondary concern that it wasn't even officially made a crime until 1996.
But that carcass is so inviting today that prosecutors have adopted an unofficial threshold: People need to steal at least $500,000 before they're charged.
"All of these prosecutions are great," says Louis Saccoccio, CEO of the National Health Care Anti-Fraud Association. "We have strike forces, but the prosecutions just tell you we have a big problem because that means the money's already out the door. So the focus now is starting to shift to prevention."
Enforcement started to pick up during the second term of George W. Bush then accelerated under Obama, who expanded the task forces and made fraud-fighting a pillar of the Affordable Care Act, otherwise known as Obamacare. CMS was given greater discretion in suspending payments and screening providers before they entered the system. Penalties and prison time were also increased.
But excuse Congressman Michael Burgess' skepticism. The Tea Party Republican from Texas has heard such talk before.
The former gynecologist is willing to concede that progress has been made. Yet the sheer size of the task makes crime fighting difficult. Every day, Medicare contractors process 4.5 million claims. Even Republicans admit that CMS is undermanned and forced to rely on contractors, whose ferreting of fraud is inconsistent at best.
"There was a famous case here in Dallas where a Nigerian woman had been busted," Burgess says. "As she was going off to jail, it was discovered that she had several other provider numbers. They discovered that she was receiving checks at the same post office box. It never occurred to anyone that, 'Hey, anything that goes to P.O. Box 9058, that's a red flag.' We were probably paying for her defense."
This slack oversight allows for glaring aberrations. In one instance, Texas' Medicaid dental program spent more on braces than the rest of the country's programs combined. But CMS only learned of it when TV reporter Byron Harris broke the story in Dallas.
Even more shocking is the case of New York state. Its centers for people with mental issues were charging the feds $5,000 per day per patient. Arizona, by comparison, charges $200 a day.
The reimbursements were based on a changing formula that CMS kept approving even as payments skyrocketed. New York's estimated overcharges: $15 billion.
This time, CMS discovered the state's gouging on its own. But six years later, it's still negotiating a remedy. CMS now plans to let New York phase out its overbilling, essentially allowing the state to steal a little less each month. (CMS officials declined to be interviewed for this story.)
More obvious improvements still elude the agency — even such basics as changing a beneficiary's Medicare number when theirs is stolen or used in a fraud. Others wonder why CMS hasn't mimicked the credit-card companies, which flag suspicious behavior within minutes.
"I sent my staffer to Chick-fil-A with my personal credit card to charge $100 of sandwiches for our office for lunch," says Burgess. "So I'm called off the floor of the House to answer a phone call from my credit-card company saying, 'Hey, someone is trying to charge $100 worth of sandwiches.' Why can't they do that?"
Obamacare has allocated $100 million to CMS to create a similar system, employing data analytics to mine for suspicious claims. The new proactive stance includes a spiffy command center in Baltimore linked to field agents. In its first full year, the system identified or prevented $115 million in fraud.
But as Burgess notes, Obamacare provided CMS with "seven new tools" to fight fraud. Four years after the law passed, CMS has managed to enact just one.
"At this rate, some point before my natural death, maybe we'll have done half of them," says the congressman.
Though most everyone agrees that the government is moving in the right direction, $100 billion continues to walk out the door each year.
"This is a lucrative business, and business is good," says Feinwachs. "The only problem is that you and I are funding it."


text:
On the day that Facebook paid $19 billion for the aptly named WhatsApp, San Francisco's Gap Inc. announced it would raise its minimum wage for American employees to $9 per hour this year and $10 per hour in 2015. The announcement probably won't make a dent in the income inequality gap in the Bay Area, but at least it showed some upward movement for low-wage workers outside the Golden State.
According to Gap CEO Glenn Murphy, politics had nothing to do with the move. He wrote on the Gap website that it was "a business decision that's right for" Gap's brands and a "strategic investment."
Nonetheless, President Barack Obama shrewdly glommed onto the announcement by applauding the retail giant for a decision expected to raise pay for 65,000 employees out of its U.S. workforce of about 90,000.
Obama then called on Congress to pass a Democratic measure to raise the minimum wage to $10.10 per hour — "all without requiring a single dollar in new taxes or spending. It's time to pass that bill and give America a raise."
Ironically, San Francisco has become ground zero in the minimum wage debate, even though the clothing chain's workers in the city won't benefit because Ess Eff's minimum wage already is $10.74 per hour. Elsewhere in California, the state minimum wage will rise to $9 per hour in July and to $10 in 2016.
James A. Dorn, a fellow with the libertarian-leaning Cato Institute, also applauded Murphy, although he came to a conclusion different from Obama's. "This is free-market, Randian thinking: self-interest is the motivating factor, not altruism," Dorn blogged. The market worked — and well. No need for another wrongheaded Washington Knows Best law when Washington really only cares about what's best for the political class.
From the West Coast of the right spectrum, there is a different voice. Palo Alto's Ron Unz, the wealthy entrepreneur and one-time GOP candidate for governor of California, has been making an alternative argument, "the conservative case for a higher minimum wage."
Unz is championing a ballot measure to raise the California minimum wage even higher than the $10 rate mandated in a law passed by the Legislature and signed by Gov. Jerry Brown last year. Unz argues that if Californians were to raise the minimum hourly rate to $12, every full-time worker would be earning $25,000 a year; for couples, that would mean $50,000. Working-class Californians would increase their income by a collective $15 billion annually.
Unz argues that higher wages should wean some workers off social welfare programs, ending "a hidden government subsidy to low-wage businesses, allowing them to shift the burden of their low-wage employees over to the taxpayer."
A new Congressional Budget Office report on a proposal to raise the federal minimum wage to $10.10 bolstered his case. It predicted the increase would cause the loss of 500,000 jobs but boost the earnings of 16.5 million workers — and lift some 900,000 Americans above the poverty level. Unz argues that taxpayers and workers do better under a higher minimum wage even if a half-million workers lose their low-paying jobs.
Problem: Voters could pass the Unz initiative, which mandates a much bigger pay hike, and Sacramento still could raise welfare spending.
Dorn warned that long term, the "substitution effect" would eliminate jobs as employers look to automation to replace low-skilled workers. That's certainly been happening in the retail biz, where online sales have moved into once-safe bricks-and-mortar turf.
Gap Senior Vice President Keith Herbert told me that as Gap brand stores institute a "reserve-in-store" program to lure online customers to stores, where they might buy more items, Gap management is asking its associates "to do much more" than in the past.
Was Gap responding to the political environment?
Herbert insisted: "This is not a political stand. As an organization, we always look at what's the right thing for our business."
It cannot hurt Gap sales that consumers know that the retailer pays its workers more than the minimum.
Be it noted: Gap has no plan to raise the wage floor for San Francisco workers.
How will the story play out? Will Republicans argue that the Gap announcement shows that the White House can raise incomes better with the bully pulpit than through legislation? Will Democrats feel emboldened by this private-sector victory and use it to argue that employers can absorb a mandate that drives up the cost of hiring new workers?
I'm not sure where I fall on this one. But right now, even though the CBO predicts 500,000 jobs will go away, it works better for the Dems.
Email Debra J. Saunders at: [email protected].:
Also see,
Liberal Plutocrats and Their Personal Campaigns


text:
Hosts: Tom Merritt, Sarah Lane, Iyaz Akhtar and Jason Howell
How Cyber is your Monday? Google punked on PR service, Minecraft Redstone update coming, and more.
Guest: Lindsey Turrentine
Download or subscribe to this show at twit.tv/tnt.
Submit and vote on story coverage at technewstoday.reddit.com.
Check out the full show notes for today's episode.
We invite you to read, add to, and amend the wiki entry for this episode at wiki.twit.tv.
Thanks to Cachefly for the bandwidth for this show.
Running time:: 0:45:37


text:
- 4 Channel High Quality Voice Cell Station
- Supports 4 simultaneous HD Voice calls
- Air synchronisation
- G.722, G.711, G.729a, G.726 codec support
- 10base –t / 100base–TX Ethernet port
- VLAN support
- DECT Encryption
- Seamless handover and roaming between cells
The new Panasonic range features two new fully featured DECT handsets, plus a new 4 channel High-Definition Voice DECT cell station.
Both handset models include a full duplex hands free mode and headset support, giving the user plenty of options for keeping both hands free while staying in touch. The KXUDT 121 also has built-in Bluetooth support allowing a wireless headset to be used. This range is platform independent and can work with any SIP compliant service, enabling high quality wireless communications in any business. Networks of up to 128 cell stations and 255 handsets can be created.
Simple Configuration
Phonebook entries for the handsets can be edited using a simple PC interface, with changes and updates sent 'over the air'. With 5 numbers stored per contact you can be sure that it's easy to keep all your contact details up to date and organized.
Audio Quality
Panasonic considers high voice quality to be paramount – to ensure your message is understood. in common with our other SIP terminals, the new range of SIP based DECT devices offers superb HD voice quality, using the G.722 wideband codec, for crystal clear call quality. Enhanced radio systems keep call quality clear even at the extremes of cell coverage, thanks to Panasonic's enhanced voice processing technology. Performance in noisy environments is also improved – ambient noise is intelligently detected and reduced, giving optimum performance in areas subject to high background noise levels. Automatic volume control is also included to enhance intelligibility.
Multi-zone SIP based DECT
the ability to handover calls seamlessly between DECT cells gives you the freedom to move anywhere in the organisation, staying in touch all the while – moving between cells in the same air sync group is completely transparent.
The range is built with a SIP server independent architecture, for wide ranging compatibility. the KX-UDS124 Cell station is already certified for use with digium asterisk, and broadsoft broadworks.
SIP DECT solutions give the opportunity to utilize an existing network infrastructure to carry voice and signalling traffic to the cell stations – no extra special cabling is required. System maintenance is simple, and can be carried out remotely using any networked PC. Cell stations are easy to deploy, thanks to their simple and powerful remote administration system.


text:
Giffords column: 'I'm furious'
Former Rep. Gabrielle Giffords (D-Ariz.) responded with anger to the Senate's rejection Wednesday of the Manchin-Toomey gun measure.
In an op-ed for The New York Times headlined "A Senate in the Gun Lobby's Grip," Giffords said that senators "gave into fear and blocked common-sense legislation."
"Speaking is physically difficult for me. But my feelings are clear: I'm furious," she wrote. "I will not rest until we have righted the wrong these senators have done, and until we have changed our laws so we can look parents in the face and say: We are trying to keep your children safe."
Giffords was wounded, nearly fatally, in January 2011 in a gunman's attack in Tucson, Ariz., that claimed the lives of six people. After a difficult recovery that led her to resign her House seat, she and her husband, Mark Kelly, became vocal advocates for gun control legislation.
"I am asking," she said, "every reasonable American to help me tell the truth about the cowardice these senators demonstrated. I am asking for mothers to stop these lawmakers at the grocery store and tell them: You've lost my vote."
Along with family members of victims of the Sandy Hook Elementary School shooting, she was present in the Rose Garden after the Senate vote failed as President Barack Obama called it "a pretty shameful day for Washington."
Obama cited her in his remarks.
"Their legislation showed respect for gun owners, and it showed respect for the victims of gun violence," the president said. "And Gabby Giffords, by the way, is both — she's a gun owner and a victim of gun violence. She is a Westerner and a moderate. And she supports these background checks."


text:
Ciao Lucia
Valentina Pullover - Blue/Ivory
From The Maker
The Valentina Pullover in blue/ivory is a cotton knit crewneck sweater with horizontal stripes across the front and contrasting blue sleeves.
Made in Peru.
We aim to process and dispatch your order as quickly as possible. Most orders are processed within 1-2 working days. If your order is urgent, please email us at email@example.com or leave us a note on your order.
Kind Curations offers shipping for delivery within Australia and internationally via Australia Post. For more information please visit our Support page.
Australia Wide:
Free Express Shipping for any order over $150.00
Regular Shipping (under $150.00) - $15.00
Express Shipping (under $150.00) - $20.00
International Standard Postage $30
International Express Postage $50
In-store pick up is also available. Please select this during checkout.
We happily accept returns, refunds and exchanges on full-priced items that are in their original condition with all packaging and tags intact. For all returns, please email firstname.lastname@example.com promptly with your request.
The return address will be provided via email. Returns must be sent back within 7 days of receiving your order.
Exchange is subject to availability and we recommend submitting your request via email promptly to arrange the exchange. A credit may be supplied subject to our assessment, and at our discretion.
Sale items are not eligible for a refund, however may be exchanged for other items or a credit note unless deemed faulty.
Please note: jewellery and lingerie are not eligible for returns unless deemed faulty.
Please view our Support page for more information


text:
April 15 (Reuters) - Italy's top bank UniCredit SpA and two subsidiaries have agreed to pay $1.3 billion to U.S. authorities to settle probes of violations of U.S. sanctions on Iran and other countries, U.S. authorities said on Monday.
In addition, UniCredit Bank AG, the bank's German unit, agreed to plead guilty to federal and New York state criminal charges for illegally moving hundreds of millions of dollars through the U.S. financial system on behalf of sanctioned entities, the U.S. Department of Justice and Manhattan District Attorney Cyrus Vance Jr. said.
The resolution ends a six-year investigation that has hung over the bank and follows last week's $1.1 billion settlement by London-based Standard Chartered Plc with U.S. and British authorities over similar conduct.
The German unit's guilty pleas are connected to violations of U.S. sanctions programs, including those related to IRISL, the state-owned Iranian shipping company sanctioned over weapons of mass destruction, authorities said.
UniCredit's German unit went to "great lengths" to help the Iranian shipping company evade sanctions and access the U.S. financial system, said U.S. Assistant Attorney General Brian Benczkowski.
Another unit, UniCredit Bank Austria AG, entered into non-prosecution agreements with federal and state authorities.
UniCredit Bank AG, Bank Austria and their parent entity, UniCredit SpA, also agreed to resolve parallel investigations with the U.S. Department of Treasury, the Board of Governors of the Federal Reserve, and the New York Department of Financial Services.
UniCredit said in a statement the penalties owed by each of the units were fully covered by provisions already made.
UniCredit said it agreed to retain an independent consultant to assess its improvements and compliance program, as part of its settlements with the Federal Reserve and the New York Department of Financial Services (DFS).
UniCredit engaged in "billions of dollars of transactions with clients from sanctioned nations, including Iran, Libya and Cuba, and then work(ed) to cover their tracks to avoid detection," acting New York Financial Services Superintendent Linda Lacewell said.
The German bank disguised transactions between 2002 and 2011 in part by stripping words like Sudan and Tehran from payment messages to New York financial institutions, the regulator said.
The settlements relate to apparent violations of sanctions targeting proliferators of weapons of mass destruction, global terrorism and Iran, Myanmar, Cuba, Libya, Sudan and Syria, the Treasury Department said.
Ten banks other than UniCredit have been penalized by U.S. and Manhattan authorities over the past decade for sanctions-related violations.
France's BNP Paribas SA pleaded guilty in 2014 and paid a record $8.9 billion penalty.
The latest Standard Chartered settlement was on top of $667 million the bank paid U.S. authorities in 2012 and another $300 million penalty in 2014 related to surveillance shortcomings.


text:
The URV is in one of the most dynamic social and economic areas in Europe and it is destined to become one of the driving forces behind the development and progress of Catalonia at the beginning of the 21st century. The powerful petrochemical industry, one of the most importanttourist sectors on the continent, and an increasing concentration of services and sectors such as automotion, agrifood, etc. mean that the levels of unemployment are extremely low.
What is more, the southern regions of Catalonia enjoy a high quality of life: medium-sized cities full of personality, a mild Mediterranean climate, sea, beaches, mountains and exceptional national landscapes such as the Ebro Delta, privileged cultural areas such as Roman Tarraco (a World Heritage site) or the Modernist legacy in Reus, a wide range of leisure activities and an important communications network (port, airport, motorway and High-Speed Train).
Chambers of Commerce, Industry and Navigation


text:
I just got back from the Big Apple very late last night. I've never been to New York City in January, and it was cold baby cold! But not unbearable, in fact it was rather brisk. Do people still use that word? Brisk? Anyway, I do a ton of walking when in NYC, and this trip was no exception. I was staying on the upper west side. In past trips, I haven't had a chance to really explore it all that much, so this was the perfect opportunity! The Upper West Side felt very "You've Got Mail" (minus the gorgeous weather in the film) and understandably so, since most of the movie was shot there.
I was scheduled for the afternoon taping with Nate, so I spent the earlier hours walking around the upper west side. Loved it! Here's a few scenes from my long morning walk, forgive the cloudiness of some of these photos, the lens kept getting foggy from the morning drizzle!
Gorgeous brownstones! Imagine this street in spring . . .
Central Park is always beautiful, even in winter.
The one place I wanted to visit was the NY Historical Society Museum, but it was closed for renovation. Boo.
So instead, I made friends with these critters in the park. They only loved me for my crackers.
"Um, no Sir, I mean I'm sorry Sir Mr. Bird. It's all gone."
Sorry. I just imagine these conversations when I travel alone.
I love the streets of New York, the energy, the pulse, the architecture.
You never know what you'll see on any given day, like these three guys moving a sofa down the street . . .
So many moms (and nannies) walking dogs and children.
This was the closest I got to these two landmarks on this short trip.
Salt & pepper shakers.
I stayed at The Lucerne, chosen by The Nate Show, I had a giant king bed and a great view, it was very very nice!
I also ate at the hotel's French restaurant, NIce Matin, for dinner the night before, it was packed with people for good reason, fantastic food! I popped in to take a picture the next morning for the wallpaper all over this swanky restaurant. Is it just me, or does this wall kind of remind you of a petri dish?
The show sent drivers to pick up this suburban tourist from the airport, and also drive me to the show. Wow, that's a first for me, nice perk!
The Nate Show gave me my own dressing room, or 'green' room. The entire staff takes great care of you, from making sure you're informed about every detail, to getting you to hair and makeup!!!
For the show, I was the 4th of 6 segments. Having visited the studio before, I was familiar with the set, so that took the edge off. Whew! My segment was certainly the shortest ~ the show opened with a big celebrity guest, an awesome table stylist, me, then Michelle Adams.
You know Michelle Adams, EIC of Lonny Magazine? She's only one of the nicest and classiest gals to walk this planet. See her looking so fabulous? And me with my fugly travel clothes and flyaway 'just walked the drizzled streets of NY' hair? Yeah.
So I made a "brilliant" wardrobe choice. A short black skirt. So they start playing my corny House Proud video (corny because of me, not the editors, they are totally fab), and I have to walk a mile across the stage in 60 seconds and get situated with Nate.
Then I see them. Barstools. HIGH barstools. And me wearing very short skirt.
The clock is ticking. 15…14…13… seconds until that red light comes on.
Me staring at high barstools: "Um, I'm wearing a short skirt."
Camera Crew: "You'll be fine. We will letcha know if you can see anything. We'll just crop your skirt out".
Me: "Um . . OK". Panicking inside that the world will see my, ahem, undergarments.
Camera Crew: "You're cool"
Me: "Um . ." nervous glance at short skirt
Angel of Mercy a.k.a. Director: "Would you be more comfortable if you were standing?"
Me: "YES !!!"
Loud guy shouts: "BARSTOOLS OFFSTAGE!!"
So then I stepped off the barstool and tripped on the slate at the bottom of the fireplace on the set. Caught myself, sorta straightened my top.
Red light! Smile and talk girl. So I did.
There are three words I remember using: "remodeling," "coax" and "strip". I pray to God that last word I used was when I was talking about my staircase. I'm not really sure. It was all a blur. So then another 60 seconds go by, we wrap it up, and then I told Nate he was an inspiration, hugged him and left the stage. The End. Sorta. I actually had a very brief chat with him after.
Ten Things You Should Know About Nate Berkus. He is 1. Genuine 2. The Ultimate Professional 3. Down to Earth 4. Witty 5. Tireless 6. Incredibly Kind 7. Welcoming 8. Crazy Talented 9. Runs a Tight Ship and 10. Extremely Good Looking (of course this last one we all know).
And he has an amazing staff. If you ever get a call from these two fabulous people Lori or Curran (Rachel too!) from The Nate Show, run don't walk, do not pass go, do not collect $200. Call them back immediately, because they are the absolute best at what they do, and couldn't be any kinder or more attentive. Big big props to the staff at The Nate Berkus Show.
I just heard my brief 'House Proud' segment with Nate will air February 3rd! Yay!
My drive to the airport included Fifth Avenue, always a favorite place for high style and eye candy!
I love this city. Where else can you stare at amazing architecture, feed a squirrel, eat anything you want, watch locals moving furniture down Broadway, catch a yellow cab, and appear on TV all within in a few city blocks and within a few short hours?
But it's good to be home.