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In last month’s Legally Speaking, we published “Health care fraud exposed” by James M. Shwayder, MD, JD. It is disturbing in its details but exposes fraud and medical malpractice that went on for years. The ob-gyn at the center of it, Javaid Perwaiz, was recently sentenced to 59 years in prison.

Even with these recommendations, women commonly ask questions about alcohol consumption and breastfeeding such as “Should I pump and dump if I have a glass of wine?” and “Do I just wait until it has passed through my system?” This month, experts Susan Crowe, MD, and Tricia Wright, MD, MS, provide the needed insight—with as much data as are available on this topic.

An analysis of individual enrollment and premium data from California’s marketplace and the American Rescue Plan premium tax credit subsidy schedule has concluded that a smart default policy avoids defaulting lower-income marketplace enrollees to objectively inferior health care insurance plans and leads to large reductions in lower-income enrollees’ deductibles, copayments, and maximum out-of-pocket amounts.

Clinicians should carefully consider using noninvasive prenatal testing (NIPT) for the screening of chromosomal abnormalities in twin pregnancies because the combined positive predictive value (PPV) is limited and the screening efficiency is not stable, according to a prospective study.

Despite the inadvisability of performing early amniocentesis (EA) before 15 gestational weeks due to a high rate of miscarriage, a retrospective cohort study has found no significant difference in the procedure-related risk of miscarriage between EA, at around 14 weeks gestation, and mid-trimester amniocentesis (MA).