Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

Federal Judge Issues An Injunction Against UnitedHeatlhcare Hours Before Physicians Were To Be Dropped From Medicare Advantage N

Posted Dec 06 2013 7:02pm

This is one of those deals the President Obama talked about in his speech this week about citizens not having the money to hire groves of lawyers to fight civil cases for them when it comes to doctors now being able to group to litigate.  United Healthcare took this and all the legal expenses for a number of years all the way up to the Supreme Court to challenge it.  Supreme Court says no, doctors can group to litigate now and those provisions are not legal in a contract any longer for it to stipulate it’s one doctor fighting the huge corporation.  Anyway you can read more at the link below and this might come in handy here for the doctors groups.  The case by the way was won in New York. 

US Supreme Court Rules Physicians Can Work As A Group To Fight Unfair Business Practices of Health Insurers–Victory Over United Healthcare (Oxford Subsidiary)–Context Once Again With Contracts

The injunction forces United do it the right way which according to the legal sources quoted here, that was not being done.  Hartford County Medical and Fairfield County Medical associations are the only two affected by the ruling as it stands now.  Again who knows now with the new ruling and I don’t know how or if it could apply to allow other groups to participate?  Maybe a good question here? 

United routinely amends contracts without getting consent from the doctors.  The doctor organizations wanted to go to mediation and United refused, and thus this fueled the judge’s ruling here, maybe they are still hot over the Supreme Court ruling allowing these two groups to work together?  Here’s another post on other states where doctors are being taken out of network with the same methodology (and algorithms). 

United Healthcare Medicare Advantage Doctor Firing Moves On Into Ohio, New York, And Maybe More? CMS Has Known For Months About the Changes And Is Monitoring….United’s Cost Algorithm Says…You’re Out the Door

Have you looked recently to see how many Quants United is hiring..groves…they want new math models and subsequent algorithms to keep profits high.  Look at the classifieds..and there’s tons of for positions, like data miners that support Quant math models.  This is what I meant back in 2009 when I said Sebelius is no contest to understand all the math models and how this works.  Scroll on down and watch the 4 videos in my footer here, especially #2 to see how Quants work at banks and hedge funds and you will be able to pretty much figure out what they do at insurance companies too, as these folks and what they do are all tied to the profits and shareholders.  Perhaps we have some Algo Duping or Attacks of the Killer Algorithms here at hand? 

In the meantime with some of their other subsidiaries they might get your rent check some day too when you are even more broke than today as they just recently dumped $50 Million into a low housing income project..hmmm..that dollar amount could pay a huge amount of medical claims, maybe?  This is why business models are important today to understand how money gets distributed and invested with huge conglomerates.  I just read the other day where the state of Minnesota is frustrated with the overseas tax havens United has in the Netherlands (as well as 3M and a few other big companies in their state) with being shorted on tax money they could use.  BD

United Invests in Another Low Income Rental Housing Project–Minnesota–$50 Million This Time


Two Connecticut medical associations won a temporary injunctive order against UnitedHealthcare in federal court hours before the health insurer was set to drop thousands of physicians and patients from its rolls . The order prevents the insurer from removing any of the doctors until the court can rule on the merits of the case.

U.S. District Court Judge Stefan Underhill ruled Friday, December 6, that the Hartford County Medical Association and Fairfield County Medical Association "met their burden of demonstrating that they will suffer harm that is imminent and cannot be adequately compensated through damages."

The associations sought a temporary restraining order preventing UnitedHealthcare from removing the physicians, approximately 20% of the UnitedHealthcare provider panel, from its Medicare Advantage networks. Anywhere from 20,000 to 30,000 patients could be affected, the medical groups say.

UnitedHealthcare intends to immediately appeal the decision, the company says in an e-mailed statement.

“We believe the court’s ruling will create unnecessary and harmful confusion and disruption to Medicare beneficiaries in Connecticut,” says Terry O'Hara, of UnitedHealthcare Group. “We know that these changes can be concerning for some doctors and customers, and supporting our customers is our highest priority. United Healthcare will continue to stay focused on the people we serve.”

Post a comment
Write a comment: