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US Appeals Court Refuses Interim Stay Requested By United Healthcare In Connecticut & Refers Matter to 3 Judge Panel While Other

Posted Dec 12 2013 10:26pm

Sounds like this is going to get nasty before it all ends and with other state medical boards lending their support there has to be a reason for that.  I live in the OC United manifesto to where they own or manage the big doctor’s groups such as MemorialCare Foundation and Monarch and own the company that manages Nautilus.  That about covers the biggest chunk of the OC with United/Optum.  Back in 2011 this made the news down here to where employees were sent an instant message and loaded on to buses and given their walking papers. 

UnitedHealthcare Lays Off 180 Employees In Orange County-Initial Notification Sent By Instant Message to Those Affected

Now you see all kinds of classifieds for Quants and data miners for the company, loads of them. 

Connecticut Attorney General George Jepsen stated he’s disappointed by the actions of CMS with their refusal to take some actions to protect thousands of patients (seniors) who will be affected by the disruption.  What in the heck do you think CMS will do?

You are talking the same government agency who could not build a website and didn’t have enough common sense or technology sense to do it correctly and choose the correct technologies and vendors for the huge project.  QSSI, the United subsidiary who’s the head contractor now in control of Healthcare.Gov didn’t step up to the plate either as a contractor to tell the folks at CMS they were dreaming with the time limits on all the code that needed to be written, but are collecting their money from the project.  Here’s more on the Algo Duping with CMS and HHS believing a huge project could be built in such a short amount of time and the latest somewhat of a joke OIG request to investigate the contractors. 

Sebelius Asks Inspector General To Review Healthcare.Gov, How Many JBoss, Red Hat, Linux, Oracle, MarkLogic And Other Experts Does OIG Have? Time Elements of Baking A Cake From Scratch With Writing Custom Code Was Just Not There..

CMS, an agency who can’t model and relies on actuaries and no Quants says they are investigating.  I said it back in 2009 that you need agency heads with “some” tech knowledge to get the necessary “logical” thinking in place so they don’t get duped.  You also might remember that less than a couple years ago United hired the former Attorney General of the State of Minnesota as their general counsel.  The state is also not happy with the tax havens that United and other companies based in the state have and claim they are missing out on needed funds as United was one of the biggest tax haven companies in the state.  Here’s how that works if you want to watch a documentary called “The Free Tax Ride”…

United has tons of money to fight course cases (just like President Obama said last week that we don’t ) and they even took the Department of Defense to court and sued them as they wanted the Tri-Care West Coast contract and there was quite a public outcry from the military not wanting it.  There are other cases out there where they just take people to court if they don’t get a contract like in Georgia where they claim the bidding was rigged, and there are quite a few more out there just like it.

They have a lot of action too going on with the low income housing investments, one more last week so they could become the landlords of some of these folks when they go broke on their healthcare. 

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

In addition the company has a lot of income from subsidiaries, 15 pages of them listed with the SEC (how they stay under the radar) and of late wants to be closer to medical records as they are working with Mayo to mine EMR records there and sell de-identified data as well as being a consultant and integrator for Epic, Allscripts and GE medical records.   They already have Cerner with getting licensing from the revenue cycling software that is part of the Millennium system too. 

In addition the NHS is going to get a new leader in April of 2014, an executive from United Healthcare to run the NHS.

United Healthcare Executive to Leave the US and Run the NHS in England-Big Data Math Models and Algorithmic Business Intelligence Formulas On the Move…All About Money…

So it comes down to their business intelligence math models and algorithms…algorithms say doctors cost to much and are gone..

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

Now another note here of interest, the other state medical are joining in as of course as they have had their issues too as I have chatted with doctors in California getting paid at rates less than Medicare with the use of complex formulated contracts that net rates less.  Here’s why the other states can now join in…

The Supreme Court gave doctors and their associations a small gift this year and good to see the state medical agencies using it, as they can now group to litigate  By the way that was the outcome of yet another United Healthcare lawsuit where they spent tons of money fighting it as they wanted to retain the clauses in the contracts that disallowed doctors from grouping to litigate to where it was always one doctor against the corporation. Here’s more on that ruling and who knows do they have balls enough at this point to appeal a Supreme Court decision too?  

I knew the dermatologists would be right in there as the old Ingenix algorithms put a few practices out of business with some false positives with their analytics in San Diego, a really rotten and mean case in 2009 and beyond against the doctors from Untied/Ingenix.

Federal Judge Issues An Injunction Against UnitedHeatlhcare Hours Before Physicians Were To Be Dropped From Medicare Advantage Network In Connecticut–supreme Court Ruling Earlier This Year Against United Allowing Doctors to Group To Litigate Might Help..

The company has a track record of the largest derivatives settlement on record back in 2007 with back dating stocks and the CEO left and current CEO stayed (former COO)  as he didn’t back date as many, it was all documented in the court decision if you take time to read it.  In addition you can go back to the class action suit the AMA won where United used their algorithmic formulas and a few others just like it to short change doctors and patients for 15 years and licensed it to other major insurers.  When you look at this and what has been done in the past you would be a fool not to keep in your thoughts when it comes to trust with this company and use the eyes in the back of your head.   BD


A federal appeals court on Thursday refused to issue an interim stay in the UnitedHealthcare case and has referred the matter to a three-judge panel.

The case focuses on a plan by the nation's largest health insurer to cut thousands of Connecticut doctors from its Medicare Advantage network on Feb. 1.

On Dec. 5, a U.S. District judge in Bridgeport issued a preliminary injunction that halted the cuts for members of two doctor associations that took UnitedHealthcare to court.

The insurer appealed to the 2nd U.S. Circuit Court of Appeals in New York and asked for an "emergency" stay of the lower-court order — and an "interim" stay until that request is decided. The appeals court Thursday referred the request for the emergency stay to the three-judge panel and denied the interim stay.

Late Wednesday, various associations of doctors across the nation joined the Connecticut State Medical Society in supporting the lower court's decision.

In what is becoming a nationally watched court case within the health care industry, the doctors who are plaintiffs in the case were given support through the amici curiae brief by medical associations in California, Florida, New Jersey, New York, Tennessee and Texas, along with county medical associations in Connecticut and organizations of specialty physicians.

Signing onto the brief filed Wednesday were: the Medical Society of the State of New York, Medical Society of New Jersey, Florida Medical Association, Tennessee Medical Association, Texas Medical Association, California Medical Association, Physicians Advocacy Institute Inc., American Academy of Dermatologists, Waterbury Medical Association, Connecticut Academy of Family Physicians, Connecticut Orthopaedic Society, Connecticut Psychiatric Society, Connecticut Infectious Disease Society and Connecticut Chapter of the American College of Surgeons.

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