Medical Quack

Fetuses Masturbate So We Should Outlaw Abortion-Many Members of the GOP Need A Digital Literacy Check as This “Default” Topic Keeps Getting More Rediculous

6/19/2013 04:13:00 PM Medically Related, My Commentaries, Other Items of Interest

I tweeted this earlier and so if the male fetus can feel pleasure, it could feel the pain of an abortion? Please! I had to laugh my head off when I heard this GOP Congressman from Texas say this on the video…again this is sad that this appears to be such a strong default topic when they are over their heads with knowledge needed for “real” lawmaking…bet it makes MSNBC Maddow show tonight:) I don’t see how she could pass this one up!

I wrote this post below a couple years ago and it still goes on…seriously can it get any sillier with abortions with these so called opinions? It’s like a virus that travels and attacks those who are and refuse to be digitally literate:) BD

Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary…

QSSI, Subsidiary of United Healthcare Building Federal Data Hub Gets Busted by the Inspector General Regarding USB Security And Compliance With Federal Requirements

6/18/2013 04:13:00 PM Insurance, Other Items of Interest, Technology

The Federal Hub project is one that remains still very controversial as QSSI received the contract from HHS, only 2 weeks later to be bought by United Healthcare. I should say Optum I guess as it is a subsidiary of United Health Group and get the “daisy chain” of subsidiaries properly stated. This makes it hard at times when the daily chain comes in as I looked at the SEC pages and I couldn’t find a couple of the subsidiaries of subsidiary listings. This is a little disturbing in the fact that USB security and restrictive use has been around for a long time and so now we have the company that is going to have access to the IRS, Immigration, Social Security and much more for health insurance exchanges with no doubt very high security clearance that doesn’t address USB drive security? This is pretty scary as it’s pretty standard in almost every IT department in government to have policies. Most in private industry also have policies.

States Slowly Getting Insurance Exchanges Set Up as Federal Exchange Hub Built By United Health Group Subsidiary. QSSI Still Remains a Mystery

As the exchanges move forward we also see fewer and fewer big carriers participating and like in California, hospital chains who have created their own insurance plans also said no thanks. In addition, ones who are there such as Kaiser in California are coming in with higher rates than normal. USB connectivity and access last I remembered could be done right in group policy, pretty standard so wonder how their other project is coming along and hope they didn’t miss any other security items when building the Federal Hub, which I still wonder how secure it will be as well. When word first broke of United buying CSSI, the notification was not timely reported to the SEC and HHS began trying to put a firewall up around CSSI after United bought it as we all know how much data United collects, sells and profit on and we never know what the Query Masters do at times. BD

An IT contractor that tests the Medicare claims standard systems needs to improve security controls for USB devices, an Inspector General report recommends — especially considering the risks of malware and breaches posed by USBs.

Quality Software Services Inc. (QSSI) provides independent testing for the Medicare Parts A and B fee-for-service standard systems with data on about 6 million Medicare beneficiaries, and until late last year, the firm hadn’t listed essential system services or USB ports in its security plan and hadn’t restricted the use of unauthorized USB device access, according to the Health and Human Services’ Office of the Inspector General.

In its report, the OIG recommended QSSI update its policies and ensure that USB controls comply with federal requirements, namely National Institute of Standards and Technology guidelines for federal agencies. Specifically, the OIG said, the firm should list essential system services and ports in its security plan, update its policies to explicitly prohibit unauthorized USB devices in systems working with Medicare data and limit USB port access to “essential connections.”

http://www.govhealthit.com/news/oig-medicare-system-needs-more-usb-security

Johnson and Johnson to Pay A Billion for Aragon Pharmaceuticals To Acquire New Prostate Cancer Drug

6/18/2013 07:32:00 AM Medically Related, Pharma/FDA News

Zytiga and ARN-509 are both prostate cancer drugs that work with blocking testosterone but are very different drugs and could even possibly work together. ARN-509 is an Androgen Receptor inhibitor. Johnson and Johnson is keeping an eye n Zytiga’s patent as well. $650 million is going out now to Aragon and #350 million if ARN-509 meets the required milestones. Aragon’s breast cancer drug is being spun off to a separate company which will be names Seragon Pharma and the current CEO of Aragon will run it. It will probably be pretty expensive when ready to go to market. BD

(Reuters) - Johnson & Johnson said it would pay up to $1 billion for Aragon Pharmaceuticals and its experimental drugs for prostate cancer, to bolster J&J's role in the field after it acquired another experimental prostate-cancer treatment four years ago that has become a leading brand.

J&J on Monday said Aragon's lead product, called ARN-509, has potential to help patients whose prostate cancer has not yet spread to other parts of the body, as well as patients whose cancer has spread.

By contrast, J&J's blockbuster Zytiga treatment, acquired through its $1 billion purchase of Cougar Biotechnology in 2009, was approved in 2011 only for patients whose cancer has already spread.

Moreover, although Zytiga has become a blockbuster only two years after being launched, it could face competition from cheaper generics by 2016 in the United States, while ARN-509 will have U.S. marketing exclusivity until 2028, Leerink Swann analyst Danielle Antalffy said in a research note

The deal does not include development of Aragon's treatment for breast cancer, which will be spun off into a separate company called Seragon Pharmaceuticals ahead of the deal and will be run by Aragon's chief executive officer.

http://in.reuters.com/article/2013/06/17/us-johnsonjohnson-aragon-idINBRE95G0DI20130617?feedType=RSS&feedName=health&utm_source=dlvr.it&utm_medium=twitter&dlvrit=309303

Remote Area Medical–The Documentary Trailer

6/17/2013 11:45:00 PM Insurance, Medically Related, Other Items of Interest

I can’t think of a finer topic for a documentary than Remote Area Medical. If you read here often enough then you know RAM (Remote Area Medical) gets a lot of exposure as it reminds us of our broken healthcare system in the US and reinforces the need for a single payer plan as the one we have keeps getting worse, due to politics and the use and abuse of data interpretations. The movie trailer is below and you can find various other news videos here at the Quack on the fine work they contribute to help those in need. In California due to the large population needing medical and dental care there’s RAM California. The Dateline episode covering RAM won an Emmy.

“Remote Area Medical–California” Begins Four Day Free Medical Clinic in Oakland–Volunteers Needed

If Healthcare was working well in the US, efforts like those from RAM would be free to help those in other countries…sad…we can’t seem to get it together in the US and it keeps getting worse. BD

The film chronicles individual stories throughout the busy weekend of medical volunteerism at Bristol Speedway in Tennessee. Most wait days, claiming parking lot territory in their vehicles, for a limited number of tickets that grant access to each day’s worth of medical care. The film is full of powerful imagery that struck at the viewers’ emotions, from the pulling of an entire top gum line of teeth in one sitting, to someone receiving a pair of eyeglasses for the first time.

During the question and answer period that followed the screening, Fitler remarked, “I’ve been a nurse for over 50 years. This is perhaps the highlight of my career, if not my life. These people that I met in Tennessee will endear to my heart forever – the volunteers that came from California, from New England, from all over the country. When you see this film, there is only one thing to say: What is wrong with this country? Why is this happening in this country today?”

The film won’t use news footage or photos. Rather, it will include some amateur video and photos from locals. The filmmakers are shooting for a spring completion date to submit it for the 2014 Lighthouse Film Festival.

http://thesandpaper.villagesoup.com/p/remote-area-medical-documentary-stirs-obamacare-debate/1013779

Positive ID, The Human Chipping Company is Back With New Product Developed Under Contract of Homeland Security

6/17/2013 04:58:00 PM Medically Related, Technology

The company used to be called VeraChip and changed it’s name a while back. The original product was a “chip” that first carried your medical records and was read by a specific viewing instrument and then later it connected to PHRs, HealthVault being one. There’s not been a big rush for people to be chipped as a personal preference and some states made it illegal to chip a person against their will. That’s was another interesting story out of Georgia a while back:) In 2001 they hooked up with Siemens for another type of chip product with their patents.

PositiveID The “Chip” People are Back-an Agreement with Siemens To Expand Wireless Body Monitoring With A Chip Implant

In addition they went into the glucose monitoring business with a “chip” that can do that too.

Prototype of iGlucose Product Created by Positive ID – Wireless Glucose Readings in Real Time

Now they have the M-BAND to collect data and it works for up to 30 days. It will analyze air samples for bacteria viruses and toxins. From the website:

“Designed for either outdoor or indoor environments, the M-BAND will operate from - 25 to 125 ºF. The M-BAND utilizes the industry-standard TaqMan® Real-Time PCR with an end-point read and toxin immunoassays which are well-established in the field for optimal specificity and sensitivity. Designed with a high level of operational flexibility, M-BAND can be remotely set to detect for DNA-based pathogens alone, with or without either RNA-based organisms or toxins, or for all three types of pathogens simultaneously at remotely programmable intervals. Air collection rates of 400L/min have been achieved providing 10 mL of concentrated fluidic sample to the detection system. Sample processing time includes: 60 minutes lysis and purification and a thermal cycling rate of 1.2 min/cycle. The typical time for combined sample processing and detection is 120 min assuming 50 thermal cycles. Toxin analysis time is 40 min. “

A little over a year ago they sold the chip implant business for medical records to VeriTeQ so now you only see the glucose chip referenced on their site.

VeriTeQ Acquisition Corporation Buys VeriChip Implanted Chip and Health Link Personal Health Record Technology from Positive ID–Implantable RFID and Sensors

With the M-BAND if I am interpreting this correctly it can find bad elements in the air as well as cancer causing elements using a portable device. BD

PositiveID's M-BAND system, developed under contract with the U.S. Department of Homeland Security Science and Technology directorate, is a bio-aerosol monitor with fully integrated systems for sample collection, processing and detection modules that continuously analyze air samples for the detection of bacteria, viruses, and toxins. Results are reported via a secure wireless network in real time to give an accurate and up-to-date status for fielded instruments. Firefly takes the Company's patented molecular diagnostic technology underlying the M-BAND system, and implements it in a handheld device that can be used anywhere, anytime for rapid biological testing. Firefly is being designed as a portable, point-of-need molecular diagnostic system to provide test results from sample input through reporting of results in 15 to 30 minutes depending on the type of test performed.

About PositiveID Corporation

PositiveID Corporation is an emerging growth company and developer of biological detection systems for America's homeland defense industry as well as rapid biological testing. PositiveID is focused on the development of microfluidic systems for the automated preparation of and performance of biological assays in order to detect biological threats at high-value locations, as well as analyze samples in a medical environment. For more information on PositiveID, please visit http://www.PositiveIDCorp.com.

Johnson and Johnson Company, Mentor Gets FDA Approval for Silicon Gel Filled MemoryShape Breast Implants

6/16/2013 02:36:00 PM Medically Related, Pharma/FDA News

Silicon is making it’s way back to the implant business with a new design to move and look more natural. The company also makes a saline product as well for breast reconstruction. If you want to compare the two products the company provides additional information here. BD

Mentor Worldwide LLC, the U.S. market leader in breast aesthetics, today announced the U.S. Food and Drug Administration (FDA) has approved MENTOR® MemoryShape™ Breast Implants, providing new options for women looking for a more natural shape and youthful feel from breast enhancement or reconstruction surgery.

"We understand each woman has different needs and specific, personal reasons for choosing to undergo breast surgery," said David J. Wilson, Worldwide President, Mentor Worldwide LLC. "As the U.S. market leader in breast aesthetics, Mentor constantly strives to develop products that celebrate a woman's uniqueness. The FDA approval of MENTOR® MemoryShape™ Breast Implants allows us to meet this need by delivering the perfect balance of shape and feel to obtain the natural and youthful look patients desire."

http://www.news-medical.net/news/20130615/FDA-approves-MENTOR-MemoryShape-Breast-Implants.aspx

Pathway Genomics to Offer BRCA Breast Cancer Test–Supreme Court Ruling Makes Testing Affordable–”Free the Data” Website Emerges

6/16/2013 10:37:00 AM Medically Related, Other Items of Interest, Pharma/FDA News, Technology

I also read where Quest Diagnostics will be offering a test as well. This has been a long time coming somewhat going back and forth with challenges. Myriad must have some very large legal bills but this ruling sets the stage for other genomic tests to be affordable as a company can no longer own a gene. Way back in 2010 the company patent was ruled invalid and it has taken this long to finally resolve with legal interpretations. Insurance companies have also been tough on approving the test, due to the cost.

Myriad's BRCA (DNA Breast Cancer) Patent Ruled Invalid Today – US Patent and Trademark Office Also Off the Hook

In celebration of the ruling a new website called “Free The Data” has been established for sharing mutation in a private fashion to help accelerate knowledge through data sharing. BD

SAN DIEGO — Pathway Genomics led the evening news Friday with an announcement that it could begin offering affordable access to genetic testing for the BRCA gene linked to breast and ovarian cancers in the wake of a Supreme Court ruling that eliminated another company’s monopoly on the test.

“These tests, these lifesaving tests will be much more affordable for all of us regardless of how much money is in your pocket.” Laura Farmer Sherman from the Susan G. Komen chapter told NBC San Diego.

http://www.heraldonline.com/2013/06/15/4948548/pathway-genomics-to-offer-brca.html

Aetna Individual Policy Consumers In California Will Have to Find a New Carrier By The End of The Year-Pulling Out of The Consumer Insurance Business

6/14/2013 08:08:00 PM Insurance, My Commentaries

We already knew that Aetna was not participating in the California exchange and this makes their participating even less as those who do not have coverage via their employer will need to find another carrier. For some, finding a new insurers may take a little time so best to look at it as soon as possible if this affects you. Aetna, like other carriers, Humana and United for example are focusing more on the employer based insurance business. This is getting a bit interesting as the California Insurance Commissioner called for Anthem to be removed from the small business option on the exchanges.

We have read about competition from private exchanges which number about 100 and this certainly looks to add to the idea that carriers are in fact moving in that direction. Ok, so who would California replace Anthem with? Anthem unlike the other major carriers has a large base of clients who are individual policy holders. Just last month Aetna announced a new focus on government and international business. Anthem, other than smaller HMO type of plans may end up being the only major carrier to still cater to individual policy holders in California. Sutter Hospitals created their own insurance plan and was going to participate but they pulled out too for another example with exchanges. Ok so the insurers have all modeled their profits and this seems to be the end result. In 2011 Aetna stopped selling individual policies in Colorado. We are seeing a lot of carriers focusing on government business and none larger than United with their efforts. A United Healthcare subsidiary is building the federal exchange net too that all the states will connect to.

States Slowly Getting Insurance Exchanges Set Up as Federal Exchange Hub Built By United Health Group Subsidiary. QSSI Still Remains a Mystery

Ok now with the current events and perhaps more of those to come, did the insurers win this battle after all? Their decisions have all been carefully calculated and modeled and lobbied. You have to stop and think about it when you see how expensive the exchange service has become for both the feds and state governments and did they set this up to fail in this manner with HHS having egg on their face? I kept saying that we needed leadership with some IT in their background to run HHS (from 2009) as without it, they are no competition for all the analytics and business models that are built almost on the hour by insurers. Sad to say but it looks like the insurers have in a way embarrassed HHS when you look at all the money and the expensive IT infrastructures they are adding and adding and adding instead of having a better style of “project management”. Sad.

I am not taking sides with the insurers by any means but do recognize how the government is so much at a disadvantage without people who understand math modeling and can’t grasp some of this first hand with some first hand experience and we all hurt because of it. DeParle was probably smart in leaving when she did seeing this coming. So the model that Aetna created told them to move in other directions for profits. Again look at the huge dollars United Health Group is making off the government, DOD and military and now Aetna announced their government focus. United was early to the game with soliciting and suing DOD to get their business while others were still working with HHS, they saw available money and used their data and subsidiaries along with a lawsuit to get a bunch of it. They created a subsidiary just to focus on getting Tri-Care business for goodness sakes. Here’s what one subsidiary, LHI, of United does with VA exams and big DOD occupational health events:

“We have administered private occupational health services in support of various federal agencies including the Centers for Disease Control and Prevention (CDC), Federal Occupational Health Service (FOHS), Department of Defense (DoD) and the Veterans Health Administration (VHA). We support a wide variety of customers, including: National Institute for Occupational Safety and Health (NIOSH), U.S. Army Medical Command (MEDCOM), the Army Reserve, Army National Guard, Air Force Reserve, Air National Guard, Army Dental Command, Navy Reserve, Army Corps of Engineers, Coast Guard, Military Sealift Command and other Federal agencies. LHI also supports a number of private sector clients with occupational health services, including four of the Class 1 railroads operating in the United States.”

Aetna may not be too big to fail but United is certainly at that point with being so intertwined with many government entities, hospitals, physicians groups, HMOs and more. Look at the SEC list of subsidiaries here and this does not list all of them that are sub-subsidiaries either, the daisy chains have more. 250 plus items listed here. SEC Aetna listings 110 plus items and no daisy chains sub subsidiaries it appears. When you open up Optum as an example there’s a whole new slew of sub, subs that all put profit to the United bottom line.

So between models that identify profit markets and non participation as a whole with the insurance companies it looks like they kind of stuck it to HHS in a huge way…billions and millions for a complex system that we have no idea if consumers will use or be able to use and understand. We have additional millions for navigators and assisters too…57 million just for that. Now I’ll be the devil’s advocate here, how many employees does it take to set up a private health insurance exchange..answer..3… if they come from Humana in this example. In other words do you see what’s happening here with employer provided health insurance? There’s about 100 private exchanges and you can bet the insurers will be marketing them as some of the insurance companies own some of them or have some kind of affiliation.

One More Insurance Exchange Started by Former Humana Executive–Currently There Are Over 100 Private Exchanges in Place To Compete With State Exchanges

The sooner the government hires people that can help them see how private industry models for profit the better off we will all be. Next send Congress off to school to learn about this too.

Again with all the millions and billions spent here on the exchanges, which in the original concept was not a bad idea, what in the world are we doing. Steve Larsen, credited with writing most of the healthcare law doesn’t care much anymore as he left Sebelius and company and sits as a VP at Optum, subsidiary of United. What’s up with that when a key regulator of the healthcare law leaves and takes all the secrets to the insurers modeling for profit…a pay raise for him for one would be an obvious. Software builds on itself and thus it is easy as a developer to keep selling software on top of software until you get a huge mess. Believe me, purchasing agents and others are an easy sell as the layers do exactly as promised but nowhere in the sale do you ever get the benefit of a good data project manager.

At some point you need to have a modeling project manager take it all apart and rebuilt it, otherwise you have what we see now. Insurers like this kind of business as it keeps prices up and money flowing to their pockets and they look at that almost hourly. If we had someone at the top who had some background in Health IT, some of this could have been altered, stopped or set in motion with a better model. The model we have now keeps going up and up with money spent and so do the profits of insurers and it’s not all selling policies. United is getting paid to build the federal exchange hub too and they don’t even want to participate anymore with such profitable business coming in via the military.

Oh and don’t forget that when you look up LHI when we talk about the DOD and VA HER records, one more item to consider, the charting that LHI does for VA disability exams and the DOD events…goes right into the EHR charts, so guess what, perhaps one more entity that has to be considered for integrated records, to make it work with the United Healthcare subsidiary. I understand why the CTO and CIO of the VA left when you start adding on those types of complexities and everyone just complains and has no clue on the fact that integrating the two systems goes way beyond the surface. BD

Aetna Inc. AET -1.72% will stop selling health insurance to individual consumers in California at the end of the year, withdrawing as the federal health law is expected to reshape the market in 2014.

The pullout is likely to draw attention as California has become a focus of national debate over the law's impact. Supporters, including President Barack Obama, who highlighted the state in a recent speech, argue that it has shown the success of the health overhaul in encouraging competition and pushing down prices.

Insurance-industry experts say similar moves by other carriers in other states may emerge in coming months, as companies with limited market share decide to avoid the uncertainty tied to the law's changes.

http://online.wsj.com/article/SB10001424127887323734304578546144234962424.html?mod=googlenews_wsj

Merck Set to Cut Research Jobs

6/14/2013 06:42:00 PM Medically Related, Pharma/FDA News

Roger Perlmutter after having only been at Merck for a couple months states this is part of the company re-organization. He was formerly at Amgen as their top scientist. The company saw a reduction of revenue of 2% last year. Patents that expired also added to the decline, namely Singulair that is now available as a generic. BD

Merck & Co. (MRK), the second-largest U.S. drug maker, plans to cut jobs at its research laboratories, two months after Roger Perlmutter took helm of the unit.

The shakeup includes immediate elimination of some positions and additional reductions over time, said Steve Cragle, a spokesman for the Whitehouse Station, New Jersey-based company. He said it’s too early to say how many or what positions are affected.

“The changes are part of our existing strategy that we’ve talked about for quite some time, as well as our commitment to streamlining our operating model,” Cragle said in a telephone interview today.

http://www.businessweek.com/news/2013-06-14/merck-to-cut-research-lab-jobs-as-perlmutter-moves-to-streamline

Former Goldman Coder Case Still Open As Questions Are Still Surfacing From Those Who Do Not Program or Understand Data Mechanics About What Kind of Code Did He Steal

6/14/2013 02:03:00 PM My Commentaries, Other Items of Interest, Technology

Sergey Aleynikov was using a Hull three-factor model" to analyze stocks, which if you read the paragraphs below, Goldman bought it from Blair Hall, a former black jack player who modified the code for stocks. When you read the rest of this it kind of goes along with exactly what I said when writing software, there are bits and pieces we copy and paste in, which are “tidbits” and don’t do much alone but save the programmer a ton of time from having to write from scratch. I did that all the time to add a quick functional algorithm to the overall program. it saves time. The tidbits of code I used were all open source and developers made some of them up as good will, to help other developers time in not having to write the same code over and over.

Former Goldman Programmer Still on the Hook for Code Theft, Perhaps Is It Time to Talk About the Model He Was Writing Code For To Finally Figure Out If That Code Had “Real” Value?

There’s a lot of repetitious code in software that is used and if you look at what Microsoft does for dot net programs, that’s a good example right there of code that is used over and over to run software on your computer, so developers don’t have to write those modules into every software program built, it saves time. So when you see a notice about dot net extensions, that’s what it is.

Goldman Sachs Programmer Who Went to Jail for Stealing Code Has His Conviction Overturned–You Can’t Get A Jury of Peers Off the Street for Crimes With High Tech Algos

Like I said how does one get a jury of peers and how long is this going to carry on. Can’t we get some “digital illiterate” experienced programmers to testify here? If the code was that valuable Goldman, believe me would have not even allowed it to be shown on the screen in the court room…you can almost guarantee that. So again this just sounds like some frequently used modules and all trading software has free and open source modules in it, so be smart and tell us what “kind” of code was taken, please. BD

Nearly four years after Mr. Aleynikov's first arrest, two big questions remain: How much is the allegedly purloined computer code really worth? And what does it do?

Few people even know exactly what Mr. Aleynikov took with him when he quit Goldman. At the first trial, a federal judge closed the courtroom to observers whenever portions of the code were discussed or shown in detail. The move was made at the request of Goldman, which said the code was too valuable to show to the public, according to court documents. Goldman declined to provide the code to The Wall Street Journal, and the judge hasn't unsealed the evidence.

Mr. Aleynikov began his programming career as a teenager at a Moscow mining college, working on Bulgarian computers that stored data on audiocassette tapes. He learned to write basic algorithms in a language that was developed by IBM Corp. IBM +0.30% in the 1950s.

At Goldman, Mr. Aleynikov worked on technology built on the remnants of software created by Blair Hull, a math genius and former blackjack player who developed successful principles for when to hold, hit or double down. In 1973, Mr. Hull applied his blackjack approach to stocks, creating an algorithm that could spit out a valuation for a stock option.

In the 1990s, he created the "Hull three-factor model" to analyze stocks. That methodology became the basis for instant, computerized stock trading. Goldman bought Mr. Hull's company in 1999 for $500 million. Federal prosecutors alleged that what Mr. Aleynikov took was worth $500 million on its own.

According to Mr. Hull, the real value isn't in Goldman's computer code. "It's people and machines that make that thing go," he said. To Mr. Aleynikov, the value of taking the code would have been saving time by applying bits and pieces of it, not trying to duplicate Goldman's high-frequency operation, Mr. Hull said.

"He said he downloaded some files and he realized after it wasn't the right thing to do and he shouldn't have done it," said David Manifold, a former colleague and friend who talked to Mr. Aleynikov after his arrest. "He didn't seem to think it was that serious." Mr. Manifold said he doesn't understand why Mr. Aleynikov would have the motive to take the code—or why it even matters. "He could sit down and rewrite the whole thing better," he said.

http://online.wsj.com/article/SB10001424127887324049504578543431598311280.html

States Slowly Getting Insurance Exchanges Set Up as Federal Exchange Hub Built By United Health Group Subsidiary. QSSI Still Remains a Mystery

6/13/2013 11:11:00 PM Insurance, Medically Related, My Commentaries

If you read around the web you have heard about the California efforts and several other states and this article talks about Maryland and their progress, but I keep seeing the same comments about the somewhat mysterious “Federal Data Hub” that QSSI, a subsidiary of United received a contract to build. QSSI is also still a topic of conversation on their contract award with HHS as well so that adds some heat to the fire of inquisitions. Colorado is asking some of the same questions but United Healthcare has their Colorado CEO sitting on the board of members to manage their exchange. Colorado has spent over $66 million haired CGI group to set it up.

If you go back in time a few months, the award to build the federal hub to QSSI has been the topic of conflicts of interest as well. What is also interesting is that we keep hearing that United themselves are not committing to participate as one of the insurers in most states, do they know something we don’t:)

It is difficult to know QSSI’s role because its contract is not publicly available and HHS did not provide a copy. A draft statement of work issued by HHS and used for the bidding process offers a glimpse of what the contract entails.

The contract was awarded to QSSI in September and then also in September, United bought them. In July, Steve Larsen left HHS and went to work for Optum as a VP, a big United Healthcare company…so does something sound fishy here? When HHS became aware of the acquisition, it was too late to cancel the contract because all was moving too far behind so HHS set up a firewall to block United Health Group from gaining access to QSSI’s data. Then the work stopped on the firewall and the acquisition was reported to the SEC and this was done after the election.

US Health Insurance Regulator Leaving to Take a Job at UnitedHealth Care As Vice President of the Optum Division – Moving to the “For Profit Side” With Business Intelligence Algorithm Dollars To Review

If you read here often enough then you have seen the “subsidiary watch” posts I have here related to healthcare mergers and acquisitions and about 70% of them are about Untied Healthcare and companies they buy or create. You can read more about their LHI division here which I rolled into a Tri-Care post, and I’ll bet you didn’t even know this division existed. They have contracts with the DOD, VA and other military entities and do occupational health, VA disability exams and more so in addition to Tri-Care one more way they make big money. So it appears while HHS was working on the exchanges, United was working on DOD, VA and other entities.

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

If you read the post, (link below) Untied created a separate subsidiary just to go after Tri-Care business, that’s it. When you look at the LHI it might make a little more sense on why they sued the DOD for the western contract as they would want to collaborate on the two subsidiaries both being military related and providing outsourced services. Just do a search on this blog using the words subsidiary watch and you will find truckloads of Untied subsidiaries and what they do. United also lost a case in the Supreme Court this week with not allowing doctors to assemble in groups to settle unfair insurance practices.

United Healthcare Referral Algorithms Not Working Well With Tri-Care, Company Moving Their Subsidiary Execs Around, DOD Could Fine The Company Later–Subsidiary Watch

There will also be a user’s fee so I guess this could be attributed to absorbing some of the cost for the federal hub? It will be interesting but with all the acquisitions and created subsidiaries is United too big to fail? Here’s one more example of making money selling data and of course they have been doing that via subsidiaries for years with prescription data.

More Data For Sale Soon With Shared Clarity With United Healthcare Labs and Dignity Health–Crunching Numbers on Medical Devices With Shared Clarity

United Healthcare Buys Humedica and Gets More Data to Analyze and Sell To Medical Device and Drug Companies–More Big Profits From Health Data

It certainly looks like United is out with their formulas and math getting what they want, more government business, enough to where they maybe don’t need the policies to be created by exchanges?

United Healthcare Wants a Bigger Portion of the Government Health Insurance–More Model Complexities–It’s a Wait and See To Determine How the Algorithms Will Play Together

It looks like all the way around United with the work of their subsidiaries has just flat out modeled HHS and I keep saying hire some modeling quants to work for the government to keep up. Back in 2009 I said technology was going to eat up Sebelius and HHS and with all the business United controls, I think they did.

I like technology and what it can do but at this point even I have to say what in the heck has been built here and where’s the value!! This is a mess and it’s not going to flow well at all.

Hats off to all who have poured hours of time and dedication from the IT end of all of this as it’s a lot of work, but gee can we get someone running HHS with some technology in their background? There’s no thinking on one’s feet here and everything depends on staff sadly. The Consumer Watchdog warned her about insurance companies back in 2010. These tech breakthroughs to save the day or just not there, but the time and expense is so the wish to “hurry up technology”…well you know that tune…”the short order code kitchen burned down a few years ago and there was no fire sale”. Perhaps a little Algo Duping going on here and there are others in the cabinet with that issue as well.

HHS Secretary Sebelius Still Looking for Tech Breakthroughs To Save the Day

WHAT IN THE WORLD HAVE WE DONE? TIME FOR SOME SERIOUS SINGLE PAYER DISCUSSIONS AS THIS CAN’T SUSTAIN ITSELF WITH PRIVATE INDUSTRY CONSTANTLY OUTMODELING GOVERNMENT IN KEY AREAS SUCH AS HEALTHCARE. BD

Second, apparently the Federal Data Hub is up and running. While that is what the Obama administration has been telling us, it has been hard to find anyone who has actually seen it or used it.

Third, Maryland has its system ready to exchange eligibility and premium information with the health insurance plans - - perhaps the biggest challenge the new exchanges, state or federal, face.

We don't know any details on just where they are and if they are on track. They continue to tell us they will be ready on October 1 to begin enrollment and on January 1 to exchange billing and eligibility information with the health plans - - by far the toughest challenge.

But why all of the secrecy? Why aren't we getting the same reports from the Obama administration we are getting from Maryland? Why isn't the GAO doing a report on just where the administration is in the 35 states' exchanges they will now manage?

Appeals Court Grants 10% Medicaid Cut In California for Doctors, Meanwhile Back at the Ranch the State Can’t Decide How to Spend the Estimated 1 to 4 Billion Dollar Surplus

6/13/2013 05:09:00 PM Insurance, Medically Related

This is a tough cut as it is retroactive to June 2011, so Medicaid patients in California are not getting a good break as many doctors will decide not to mess with it any longer as the pay is at the bottom of the barrel for doctors. Well let’s see we have thing thing called “insurance exchanges” coming soon and subsidies will be provided there so if that part is in motion and not enough doctors to see patients…what has been accomplished?

The surplus amount is not finalized yet but between 1 and 4 billion is what is being projected as reported in the New York Times less than a month ago. The state saves half a million with this cut; however, what doctors see in actual losses is roughly a billion in losing federal and state funds. This could go to the Supreme Court. This week the Supreme Court also ruled in favor of doctors to now allow them to organize in groups to work with resolving unfair practices by insurance companies, so now it’s not just one guy or gal as and MD up against a huge corporation any longer. Contracts the doctors had to sign to be in network had that “bully” stipulation which now has to be reversed as this decision against a subsidiary of United Healthcare stated.

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

As this AMA article reads, HHS tried to get the cut reversed by it was ruled they had no authority.

“Some doctors with Medicaid patient bases of 50% or higher are especially concerned about how this pay cut will affect their overhead. Pamela Davis, MD, a family physician in Northridge, near Los Angeles, whose practice is 70% Medi-Cal, said the results could be “devastating.” Medicaid currently pays just a third of what physicians receive from other payers, and the cut will drop that figure down to about 20%, she said. Dr. Davis said she hopes she isn’t forced to lay off staff or cut the number of patients she sees. “It’s unbelievable that in this era where we need primary care doctors, money is being taken away.”

How low does it go, about 51% of what Medicare pays. It gets more complex too as the provisions of the ACA gives the doctors an increase by exempting some who are eligible but those providing primary care service who don’t qualify will get the 10% decrease. Nobody has an answer yet on how the 10% cut interacts with the Accountable Care Provisions either..everyone is confused. The ACA act also down the road has a 5% cutback on future payments…so this model looks broken all the way around as nobody, even the Query Masters can give a definitive answer., so where does that California surplus go? BD

Washington Physicians and other health care professionals in California blasted a federal appeals court’s decision to uphold a 10% Medicaid rate cut approved by the state, predicting a dismal future for patient access under the program. Organizations representing the professionals responded to the ruling by laying the groundwork for a possible appeal to the U.S. Supreme Court.

On May 24, the 9th U.S. Circuit Court of Appeals denied a petition that had been filed by various health care organizations to prevent the state from reducing their Medicaid pay. The first of several rounds of cuts initially was enacted in 2008 to help offset budget shortfalls, but a series of legal battles between California’s medical associations and state and federal regulators had delayed their implementation.

The state expects to save about a half-million dollars annually from the reductions, but for California’s health care professionals, this amounts to a roughly $1 billion loss in state and federal funds, said Lisa Folberg, vice president of medical and regulatory policy with the California Medical Assn.

Folberg emphasized that the rate revision is “a 10% cut in perpetuity” and is retroactive to June 1, 2011. “As a result, moving forward, physicians can expect to see a reduction exceeding 10% until the retroactive collections are all made.”

Some doctors with Medicaid patient bases of 50% or higher are especially concerned about how this pay cut will affect their overhead. Pamela Davis, MD, a family physician in Northridge, near Los Angeles, whose practice is 70% Medi-Cal, said the results could be “devastating.” Medicaid currently pays just a third of what physicians receive from other payers, and the cut will drop that figure down to about 20%, she said. Dr. Davis said she hopes she isn’t forced to lay off staff or cut the number of patients she sees. “It’s unbelievable that in this era where we need primary care doctors, money is being taken away.”

http://amednews.com/article/20130610/government/130619972/6/

Restless Leg Syndrome Study “May” Lead Men to Early Deaths? Does This Have a “P” Value To Give It Some Context?

6/13/2013 03:38:00 PM Medically Related, Other Items of Interest

The “media shocking headlines” is what makes this kind of well, silly as it is done to get attention obviously and when you read through here numbers were crunched and those with the standard chronic illness were eliminated. So now what? As it mentions lack of sleep contributes to shorter mortality and we have seen those numbers out there, but good grief give me a break on the “urgency” stated in the “context” of this study would you? Is every man out there with RLS going to wonder if that’s going to make him die sooner? 10% more of the RLS patients died over an 8 year period than those who do not have it. Back in 2008 we had this study to where your risk of stroke doubles …and you can do what you want with that.

Restless Legs Syndrome Doubles Risk Of Stroke And Heart Disease

Old age, being fat, smoking, inactivity and all the usual evil twin lifestyle elements also made no difference. What drugs were the men taking who had RLS in the study..didn’t see that anywhere…hmmm…anti-nausea drugs or antipsychotics can contribute to RLS the article says as well….so what did we learn here? If you read beyond the “contextual title’ created to present some sense of urgency then you can just go about your day as usual:) Here’s a good introduction to P Values.

Scroll on down to the footer of this blog to watch the first video or click here and you can find out what P-Values are and how some studies can either dupe or distract or mislead you. Context is everything. BD

Researchers looked at more than 18,000 men who went to a doctor to get evaluated for the neurological disorder, and tracked them for about eight years. They found men who were diagnosed with the syndrome were about 40 percent more likely to die prematurely compared to men without the condition.

"Our study highlights the importance of recognizing this common but underdiagnosed disease," study author Dr. Xiang Gao, an associate professor of medicine and epidemiology at Harvard School of Public Health and Harvard Medical School, said in a statement.

Dr. Steven Feinsilver, director of the Center for Sleep Medicine at the Mount Sinai School of Medicine in New York City, explained to CBSNews.com that about 90 percent of people who have ever experienced these symptoms during their lifetimes won't need treatment, pointing out the remainder may experience disabling symptoms that prevent them from even sitting for 10 minutes at a time.

"If its associated with mortality, I may have to rethink that," said Feinsilver, who was not involved in the new research.

"We found that the increased risk was not associated with the usual known risk factors, such as older age, being overweight, lack of sleep, smoking, being physically inactive and having an unhealthy diet," Gao said. "Through research, we need to pinpoint why and how RLS leads to this possible higher risk of dying early."

The findings were published June 13 in Neurology.

http://www.cbsnews.com/8301-204_162-57589207/restless-legs-syndrome-may-lead-men-to-early-death/

House Committee Investigating IRS Agents For Improperly Seizing 60 Million Medical Records, Threating to Rip The Servers Out…

6/13/2013 12:24:00 AM Medically Related, Technology

Oh heck maybe I don’t know what I am talking about here but a few months ago before this made the news I thought it mightt be a good idea to take HIPAA out of the HHS silo, in other words republish the rules and laws in some format in other places. The IRS with their involvement with healthcare is new and so what do they know, right? You can read about this idea at the link below.

Time to Take HIPAA Out of the Healthcare Silo–Needs to Be Integrated In Overall Privacy Laws Healthcare Information Is All Over The Place And Privacy Efforts Will Fail Without Real Algorithmic Levels of Regulation

A lawsuit has already been filed over the alleged HIPAA violations. You know again with the IRS exploring new territory here, this could have been just some enforcement officers that have never studied HIPAA, can happen.

IRS Facing Lawsuit Over HIPAA Violations Considered a Data Breach of Ten Million Records With Unauthorized Seizure

Like everyone else I am curious to see who the unnamed healthcare provider is and the court documents were filed in San Diego which may or may not offer a clue of some sort as to who it was. Had to be big if they are claiming 60 million here, so that seems bigger than a hospital and maybe an HMO or insurance company? I guess we will have to wait and see. In other news the IRS has admitted to using social networks to check up on you as well if they feel the need. Sow what did they do with the servers? Inquiring minds want to know:)

IRS Using Facebook and Twitter as Part of Their Intelligence–Opportunities to Sell Data Continue As Private Industry and Government Cash In On Intangibles Leaving Tangibles in the Dust…

A U.S. House committee is investigating whether Internal Revenue Service agents improperly seized private medical records. The IRS is already being sued for the seizure of 60 million medical records, which is alleged to be a violation of the Fourth Amendment's Search and Seizure Clause.

In March 2011, IRS agents used a search warrant to seize the medical records from an unnamed California health care provider in its pursuit of a tax violation by a former employee of the company, according to Courthouse News Service. The suit, filed March 11, 2013, claims that the search warrant did not authorize the seizure of medical records of those who were not suspects in the case. More than 60 million medical records of more than 10 million Americans were seized, according to the complaint.

The complaint states that the records "contained intimate and private information" such as "psychological counseling, gynecological counseling, [and] sexual or drug treatment."

The suit also alleges that the IRS agents involved in the raid "threatened to 'rip' the servers containing the medical data out of the building" if the records were not handed over.

http://www.christianpost.com/news/irs-under-investigation-for-seizure-of-60-million-medical-records-97852/

Glaxo Drug Tests Put on Hold for Multiple Sclerosis After Claims of Fraud In Scientific Paper–Researcher Fired in China

6/12/2013 11:50:00 PM Medically Related, Pharma/FDA News

Glaxo in the UK was reviewing the data on the drug which was in early clinical trials. Someone gave Glaxo a tip on the data and information being misrepresented and fired the researcher. The company has not stopped tests and will continue to study for use with other auto-immune diseases. The researcher denies falsifying any data in the reports.

We have heard this time after time with science and medical journals. so much to the point to where PLOS one published a paper on who to look for P Values that have been “fiddled” with in the area of showing value. BD

PLOS One Abstract–Methodology for Detecting Manipulation of “P Values” To Show Significant Statistical Value, “Inappropriate Fiddling” Which Can Lead to “Algo Duping” Situations And Numbers

GlaxoSmithKline has put on hold tests on human volunteers of an experimental compound for multiple sclerosis, after claims of fraud in a scientific paper that led it to dismiss its top researcher in China.

The UK company said it was reviewing the data on GSK 2618960, which was in early stage clinical trials as a compound using a mechanism identified in the paper published in 2010 in the journal Nature Medicine.

Despite the apparent falsification, research has confirmed the potential for the possible drug which is being studied by GSK and other pharmaceutical companies

http://www.ft.com/intl/cms/s/0/f9531616-d379-11e2-b3ff-00144feab7de.html#axzz2W2kQRDDR

US Surgeon General Regina Benjamin Resigns

6/12/2013 11:18:00 PM Medically Related, Personal Health Records

There’s no big story here with her resignation other than the fact that she plans to return to Alabama and donate time at a rural clinic as she was doing before being appointed. Like every other government entity the office had plenty of apps and does provide a PHR, which for some reason or another doesn’t get a lot of attention and I asked if the doctor was a user herself at one point. There was actually a lot of coding done to have the PHR integrate with other systems but at least in the media, it never really took off. It is still there if you want to use it as your choice of a PHR and integrates with HealthVault. BD

Surgeon General Announces Yet Another App Contest Maybe to Promote Their PHR “My Family Health Portrait”? Does She Use The PHR Personally?

U.S. Surgeon General Regina Benjamin said she would step down next month.

“We are grateful for her leadership and service,” said Dori Salcido, a Department of Health and Human Services spokeswoman.

Dr. Benjamin has served in the post since being named by President Barack Obama in 2009. During her tenure as “America’s doctor,” she has promoted physical activity and efforts to prevent and stop smoking by children and adolescents.

The U.S. Public Health Service Commissioned Corps, which is overseen by the surgeon general, is made up of about 6,500 people who work in several government agencies including the National Institutes of Health and the Food and Drug Administration.

http://blogs.wsj.com/washwire/2013/06/12/surgeon-general-to-step-down/

United Healthcare Referral Algorithms Not Working Well With Tri-Care, Company Moving Their Subsidiary Execs Around, DOD Could Fine The Company Later–Subsidiary Watch

6/12/2013 12:05:00 AM Insurance, Medically Related, Other Items of Interest

This company has more subsidiaries than Carter has pills. Due to doctor and patient complaints on referrals, the DOD is keeping a close watch and United said they are getting things in order. Well moving a CEO from one subsidiary to another should do it, right..not really it’s the automated algorithmic processes that need to work but to show they were addressing the situation they moved people around. I was not aware of the UnitedHealthcare Military & Veterans Inc. that was created just to go after Tri-Care contracts..and they did..they sued the government in a long drawn out affair for the west after they lost the bid on the south portion of the Tri-Care area of the US. If you read more about the LHI subsidiary maybe this had something to do with the lawsuit as it also is contracted to the military and the VA and they wanted LHI and Tri-Care to work with both subs?

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

UnitedHealth Loses Tri-Care Protest Again With Contract Awarded to Humana in the South-Now Protesting Contracts Awarded In Both the South and the Western States

The company is moving a person over from the LHI United Subsidiary over to the Military and Veterans subsidiary. The LHI subsidiary of United conducts VA DEM disability exams and is looking for more doctors to enroll in the program and they have a website set up to where the exam information is entered (one more thing for a participating physician to learn) and the results are populated directly to the VA records via the web service, so I guess this means that this subsidiary of United can populate a VA chart? It sounds that way from what I am reading here. So in addition to Tri-Care services, United also appears to be making money with the VA and other areas of the military with the LHI subsidiary in having a contract to help the VA catch up with their disability claims.

From the website it appears the government is one of the main clients of LHI (or maybe the only one) as the company comes in and does an “event” on location for physicals, etc. for the military. You can read more about this United Healthcare subsidiary and their services they provide to the VA here with their contract to provide clinical disability exams for the vets. I swear this company with their subsidiaries is every where getting a part of the action and in the world of insurers, do we have a too big to fail company here? The corporation has board members sitting around all over the corporate world too and some come from subsidiaries.

The military has given United another month to address the problems with the United Healthcare Military subsidiary and has until June 18th to clean things up or United could get yet another extension. BD

UnitedHealthcare Military & Veterans Inc. has changed leaders after encountering serious problems administering a new $20.5 billion federal contract to provide health care to active military members, retirees and their families in 21 states, including Minnesota.

Tina Jonas, a former undersecretary of defense now presiding over a UnitedHealth Group subsidiary called Logistics Health Inc., will take a newly created position of president at UnitedHealthcare Military & Veterans, said Bruce Jasurda, the company’s vice president of communications. The company did not name a CEO.

“We have substantially processed the pending referrals and authorizations, largely clearing the previously existing queue,” Jasurda said. “We are confident that we will continue to process referrals and authorizations after the June 18 waiver expiration in a timely manner consistent with DoD [Department of Defense] guidelines.”

UnitedHealth formed UnitedHealthcare Military & Veterans Inc. in 2007 specifically to go after Tricare contracts. McDougal, who has been working at UnitedHealth since 1983, was originally named chief operating officer. She became CEO in early 2008.

http://www.startribune.com/business/211121181.html?page=1&c=y

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

6/11/2013 04:05:00 PM Insurance, Medically Related

This was written into their contracts…and I agree with the Supreme Court on this one for sure and it has plagued physicians for years. This contract provision is probably the works of one of the United big lobbyists groups. They are everywhere and United even hired Steve Larson from HHS and made him a VP at the Optum division. Steve Larsen is credited with writing most of the healthcare reform law. The decision is final and no reruns for Oxford. This goes back to 2003 and if you look at the little guys up against the big guys with millions to spend on legal cases this is a nice victory for the doctors as insurers knew that arbitrating against one MD at a time improved their chances by allowing under payments to continue as well as contract violations.

We can also reflect back on the under payments lawsuit settled by the AMA with United and the other major insurers that licensed their algorithms to short pay doctors and hospitals for 15 years.

AMA Announced Settlement of Class Action Suit of $350 Million with Ingenix (United Healthcare)

Here’s where Aetna just settled their 15 years of short payments using algorithms from Ingenix, now called Optum. If this is not about context and using an advantage of data over one physician at a time, I don’t know what is.

Aetna Payment of $120 Million To Settle 15 Year Ingenix/United HealthCare Out of Network Erroneous Payment Algorithms Cuts Income for 4th Quarter

In addition there are still quite a few lawsuits floating around out there relative to the AMA class action suit that take up the 15 years of short pay, but are their own lawsuits.

Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

Skins game with dermatology offices in California – Ingenix

When I write about articles like this today, I think of Snowden..it’s all about context and with doctors not allowing to group and arbitrate as a group this is as about as close as to what I would call the “bully” effect as when you line up a huge corporation with tons of lawyers on board against one MD and with a big bankroll for court appearance, how do they stand a chance? We get this too as consumers as well in other areas of healthcare so nice to see the Supreme Court cut the bullies down a little with contract provisions. We already know that United and their subsidiaries makes millions selling our data as well.

Contract provisions can easily be taken out of context in court as we see it all the time. This contract provision is could be classified as “corporate algorithm balls” in my opinion. BD

Washington, D.C. – The American Medical Association (AMA) and the Medical Society of New Jersey (MSNJ) heralded yesterday’s decision by the U.S. Supreme Court allowing individual physicians to come together as a group to fight the unfair business practices of large health insurance companies.

“This important ruling allows thousands of physicians to use class arbitration against a health insurer that has underpaid them for more than a decade,” said AMA President Jeremy A. Lazarus, M.D. “Without this broad-scale arbitration, physicians would have no practical means of challenging a health insurer's unfair payment practices.”

“It is a sad commentary that it took a decade for Dr. Sutter and other New Jersey physicians to exercise the dispute mechanism allowed by their contracts,” said MSNJ General Counsel Melinda Martinson. “A timely class-arbitration would have allowed them to have their payment disputes resolved more expeditiously and cost-effectively. The decision is welcome news to physicians in New Jersey and all who are concerned with reducing the cost of medicine in this country.”

The decision in Sutter v. Oxford Health Plans concludes a dispute dating back to September 2003 when New Jersey pediatrician John Sutter, M.D., alleged that Oxford Health Plans had systematically bundled, down coded and delayed payments for his services and those of 20,000 other physicians in its network. Oxford Health Plans had challenged legal decisions supporting class arbitration of the dispute and appealed the case to the U.S. Supreme Court.

The high court’s ruling in favor of physicians gives a boost to the medical profession’s efforts to address unfair corporate policies of large health insurers that are bad for patients and physicians.

http://www.ama-assn.org/ama/pub/news/news/2013/2013-06-11-supreme-court-arbitration-health-insurer.page

Healthcare Reform Continues to Expand and Grow CEO and Executive Compensation in the Millions…

6/11/2013 02:57:00 PM Insurance

Everyone out there is getting hurt in some way, the sequester, budgets, you name it, all but the CEOs of health insurance companies. $47 Million was the topper at United Healthcare, which pretty much doesn’t even resemble the way the company operated just 15 years ago with so many subsidiaries and analytics divisions. Have you also noticed that most are not participating in many state insurance exchanges with the exception of Blue Cross?

I have been in Phoenix for a few weeks and boy I can certainly see the changes here with health insurance buildings now lining the sky line and I guess they need to have places to put all the new data miners insurers are hiring right and left too. I haven’t heard of any of these folks donating either to the HHS campaign to help with healthcare reform come to think of it. BD

The highest-paid executive at each of the "Big Five'' health insurers -- UnitedHealth Group, Aetna Inc., WellPoint Inc., Humana Inc. and Cigna Corp. -- made more than $8 million each in 2012, according to filings this spring with the Securities and Exchange Commission. The CEO of EmblemHealth Inc., a nonprofit that owns ConnectiCare, also had total compensation at that level in 2011, the last year for which information is available.

Pay for top management teams -- the five highest-paid executives at each company -- ranged from $21 million at Humana to $47 million at United Health. Compensation includes salary, bonus, stock gifts and options granted that year, non-equity pay and benefits.

"People don't begrudge good incomes. But when is enough ever enough?" she asked. "Insurers are definitely feeling the pressure. How they will respond is still in question."

http://www.ctpost.com/local/article/Top-health-insurance-bosses-earn-millions-4592322.php#ixzz2Vwl8Ri00