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Message
re: UNH's UnitedHealth CEO shot and killed
Posted on 12/6/24 at 8:37 am to REG861
Posted on 12/6/24 at 8:37 am to REG861
quote:
United is by far the worst offender for denying care under Medicare advantage , vastly outpacing bcbs and others. The OIG has documented this. United is getting our money to provide care under MA and then breaking their contractual obligations to do so. As others have said, it’s crony capitalism at its worst. When the congressional investigations come United will be first against the wall.
LINK
No, they aren't. You guys gotta stop making shite up... lol
Also, the BCBS companies (2 per member) require PA's at more than 2x the rate of UHC (.9 per member). BCBS companies have a PA denial rate of 6.3% versus 8.7% for UHC.
Posted on 12/6/24 at 8:40 am to LegendInMyMind
quote:
Now, that would be a hard pivot. After all the hypotheticals and gossip if this all turns out to be a domestic issue just like regular old poor people there are going to be a lot of disappointed people.
Personally, I’m hoping it’s either this or he FAFO’d with the mob or some cartel.
Probably not a popular opinion here, but I prefer that we don’t have a country where executives are shot in the street for running companies that people don’t like.
Posted on 12/6/24 at 8:40 am to bcflash
quote:
Guy was separated from his “ estranged “ wife… now the real stuff starts.. shacked up with killers wife?? Wife hires hitman???
This makes it seem almost certain it was a vengeance killing:
quote:
The three words were written on the ammunition a masked gunman used to kill UnitedHealthcare CEO Brian Thompson, according to two law enforcement officials who spoke to The Associated Press on condition of anonymity Thursday. They’re similar to the phrase “delay, deny, defend” — the way some attorneys describe how insurers deny services and payment, and the title of a 2010 book that was highly critical of the industry.
Posted on 12/6/24 at 8:41 am to Wiener
quote:
You've covered yourself with the word "almost" everywhere.
Thats because I try to not speak in absolutes. It's intentional and remains true.
quote:
I order medically necessary things for patients that get denied on an almost regular basis.
I don't doubt that you and others do. But, without reviewing one request or your notes I can confidently say after reviewing hundreds and hundreds of denied requests that ALMOST all denials for medically necessary services are because of shortfalls in documentation, coding or some other error in the actual submission of the request.
Be honest, regardless of payor, you're not seeing an abundance of denials for medically covered requests when whatever criteria (interqual, etc) is met, documented and the request is submitted correctly. Are errors made sometimes, sure but the vast majority of medically necessity requests are approved and many of them are auto approved without review,.
Posted on 12/6/24 at 8:42 am to Dadren
quote:
Personally, I’m hoping it’s either this or he FAFO’d with the mob or some cartel.
Probably not a popular opinion here, but I prefer that we don’t have a country where executives are shot in the street for running companies that people don’t like.
Someone downvoted this, which is scary. Might be some legit psychos in this thread.
Posted on 12/6/24 at 8:43 am to Dadren
quote:
Personally, I’m hoping it’s either this or he FAFO’d with the mob or some cartel.
I’m sure the mob or cartel hired some white nerd to do their dirty work
Posted on 12/6/24 at 8:45 am to gdzgft28
quote:
No, they aren't. You guys gotta stop making shite up... lol Also, the BCBS companies (2 per member) require PA's at more than 2x the rate of UHC (.9 per member). BCBS companies have a PA denial rate of 6.3% versus 8.7% for UHC.
Your link shows nothing relevant, but here’s something for you to chew on:
https://www.aha.org/news/headline/2024-10-17-senate-report-scrutinizes-medicare-advantage-prior-authorization-denials-post-acute-care-services
quote:
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care. The subcommittee sought documents and information from the three largest MA insurance companies — UnitedHealthcare, Humana and CVS — and investigated their practice of “intentionally using prior authorization to boost profits by targeting costly yet critical stays in post-acute care facilities.” The report found that between 2019 and 2022, UHC, Humana and CVS denied prior authorization requests for post-acute care at far higher rates than other types of care. In 2022, UHC and CVS denied prior authorization requests for post-acute care at approximately three times higher than the companies' overall denial rat
Let me know if you need help responding to your subpoena. Thanks for playing!
This post was edited on 12/6/24 at 8:46 am
Posted on 12/6/24 at 8:47 am to LegendInMyMind
quote:
Now, that would be a hard pivot. After all the hypotheticals and gossip if this all turns out to be a domestic issue just like regular old poor people there are going to be a lot of disappointed people.
i am rooting for a dog day afternoon situation
Posted on 12/6/24 at 8:47 am to REG861
quote:
Your link shows nothing relevant, but here’s something for you to chew on:
You wouldn’t know what’s relevant if it slapped you in the face. My link concerns denial rates for ALL prior authorizations… yours is concerning only acute care. And your link doesn't say that UHC denies acute care at a higher rate than other companies, only that it denies it at a higher rate than other forms of care. You don't even understand what your reading, dummy.
quote:
The report found that between 2019 and 2022, UHC, Humana and CVS denied prior authorization requests for post-acute care at far higher rates than other types of care. In 2022, UHC and CVS denied prior authorization requests for post-acute care at approximately three times higher than the companies
lol… it’s like you guys don’t understand words and numbers…
This post was edited on 12/6/24 at 9:57 am
Posted on 12/6/24 at 8:50 am to Chucktown_Badger
quote:
How is that not possible now?
I mean as individuals.
Posted on 12/6/24 at 8:51 am to Chucktown_Badger
quote:
Someone downvoted this, which is scary. Might be some legit psychos in this thread.
Hopefully it’s just a matter of it being an internet interface where people click without really making a true moral decision.
A lot of otherwise normal folks have that frick’em/FAFO feeling these days.
We all need to be better and in many ways.
This post was edited on 12/6/24 at 8:52 am
Posted on 12/6/24 at 9:00 am to REG861
quote:
costly yet critical stays in post-acute care facilities
This is more of a referendum on medicare advantage as a whole. With original medicare skilled nursing is given out like candy. With managed care (medicare advantage) request are reviewed and granted in more "necessary" situations whereas with medicare, they do not have prior authorization reviews and will pay up to 100 days. People can bill whatever they want and SOMETIMES Medicare does retrospective reviews and takes back money if they seem something wasn't necessary BUT the money that is earned as whole makes the gamble worth it.
Post acute facilities LOVE original medicare because they can keep a patient there as long as they need or want to fill a bed and don't ever have to prove medical necessity until MAYBE after the payments have been made on not even on that many so it's an easy revenue source. This is one reason Medicare is dead arse broke; it's so easily abused, overused and frauded.
Posted on 12/6/24 at 10:06 am to REG861
quote:
When the congressional investigations come United will be first against the wall.
Well a civilian already did an investigation and put the CEO against the wall. And some people like this tool can't understand why no one is sad.
Posted on 12/6/24 at 10:08 am to Dadren
quote:
Probably not a popular opinion here, but I prefer that we don’t have a country where executives are shot in the street for running companies that people don’t like.
I think everyone would agree with that in principle. The issue is the agency that is supposed to keep them in check, the government, is in bed with them.
So what choice is left?
Posted on 12/6/24 at 10:16 am to IT_Dawg
quote:
I said 2 days ago it was probably the wifes boyfriend and she helped him with the logistics of the travel since he would have to coordinate kids around travels.
Count me in the camp that believes this is more likely a hit and not a civilian seeking vengeance over denied insurance. I think it's clear the guy had help from someone who knew the CEO.
This post was edited on 12/6/24 at 10:22 am
Posted on 12/6/24 at 10:20 am to Goldrush25
quote:
Count me in the camp that believes this is more likely a hit and not a civilian seeking vengeance over denied insurance. I think it's clear the guy had help from someone.
It's always a higher likelihood that it's something personal. Maybe the CEO was fricking this guy's wife or girlfriend.
Posted on 12/6/24 at 10:41 am to LSUfan4444
quote:
I don't doubt that you and others do. But, without reviewing one request or your notes I can confidently say after reviewing hundreds and hundreds of denied requests that ALMOST all denials for medically necessary services are because of shortfalls in documentation, coding or some other error in the actual submission of the request.
This reads like advocating for increasingly complex documentation requirements (that aren't uniform between companies by the way) meant to initially deny with intent to delay/avoid paying for care.
Yes, most end up getting approved, but there's not really any arguing that it's done that way intentionally in hopes that we'll just tire of going through the approval process.
Posted on 12/6/24 at 10:46 am to Goldrush25
quote:
Count me in the camp that believes this is more likely a hit and not a civilian seeking vengeance over denied insurance. I think it's clear the guy had help from someone who knew the CEO.
I think there’s a question of whether the shooter was acting alone. He was using his burner phone in the minutes prior to the shooting. If it’s true about the unspent casings with writing on them then my thoughts lead to him being a fanatic.
This post was edited on 12/6/24 at 10:47 am
Posted on 12/6/24 at 11:00 am to TripleBarrelBluff1
quote:
A Clark County, Nevada, jury agreed with TeamHealth that United engaged in unfair reimbursement practices by deliberately failing to pay frontline emergency room doctors adequately for care provided to patients. The jury assessed about $60 million in punitive damages against UnitedHealthcare, finding it was guilty of fraud and malice in its conduct.
But the chart is wrong he screams.
To be fair, every company in the world that does $100 bil per quarter or $400 bil per year is going to have a shite ton of lawsuits for stuff like that.
Posted on 12/6/24 at 11:02 am to Decatur
quote:
If it’s true about the unspent casings with writing on them then my thoughts lead to him being a fanatic.
It really depends on how smart this person is. They could have potentially left that to throw off investigators.
There have been known criminals in the past that would leave random items at crime scenes just to muddle up the investigation.
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