Entries by David Anderson

Words to look for sabotage of the ACA

Charles Gaba is doing his usual exceptional work of tracking rate increase requests from insurers that want to sell plans on Exchange. He recently highlighted Oregon’s initial requests. As I was reading through the actuarial summaries, the different insurers modeled sabotage risk differently. Two carriers effectively discounted it. The rest are extremely concerned. I will […]

Pens vs. Sens open thread

Let’s avoid talking about the newest round of crazy that has been dropped on us by the Orange Gibbon and enjoy a great hockey game tonight! **     ** This post written on Monday evening with no knowledge of what the cray-cray will be but high confidence that there will be said crazy.   […]

Oh boy… now it is getting real and weird

BREAKING: DOJ appoints former FBI director Robert Mueller as special counsel to investigate Trump-Russia ties https://t.co/xBIBWBXc3p pic.twitter.com/KXaKPvfjsa — HuffPost (@HuffPost) May 17, 2017 Oh yeah, the Majority Leader in the House is arguing that his statement on tape that the statement he made that the current President and a senior member of his caucus were […]

Oscar’s strategy change goes Meh

Zachary Tracer at Bloomberg recently reported on Oscar’s first quarter results. They are mixed. They are only losing $25 million dollars this quarter instead of almost $50 million dollars. The privately held health insurer, created to sell plans under the Affordable Care Act, lost $25.8 million across three states in the first three months of […]

Things that make you go hmm….

Just saw this tweet from a reporter at the Hill: Durbin tells me it's ok for Dems to meet with Cassidy/Collins on healthcare b/c those 2 are "beyond repeal" https://t.co/F0RBQb8GvR pic.twitter.com/recMUqHDm3 — Peter Sullivan (@PeterSullivan4) May 16, 2017 When I read through Cassidy-Collins in January, my impression was that this was the contours of a […]

Medicare Advantage aggressive coding or fraud

The New York Times has a good story from the 15th on a False Claims Act lawsuit filed by a former United Healthcare employee.  It alleges UHC systemically defrauded the US government of billions from up-coding its Medicare Advantage claims to get bigger risk adjustment payments.  This is a big deal.  Medicare knows that the […]