National, Regional and Local News

[ti-amie]

Katie Phang
@KatiePhang
Interesting point raised by the DA: He advised that members of his office may appear tomorrow in court to express their objections to the resentencing.

[ti-amie]

Margaret Kimberley
@freedomrideblog
·
Oct 30
She was arrested and indicted.

If the camera had not been on I hate to think what story she would've concocted if he'd reported the incident. He also had the presence of mind to move his car to the curb so no one would be injured.

[ponchi101]

That is the kind of thing ONE MAN can inspire.
No way I can't believe the rise of this psycho is not connected to cases like this.

[mmmm8]

That is the kind of thing ONE MAN can inspire.
No way I can't believe the rise of this psycho is not connected to cases like this.

I wonder which way the causal link goes. I think it's cyclical.

[ponchi101]

I would say the chain is:
1. Tiny delivers his vitriol on foreigners in the USA.
2. It does not affect him one bit (he was elected president, after all)
3. Many of his affiliates behave the same way.
4. They get away with it
5. Lightbulb goes off: "Hey, this is not only acceptable, it is actually encouraged".

Tiny see people do it, he pumps up the volume. Yes, very well can be cyclical.

[ti-amie]

These people used to hide their beliefs/feelings in the shadows speaking about them with close, like minded family members since as the song from South Pacific says "you have to be taught to hate and fear".

Tiny has emboldened them using the term "free speech" which has now become code for saying you can say and do whatever you want against others because you're exercising your right to speak and act freely.

Hilary called them deplorable. She was right.

[mmmm8]

These people used to hide their beliefs/feelings in the shadows speaking about them with close, like minded family members since as the song from South Pacific says "you have to be taught to hate and fear".

Tiny has emboldened them using the term "free speech" which has now become code for saying you can say and do whatever you want against others because you're exercising your right to speak and act freely.

Hilary called them deplorable. She was right.

If only we could fit them all in a basket.

[mmmm8]

The CEO of UnitedHealthcare, Brian Thompson, was shot and killed this morning outside a Hilton a couple blocks from my office (also a couple blocks from tonight's Rockefeller Center Tree Lighting Ceremony.

https://apnews.com/article/manhattan-sh ... e0242f1683

[Owendonovan]

I've often wondered if these insurance C suite folks worry they'd be killed for not paying out claims. (considering few people have good experiences with insurance companies)
I don't know if that's the case here, but it was my first thought.

[ti-amie]

Anthem Blue Cross Blue Shield calls off surgery anesthesia cap

Nathan Bomey

A major health insurance company is backing off of a controversial plan to limit coverage of anesthesia, according to public officials.

Why it matters: Anthem Blue Cross Blue Shield recently decided to "no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes," according to the American Society of Anesthesiologists, which opposed the decision.

The decision covered plans in Connecticut, New York and Missouri.
The insurer had based the move on surgery time metrics from the Centers for Medicare and Medicaid Services, NPR reported.

Friction point: The decision was controversial at the time — but outrage erupted this week after the murder of UnitedHealthcare CEO Brian Thompson in New York City cast a spotlight on divisive insurance decisions.

The latest: "After hearing from people across the state about this concerning policy, my office reached out to Anthem, and I'm pleased to share this policy will no longer be going into effect here in Connecticut," Connecticut Comptroller Sean Scanlon said Thursday on X.

"We pushed Anthem to reverse course and today they will be announcing a full reversal of this misguided policy," New York Gov. Kathy Hochul said Thursday in a statement. "Don't mess with the health and well-being of New Yorkers — not on my watch."

Anthem representatives did not immediately respond to requests for comment.
The initial coverage decision was very unusual for a major health insurer, said Marianne Udow-Phillips, who teaches insurance classes at the University of Michigan School of Public Health and formerly made coverage decisions at Blue Cross Blue Shield of Michigan.

"When patients become financially responsible because a health plan cuts how much they pay providers, that's what breeds all this anger," Udow-Phillips tells Axios.
"This is a colorful and terrible example of administrative excess in the insurance industry, but boy, I tell you, it's just the tip of the iceberg," Gordon Morewood, an anesthesiologist and vice chair of ASA's Committee on Economics, tells Axios' Maya Goldman.
On social media, critics drew a direct line from controversial coverage decisions to the death of Thompson.

"When you shoot one man in the street it's murder. When you kill thousands of people in hospitals by taking away their ability to get treatment you're an entrepreneur," an X user wrote.
"Saw mainstream news coverage about the killing of the CEO of United Healthcare on TikTok and I think political and industry leaders might want to read the comments and think hard about them," activist Tobita Chow wrote on X.
The bottom line: The fact that public scorn toward insurance executives could turn into violence is a startling reflection of how social media outrage can translate into real-world consequences.

"I would never have thought at that time that I needed security," Udow-Phillips said of her time at BlueCross. "Does this give permission to other people? It's terrifying."
Editor's note: This report was updated with the statement from New York Gov. Kathy Hochul.

https://www.axios.com/2024/12/05/blue-c ... t-new-york

[ponchi101]

"Here's a piece of leather. Bite it!"

[Owendonovan]

"Here's a piece of leather. Bite it!"

LOL. If only for them. The comments sections of various news sources are in no way sympathetic to this mans murder. It's understandable. There's literally tens of thousands of stories of how insurance companies screwed someone over in a life changing, or ending way.

[ti-amie]

Torrent of Hate for Health Insurance Industry Follows C.E.O.’s Killing
The shooting death of a UnitedHealthcare executive in Manhattan has unleashed Americans’ frustrations with an industry that often denies coverage and reimbursement for medical claims.


Messages found on bullet casings at the scene of the Wednesday shooting — “delay” and “deny” — are two words familiar to many Americans who have interacted with insurance companies.Credit...Karsten Moran for The New York Times

By Dionne Searcey and Madison Malone Kircher
Dec. 5, 2024
Updated 4:09 p.m. ET

The fatal shooting on Wednesday of a top UnitedHealthcare executive, Brian Thompson, on a Manhattan sidewalk has unleashed a torrent of morbid glee from patients and others who say they have had negative experiences with health insurance companies at some of the hardest times of their lives.

It is unclear what motivated the incident or whether it was tied to Mr. Thompson’s work in the insurance industry. The police have yet to identify the shooter who is still on the loose.

But that did not stop social media commenters from leaping to conclusions and from showing a blatant lack of sympathy over the death of a man who was a husband and father of two children.

“Thoughts and deductibles to the family,” read one comment underneath a video of the shooting posted online by CNN. “Unfortunately my condolences are out-of-network.”

On TikTok, one user wrote, “I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick. I just can’t feel sympathy for him because of all of those patients and their families.”

The dark commentary after the death of Mr. Thompson, a 50-year-old insurance executive from Maple Grove, Minn., highlighted the anger and frustration over the state of health care in America, where those with private insurance often find themselves in Kafka-esque tangles while seeking reimbursement for medical treatment and are often denied.

Messages that law enforcement officials say were found on bullet casings at the scene of the shooting in front of a Midtown hotel — “delay” and “deny” — are two words familiar to many Americans who have interacted with insurance companies for almost anything other than routine doctor visits.

Mr. Thompson was chief executive of his company’s insurance division, which reported $281 billion in revenue last year, providing coverage to millions of Americans through the health plans it sold to individuals, employers and people under government programs like Medicare. The division employs roughly 140,000 people.

Mr. Thompson received a $10.2 million compensation package last year, a combination of $1 million in base pay and cash and stock grants. He was shot to death as he was walking toward the annual investor day for UnitedHealth Group, UnitedHealthcare’s parent company.

Stephan Meier, the chair of the management division at Columbia Business School, said the attack could send shock waves through the broader health insurance industry.

About seven chief executives of publicly traded companies die each year, he said, but almost always from health complications or accidents. A targeted attack could have much larger implications.

“The insurance industry is not the most loved, to put it mildly,” Mr. Meier said. “If you’re a C-suite executive of another insurance company, I would be thinking, What’s this mean for me? Am I next?”

A longtime employee of UnitedHealthcare said that workers at the company had been aware for years that members were unhappy. Mr. Thompson was one of the few executives who wanted to do something about it, said the employee, who spoke on condition of anonymity because the company does not allow workers to speak publicly without permission.

In speeches to employees, Mr. Thompson spoke about the need to change the state of health care coverage in the country and the culture of the company, topics other executives avoided, the employee said.

Already, there is heightened concern among some public-facing health care companies, said Eric Sean Clay, the president of the International Association for Healthcare Security and Safety. The trade group includes members that offer security to some of the largest health care companies in North America.

“The C.E.O.s are quite often the most visible face of an organization,” he said. “Sometimes people hate on that individual, and wish to do them harm.”

But few health care companies provide security for their executives, he said, in part to avoid bad optics, or because it may seem unnecessary.

In the hours after the shooting early Wednesday morning, social media exploded with anger toward the insurance industry and Mr. Thompson.

“I pay $1,300 a month for health insurance with an $8,000 deductible. ($23,000 yearly) When I finally reached that deductible, they denied my claims. He was making a million dollars a month,” read one comment on TikTok.

Another commenter wrote, “This needs to be the new norm. EAT THE RICH.”

“The ambulance ride to the hospital probably won’t be covered,” wrote a commenter on a TikTok video in which another user featured an audio clip from the Netflix show “Queen Charlotte: A Bridgerton Story.” In it, the queen makes a dramatic show of faux sorrow over a death.

The shooting prompted a wrenching outpouring of patients and family members who also posted horror stories of insurance claim reimbursement stagnation and denials.

One woman expressed frustration with trying to get a special bed for her disabled son covered by UnitedHealthcare. Another user described struggling with bills and coverage after giving birth.

“It is so stressful,” the user said in a video. “I was sick over this.”

Stefanos Chen and Maria Cramer contributed reporting, and Kitty Bennett contributed research.

https://www.nytimes.com/2024/12/05/nyre ... mpson.html

[ti-amie]

"Here's a piece of leather. Bite it!"

LOL. If only for them. The comments sections of various news sources are in no way sympathetic to this mans murder. It's understandable. There's literally tens of thousands of stories of how insurance companies screwed someone over in a life changing, or ending way.

I have yet to see anything approaching sympathy and to be honest I'm surprised about that. I think the NYTimes is trying when they say that he leaves a wife and two children though.

[Owendonovan]

Anthem heard something. Is this a spark?

Insurer Reverses Policy That Would Have Limited Anesthesia Periods
Anthem Blue Cross Blue Shield officials had planned to roll out the changes nationwide but said they were misunderstood.
By Roni Caryn Rabin
Dec. 5, 2024, 9:37 p.m. ET
Anthem Blue Cross Blue Shield, a major health insurer, on Thursday rolled back a policy change that would have capped payments for anesthesia for patients, and would have denied claims altogether if any given procedure exceeded a time limit.

The policy, which was to be tested before a national rollout, prompted controversy — first from anesthesiologists and then, after a flurry of media reports, from legislators in Connecticut and New York, where the policy was to go into effect in February.

Anesthesiologists said that the change in reimbursement was unprecedented and would have overturned a formula standard since the 1990s.

“No other commercial health insurer, no government payer, Medicare or Medicaid, has ever done anything like this and come up with an arbitrary time limit for anesthesia services,” Dr. Don Arnold, president of the American Society of Anesthesiologists, said.

“Surgery and other procedures can take variable lengths of time,” he added. “Certainly procedures and techniques are standardized, but patient needs are unique and they require variable amounts of time, care and attention.”

Gov. Kathy Hochul of New York wrote on X, formerly known as Twitter: “Outrageous. I’m going to make sure New Yorkers are protected.”

A spokeswoman for the insurer said on Thursday that the letters — to commercial providers on Nov. 1 and to Medicaid providers on Dec. 1 — misstated the planned policy change, and that it really “wasn’t a big deal.”

“We are not moving forward with the policy change because of the misinformation,” Janey Kiryluik, staff vice president for corporate communications with Elevance Health, Anthem’s parent company, said.

“We realized, based on all the feedback we’ve been receiving the last 24 hours, that our communication about the policy was unclear, which is why we’re pulling back.”

“Generally speaking, any medically necessary anesthesia, we will and always have and will pay for, even with this change,” Ms. Kiryluik added.

Even now, though, if an anesthesiologist bills for eight hours of services for a procedure that typically lasts four hours, she said, documentation would be required to support the charges: “We won’t automatically approve that.”

The company’s earlier letters to providers stated otherwise, saying that new time limits would be enforced.

The advice said that Anthem Blue Cross Blue Shield for New York, Connecticut and Missouri were changing how they evaluate claims for anesthesia services starting on Feb. 1, 2025.

The standard payment formula is based on medical codes indicating the type of care provided, as well as a time element, anesthesiologists said.

Those in private plans who reported times exceeding the average for a procedure would not be paid at all, Anthem said.

“Claims submitted with reported time above the established number of minutes will be denied,” the company’s letter said.

In a separate missive regarding Medicaid plans, Anthem said that claims for anesthesia services exceeding the set limits would be reimbursed only up to the limit, or preset average time for the procedure.

Anthem noted that the new limits would not be applied to maternity care or to pediatric patients 21 or younger.

https://www.nytimes.com/2024/12/05/heal ... nthem.html