Here’s a couple examples below on how the bids go today with one insurer just suing municipalities if they don’t get the contract.  Just recently the company lost a big lawsuit with their Oxford Insurance division in New York to where the Supreme court ruled that doctors now can “group together” to dispute and litigate insurance problems, billing and accusations of fraud. 

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?
United Healthcare Files Lawsuit Against the City of Birmingham Disputing Contract Award To Blue Cross
State of Louisiana Rejects United Healthcare’s Protest Over Awarding Blue Cross/Blue Shield Contract To Manage State Employee Health Insurance–Battle of the Insurance Algorithms Continues..

Here’s the recent ruling from the Supreme Court where the decision was made relative to insurance contracts as for years doctors, to be in network, have had to sign contracts that did not allow them to work as a group to litigate, so it has always been the big corporation against “one single doctor” so you know what advantages are had there with big insurer conglomerates.  If you were not aware of this, it has been going on for a long time and at the end of 2012 the AAFP confronted United as they found these complex contracts also ended paying doctors at a rate less than Medicare. 

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

There’s other instances of contract disputes over the last couple years floating around out there too, but it does make one wonder about the bidding process and also wonder about Steve Larsen who left HHS to work as a VP at the Optum division of United too. 

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

So who’s going to be invited to bid on this big contract?  There’s a lot of money involved here and are we to the point of lawsuits if not selected?  There seems to be some kind of a trend going on here.  It is also interesting how QSSI, a subsidiary of United is also building the federal data hub, as they purchased QSSI two weeks after HHS awarded the contract…very aggressive analytics company here and also has hospice services for profit as well…scary when an insurer has so many subsidiaries and has to profit from end of life care as well.  It really make you wonder about the bidding system as a whole when business intelligence algorithmic formulas are used as the sole basis for most of the business practices of insurers and this is what we are stuck with.  On the topic of exchanges I don’t think it’s Obamacare itself that is the bottom line, but rather the requirement by law to have to purchase from what is beginning to morph out as “too big to fail” insurers, just like the banks, way too much power.   BD

NEW YORK — Mayor Michael Bloomberg says New York City will seek bids within days for its multibillion-dollar health insurance contracts.

The step comes amid a standoff between the city and unions over expired contracts.

Bloomberg re-emphasized his stance on the labor issues during a speech Tuesday.

He wants more city employees to contribute to their health insurance. He also wants changes to a pension system he says is becoming too costly.


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