United Healthcare Denies Diabetes Pumps for Insured Members That Other Insurers Cover–Medtronic MiniMed 530G

<p>There has to be a way to keep shareholder interesting rolling right?  What makes this story interesting is the fact that other insurers are already covering the device and United, who preaches preventional  medicine doesn’t seem to be in line<img align="right" alt="image" border="0" height="162" src="http://lh3.ggpht.com/-cbj5qEwuYkc/VPIGQF8EJYI/AAAAAAABMAE/55XcbnHhlVs/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="248" /> with what most of what they write today?  You can read the article below on how algorithmic decisions on expenses are weighing heavily on what decisions they make.  What makes this device unique is the fact that it monitors dropping sugar levels and that’s a big deal for those with diabetes too.  As I commented below, is this move one for keeping more money available for stock buy backs?  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/02/united-healthcare-to-now-require-prior.html">United Healthcare To Now Require Prior Approval on Non Vaginal Hysterectomy Procedures–Laparoscopic Power Morcellator Controversy Fueled the Fire And Now More Savings To Facilitate Bigger Stock Buy Backs?</a></h5> <p>The video here discusses how the device costs $10,000 for the patient to buy on her own.  Ok that is the “stock” price and we all know that insurers via purchasing associations and hospitals do not pay that price, so overlook that in the video if you will as far as  being what the insurer, United  would pay.   Look at this from last year in New York, United has no problem kicking out a huge check for a $175,000 hammer to procedures that normally runs between $10-20k as an average.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/03/17509880-to-fix-hammer-toe-billed-by.html">$175,098.80 To Fix A Hammer Toe Billed by New York Podiatrist And the Insurer Paid It, Well Sort Of As They Sent the Check to the Patient By Accident, A New Investigation For “Out of Network” Charges Has Resulted</a></h5> <p>Well let’s take one more look at a similar case in California with lap bands and this one is very<img align="right" alt="image" border="0" height="166" src="http://lh6.ggpht.com/-asDNy_SeDeQ/VPIGRDoz71I/AAAAAAABMAM/XOLO_KElxSg/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="230" /> interesting for sure as the corporate lawyer in their defense seems to be totally unaware that United sells and markets anti fraud software and has for years, so even their own lawyers don’t understand the armies of subsidiary companies that United runs.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/09/lap-band-surgeries-go-full-circle-with.html">Lap Band Surgeries Go Full Circle With Lawsuits–Now United Who’s Being Sued, Files Case Against Company Who Provided the Advertising and Services</a></h5> <p>Again I look at the entire company as a whole and look at what each subsidiary does and United has a big stock buy back program going on as well as a dividend offering to shareholders so don’t let this side of the business decisions pass you up as it does have impact.  Al the major insurers are listed on the  S and P 500 and recently Bloomberg came out with an article that said 95% of the profits made by S and P 500 companies were going back into stock buy backs…so you put the two together here ok?  Don’t’ be naïve on some of the decision making as there’s 2 sides to every story.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/12/insurance-carrier-stock-buy-backs.html">Insurance Carrier Stock Buy Backs Continue to Rise While Consumers Are Finding It Harder to Afford Some Policies and Care With Dealing With High Deductibles And Narrow Networks…</a></h5> <p>So as it goes different insurers can make different decisions, so according to this story, United has not deemed this device to be a covered device and perhaps a purchasing organization will come in to play here as again we know insurers do not pay “stock prices”.  BD  </p> <script type="text/javascript" charset="UTF-8" src="http://www.nbcchicago.com/portableplayer/?cmsID=294474351&videoID=IonJynLRpxcZ&origin=nbcchicago.com&sec=news&subsec=local&width=450&height=360"></script> <hr />A suburban mother living with Type 1 Diabetes said she is being denied a potentially life-saving medical device by her insurance provider. <p>Amy Carbone of Palos Heights said she also has hypoglycemia unawareness, a complication of diabetes in which the patient is unaware of a deep drop in blood sugar levels. She said her condition makes her more susceptible to losing consciousness.</p> <p>That’s why Carbone’s nurse practitioner prescribed her a new device called the Medtronic MiniMed 530G with Enlite. It includes an insulin pump and a continuous glucose monitoring system. The device shuts off when blood sugar gets low.</p> <p>“I’ve got other patients who are on this device who said it’s a God-send because without it they would have no idea that their sugars were dropping,” said Terese Bertucci, APN.</p> <p>Carbone’s insurance provider, United HealthCare, will not cover the device for her. The company sent a denial letter to Carbone which read the services “are not eligible for coverage because your plan does not cover unproven procedures.” The letter also stated “current medical studies have not shown that this device is equal to or better than other standard pumps” for Carbone’s condition. </p> <p>The FDA-approved MiniMed 530G with Enlite is listed online at a cost of more than $10,000. The device also requires constant supplies. But other insurance companies, including Aetna, Cigna, Humana and Blue Cross/Blue Shield, told NBC 5 Investigates they would cover the device for members who meet their criteria. </p> <p><a href="http://www.nbcchicago.com/investigations/Suburban-Mother-Denied-Potentially-Life-Saving-Medical-Device-by-Insurance-294471481.html#ixzz3T3xbjq17">http://www.nbcchicago.com/investigations/Suburban-Mother-Denied-Potentially-Life-Saving-Medical-Device-by-Insurance-294471481.html#ixzz3T3xbjq17</a></p>

United Healthcare Denies Diabetes Pumps for Insured Members That Other Insurers Cover–Medtronic MiniMed 530G

There has to be a way to keep shareholder interesting rolling right?  What makes this story interesting is the fact that other insurers are ...

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“Get Your F**king Kids Vaccinated” – Jimmy Kimmel With a “Message From Real Doctors Who Know What The Hell They Are Talking About”…

<p>This is good all the way around and what better way to share the love here.  I like the way that Kimmel emphasizes that “doctors know what they are talking about” as today we have insurers and others constantly picking them to death on their decisions.  </p> <p><img align="left" alt="image" border="0" height="122" src="http://lh3.ggpht.com/-qxdMW3QT8yE/VPCgXDL20XI/AAAAAAABL_w/bkblDxb6i0w/image%25255B4%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="246" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>Doctors didn’t learn about medical diseases from their Facebook friends pages:)  It’s just like a Botox shot.  Are you one of those people who knows more about doctors Kimmel asks?  “Let your kids smoke, the only ones who say not too are doctors”…again a pun and bringing to the forefront the attack of doctor knowledge..funny.  “I had to go to school for 8 f**king years to tell you this about vaccinations”…comments from doctors are great.  BD </p> <p><iframe height="315" src="https://www.youtube.com/embed/QgpfNScEd3M" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p><a href="https://www.youtube.com/watch?v=QgpfNScEd3M&feature=youtu.be">https://www.youtube.com/watch?v=QgpfNScEd3M&feature=youtu.be</a></p>

“Get Your F**king Kids Vaccinated” – Jimmy Kimmel With a “Message From Real Doctors Who Know What The Hell They Are Talking About”…

This is good all the way around and what better way to share the love here.  I like the way that Kimmel emphasizes that “doctors know what t...

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United Healthcare To Now Require Prior Approval on Non Vaginal Hysterectomy Procedures–Laparoscopic Power Morcellator Controversy Fueled the Fire And Now More Savings To Facilitate Bigger Stock Buy Backs?

<p>You may or may not have read about the morcellator issues with the potential to spread cancer cells, but it’s been out there and all non vaginal hysterectomies don’t require the use of that tool; however it gave United Healthcare the fuel they needed to cut costs and require approval for non vaginal procedures.  The problem stated in the story here is that there’s not enough doctors that know how to do the non vaginal procedures, so here we go with procedure needing to be approved ahead of time and the MDs having to submit data to substantiate such.  <img align="right" alt="image" border="0" height="93" src="http://lh6.ggpht.com/-ilZbQsAtu5g/VO_czBXOa9I/AAAAAAABL_U/4exIltU54IU/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="334" /></p> <p>So once again the insurer, United says they know better than the doctors it appears.   Sure if a vaginal procedure is available and is recommended by a doctor, it’s one less item to heal but again you need the doctors trained to do so.  Sometimes a vaginal procedure may not work depending on other things going on with a woman’s health too.  </p> <p>So here we go, as they seized the opportunity to take over the decision making for the doctors and again using the morcellator as the vehicle to drive this.  United is pretty well known for driving down pay for MDs and in the OC where I am, many of them tell me the net payments from the company end up being less than what Medicare pays.  Maybe they are counting on the money saved here to help finance more stock buy backs too?  United has a  big one and also has to finance dividends for shareholders too.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/02/united-healthcare-extending-narrow.html">United Healthcare Extending Narrow Networks in California–More Secret Scoring of Doctors in the US–Telling The Doctors If They Are “Allowed” To Be In Network…</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2014/12/insurance-carrier-stock-buy-backs.html">Insurance Carrier Stock Buy Backs Continue to Rise While Consumers Are Finding It Harder to Afford Some Policies and Care With Dealing With High Deductibles And Narrow Networks…</a></h5> <p>On a related note, Johns Hopkins is taking United to court as they narrowed them out of <img align="right" alt="image" border="0" height="229" src="http://lh6.ggpht.com/-CyHlF11dHZA/VO_c0V-l8zI/AAAAAAABL_c/CdaAiHfikQA/image%25255B7%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="228" />the network for some of their insured, mostly those who buy a policy from an insurance exchange, where United pays the doctors somewhere between Medicaid and Medicare rates.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/11/johns-hopkins-states-insurance-plans.html">Johns Hopkins -Insurance Plans From UnitedHealthcare Bought Via Exchanges Will Not Be Able to Use Johns Hopkins Physicians or Medical System–Filed Lawsuit To Sue United, Stating Violation of 1997 Contract</a></h5> <p>When the procedures is all done, we have this United/Dignity company that’s going around looking for contracts with hospitals to take over all the revenue cycling too, which involves firing current employees (maybe hiring some back) of a hospital to do all the billing and revenue cycle work.  If they get contracts with hospitals, even outside of the Dignity chain they are doing now (Dignity is their 49% partner), they can wipe the slate clean on billing and analyzing each procedure done. <strong> There should be a law against “too big to fail insurers”, you think?</strong>  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/10/united-healthcare-adding-yet-one-more.html">United Healthcare Adding Yet One More Subsidiary to the Very Large Number of Subs They Already Own/Operate-Optum and Dignity Healthcare (A System Wide Cerner EHR Client) Form New Venture Called Optum 360–Subsidiary Watch</a></h5> <p>You can even find United aka Optum over here at SAS..selling their analytics goods too.  BD</p> <h5><a href="http://ducknetweb.blogspot.com/2012/12/sas-adds-optum-unitedhealthcare-fraud.html">SAS Adds Optum (UnitedHealthcare) Fraud Prevention Algorithms That Includes Social Network Data Mining Analytics To Their Fraud Prevention Framework Software</a></h5> <p> <hr />The nation’s largest health insurer is imposing tighter controls on its coverage for hysterectomies after more than a year of debate over a medical device that was found to spread hidden cancer in some women undergoing the procedure.</p> <p>As of April, <a href="http://quotes.wsj.com/UNH">UnitedHealth Group </a>Inc. will require doctors to obtain authorization from the insurer before performing most types of hysterectomies, according to a <a href="https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/News/January_2015_Network_Bulletin.pdf">bulletin sent to physicians and hospitals</a>. </p> <p>Only vaginal hysterectomies performed on an outpatient basis won’t require prior approval. The method, in which the uterus is removed through the vagina, has long been considered both the least invasive and cheapest option yet is used in only about 15% to 20% of cases, according to federal data and studies. The technique hasn’t been emphasized enough in medical training, many doctors say. </p> <p>Still, prior authorization had been uncommon for hysterectomies. Among the major commercial insurers, only <a href="http://quotes.wsj.com/ANTM">Anthem </a>Inc. requires them. A spokeswoman said the company started the practice last year over concerns that doctors weren’t fully considering alternatives to hysterectomies to treat fibroids.</p> <p><a href="http://quotes.wsj.com/CI">Cigna </a>Corp. and <a href="http://quotes.wsj.com/AET">Aetna </a>Inc. said they don’t require the extra step. “We believe this is best left up to the physician and patient based on clinical circumstances,” an Aetna spokeswoman said.</p> <p><a href="http://www.wsj.com/articles/biggest-u-s-health-insurer-tightens-rules-on-hysterectomy-coverage-1424990877">http://www.wsj.com/articles/biggest-u-s-health-insurer-tightens-rules-on-hysterectomy-coverage-1424990877</a></p>

United Healthcare To Now Require Prior Approval on Non Vaginal Hysterectomy Procedures–Laparoscopic Power Morcellator Controversy Fueled the Fire And Now More Savings To Facilitate Bigger Stock Buy Backs?

You may or may not have read about the morcellator issues with the potential to spread cancer cells, but it’s been out there and all non vag...

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Why Do We Discuss Supreme Court Ruling On Affordable Care Act Like a Bunch of Morons? Want to Make Changes and Review Legal Interpretation? Bring Code Please

<p>I tweeted this yesterday and I think it deserves an actual blog post to bring a little bit of reality into the picture after seeing all the “Magpie Tweets” on this topic yesterday.  Have we all forgotten about the roll out of Healthcare.Gov?  Have we all forgotten that there’s still work in progress with the website in connecting health insurance data that is not finished yet?  I ask these questions as they are relevant to making changes to the Affordable Care Act, or interpreting legal verbiage.  For some strange reason we seem to have gone backwards <img align="right" src="http://lh3.ggpht.com/-eOr42zvKZnU/VF2qnyT-0QI/AAAAAAABLvU/LGJW58fwYE0/image%25255B13%25255D.png?imgmax=800" style="float: right; display: inline" />with our perceptions here and are back living the “Sebelius Syndrome” of whacked out perceptions again.  </p> <p>I began calling the “whacked out” perceptions <a href="http://ducknetweb.blogspot.com/2014/04/secretary-sebelius-at-hhs-resigns-wrong.html">“The Sebelius Syndrome”</a> a while back and she got the name as her public comments were so just off the wall and folks in tech just shook their heads in the past at what was said.  (By the way thanks to all the investors that read here that enjoy that name as I do like your comments on it:)  Again Sebelius just got the name but there’s many more suffering from the Syndrome, and all you had to do was read all the press yesterday about “there’s no fix as a back up for the insurance policies if the Supreme Court rules against them”.  Good grief, I never saw such rhetoric in my life on this topic.  </p> <p><strong>Of course there’s no back up as you need to write code based on “verbiage” that is determine as legal from the Supreme Court.  Actually a while back I did blog that too asking if the Court realized how much “code power” their verbiage has the potential to create and asked if they realized it themselves?</strong>  I’m trying to stay neutral here with opinions and just looking at the “real world” with what comes out of virtual values that will have “real” impact on consumers, ok?   I guess at this point I’m asking “how far off do you want to go with whacked out perceptions”?</p> <h5><a href="http://ducknetweb.blogspot.com/2014/11/supreme-court-to-hear-challenge-to.html">Supreme Court to Hear Challenge to Obamacare Subsidies- They Hold the Code In Their Hands That Controls the All the Machines Running the Affordable Care Act..</a></h5> <p>Actually, even before I wrote that post I addressed the fact that members of Congress seem to also be oblivious to this fact as well with saying “the machines run the Affordable Care Act” and they do.  Again, let’s revisit Healthcare.Gov and notice that there’s still work in progress there and remember how bad the code was when it rolled out…need anymore proof…we need code here to change or fix things?  Geez…</p> <h5><a href="http://ducknetweb.blogspot.com/2014/11/the-affordable-care-act-is-run-by.html">The Affordable Care Act Is Run By the Machines–So Now What Do Human Lawmakers Think They Are Going To Do About It?</a></h5> <p>Seriously, can’t we get out of this make believe “virtual world value” here and come back to the real world?  This is a big part of our problem today as a nation, people that can’t tell the difference between virtual and the real world values.   In many ways, it seems HHS/CMS didn’t see enough at the VA with their Stat Rat Fever issues and are still going right down the same path as well.  We have a lot of broken models and software out there as it comes down to this<strong> “People don’t work that way”..</strong>and I don’t care how hard you try to market things today, if we don’t’ work that way, our behaviors will not change or adapt to the “proof of concept” model that is touted.  Sometimes we hit the jackpot and get it right all the way around and those are joyous moments for sure.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/05/va-crisis-just-tip-of-iceberg-as-us.html">VA Crisis Just The Tip of the Iceberg As US Needs a Full On Healthcare Culture Change Everywhere To Get Back In Touch With the Real World of Patients…</a></h5> <p>Actually I borrowed “People don’t work that way” from Emanuel Derman, world famous quant who’s written books on modeling.  He spoke those words during an interview in a documentary on the Quants of Wall Street and just scroll down to the bottom of this page and<img align="right" src="http://lh6.ggpht.com/-4yKeXZOGJWY/U2hj_S1gpvI/AAAAAAABKL4/8L1D77wzoQY/image%25255B20%25255D.png?imgmax=800" style="float: right; display: inline" /> watch video #2 if you want to read up and get introduced to the world of Killer Algorithms out there.  Mr. Derman gets it and I agree, why we have all these broken models and people that can’t work with them…<a href="http://ducknetweb.blogspot.com/2014/11/how-many-more-bloomberg-big-gulp-failed.html">look at how Bloomberg got fooled with Big Gulp too…everyone can get fooled.</a>  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/05/people-dont-work-that-way-world-of.html">“People Don’t Work That Way” A World of Broken Software Models That Don’t Align To the Human Side,Too Much Push At Times With Only A Proof of Concept That Fails in the Real World..</a></h5> <p><strong>So yes a ruling from the Supreme Court without some code infrastructure will place those affected consumers into “algorithm hell”..period</strong>.  There’s no algorithm fairies out there to wave a magic wand to make the IT infrastructure work overnight?  Did you all once again forget the roll out of Healthcare.Gov?  Wake up folks, still need code and that has not changed.  We had the question too about the impact on such a decision on insurers…well same thing there with writing new code and using new math models to design policies.  If you look at the classifieds today you can see the armies of Quants that insurers have hired to model policies.  </p> <p>Actuaries of course are still very much involved in the models, but by adding Quant models to the process insurers get the forecast of the “long” of the actuary and the “short” of the Quants to also bring in analytics on the impact of policies on stock price.<strong>  Yup, get in to it as that’s the real story here and the math and code that makes all of it work for them.  Insurer models run a lot of models that parallel those of the banks, traders, hedge funds, etc. and Quants move from one to another of those verticals to do their work.  Read the post below for a discussion</strong> on the correlation of how the models are<img align="right" alt="image" border="0" height="141" src="http://lh6.ggpht.com/-XKJUBKw32xQ/VO81AAjCufI/AAAAAAABL_A/jMHd2k8DyHY/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="289" /> similar and how we can’t run through markets as humans like data does with stock exchanges.  They do try to use some of those financial elements but we hit the wall when we can’t change doctors, plans, and everything else they put in the model in a time frame that suits profits for share holders.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/10/data-scientistsquants-in-health.html">Data Scientists/Quants in the Health Insurance Business–Modeling Beyond the Speed and Capabilities of Humans To Keep Up With The Affordable Care Act–Turning Into A World of Killer Algorithms That We All Hate..</a></h5> <p><strong>So again, can we step into the “real” world here and stop projecting a world of algorithm fairies that will step in and take care of the Supreme Court ruling should it go south?</strong>  This is is getting old, ok?  Let’s look at the “real” impact here and stop thinking that the math models and computer code are some kind of magical force out there, as it takes humans and time to create such infrastructure.  </p> <p>Can we please stop talking like morons when it comes to the Affordable Care Act and look at the real world here on what needs to be done to change, amend, repeal or whatever your heart desires? <strong>  Let’s put an end to the “Sebelius Syndrome” of whacked out perceptions once and for all and let’s get out of the virtual values that being confused with the real world.</strong>  We need both and we need balance.  I too even get tired of seeing the White House putting out emails using numbers and stats that nobody can predict, it ends up shooting them in the foot instead of being a campaign for promoting laws and issues.  This crap is everywhere and we need to take on reality here and stop writing articles that make us look like morons sometimes.  </p> <p><strong>Want to change or rule on the Affordable Care Act-where’s your code?  BD</strong></p>

Why Do We Discuss Supreme Court Ruling On Affordable Care Act Like a Bunch of Morons? Want to Make Changes and Review Legal Interpretation? Bring Code Please

I tweeted this yesterday and I think it deserves an actual blog post to bring a little bit of reality into the picture after seeing all the ...

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Does Your Doctor Share Your Medical Record Information With an HIE (Health Information Exchange)…

<p>This is a question that may come up from time to time.  Pam from the World Privacy Forum explains how it works in California.  Also you can request the Notice of Privacy Practices.  Most providers do provide this information and as she states sometimes there’s an additional statement that shows what HIE(s) the doctor is participating in.  With all the security breaches we have had, I felt this was an important item to include, so you can find out if your records are being shared and where.  BD  </p> <p><img align="left" alt="image" border="0" height="219" src="http://lh3.ggpht.com/-A0Q5vDDkLkA/VO5PzxvBIKI/AAAAAAABL-s/XbpEMh7IsKw/image%25255B11%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: left; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="509" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <iframe height="281" src="//player.vimeo.com/video/103497993" frameborder="0" width="500" allowfullscreen="allowfullscreen" mozallowfullscreen="mozallowfullscreen" webkitallowfullscreen="webkitallowfullscreen"></iframe> <p><a href="https://vimeo.com/103497993">WPF: Does your doctor share your information in a health information exchange?</a> from <a href="https://vimeo.com/worldprivacyforum">World Privacy Forum</a></p>

Does Your Doctor Share Your Medical Record Information With an HIE (Health Information Exchange)…

This is a question that may come up from time to time.  Pam from the World Privacy Forum explains how it works in California.  Also you can ...

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Apple and Google Have Still Not Removed Dangerous App Used for Checking Blood Pressure and More “Me Too Apps” Arrive

<p>This is an interesting story here from a doctor who works in an ER and is right on top of all of this.  <img align="right" alt="image" border="0" height="229" src="http://lh3.ggpht.com/-o2-4WoGjs3Y/VO3nXXyYxtI/AAAAAAABL-U/sLYf42SrqgQ/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="295" />The big issue here is questioning the accuracy of the readings for the first issue with the app.  We all know how we need the blood pressure cuff to get an accurate reading and there are numerous types of home units you can buy versus this app on the phones. </p> <p>With this app you place the unit on your chest.  This is interesting as it was just in the last couple of days that we had the FTC question and fine a couple of apps that are used to detect potential skin cancer with moles too.  Perhaps the most profound statement in this entire article is this:</p> <p><strong><em>“Blood pressure management is not for “recreational purposes”. This is not entertainment. This is real life.”….<strong>Iltifat Husain, MD</strong></em></strong></p> <p>The doctor is the Founder, Editor-in-Chief of iMedicalApps.com. Assistant Professor of Emergency Medicine and Director of Mobile App curriculum at Wake Forest University School of Medicine.  His credentials speak for themselves.  </p> <p>In addition, Vanderbilt and Johns Hopkins have also commented on their concern about the apps that continue to remain.  In the world of apps today, it’s interesting and and actually good that both the FDA and the FTC seem to be paying closer attention to what’s going on out there to ensure we get “real” information.  BD  </p> <p> <hr /></p> <p>For $4.99, the app promises to measure your blood pressure by using your iPhone’s microphone and LED light. You place the iPhone on your chest and it “measures” your blood pressure. Obviously — no physician or health care professional would recommend that you measure your blood pressure in this non-validated method.</p> <p>Instant Blood Pressure has now become a top 5 downloaded app in the Health section of the App Store — and is being used by tens of thousands of people to measure their blood pressure.</p> <p>Wired Magazine <a href="http://www.wired.com/2014/07/medical_apps/">picked up on</a> the story, did the developers even bother to put a disclaimer within the app. The developers were also initially implying that Johns Hopkins was supporting their claims in their App description, but were forced to remove the institutions name after Johns Hopkins found out their name was being used in an inappropriate manner.</p> <p>The developers initially asked me not to publicize the app at all, and refused to show data <img align="right" alt="image" border="0" height="143" src="http://lh6.ggpht.com/-qzMGs2QesPo/VO3nYVkfmYI/AAAAAAABL-c/Usn8rJ_9WUM/image%25255B6%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187" />or any type of study that backed up their claims, stating they were creating proprietary algorithms. They kept mentioning they would “soon release data” that showed how the app worked, but more than eight months later they still haven’t released any studies or proof showing how the app works.</p> <p><strong>Instant Blood pressure has become so popular that it has spawned a number of spin offs.</strong></p> <p><strong>Even a recent publication in the American Society of Hypertension takes aim at these apps, raising alarm at how often they are being used by patients.</strong></p> <p>The iMedicalApps team of physicians implores Apple and Google to remove these apps from the App Store.<strong> There is sufficient proof in the comments section alone that patients are using these apps not for recreational purposes, but as medical devices, having the potential to lead to disastrous health consequences. Apple and Google shouldn’t allow developers to hide behind veiled disclaimers that try to prevent FDA regulation and liability if someone were to die. If an app even has the potential to be used as a medical device using sensors on a phone, it should be regulated in the appropriate manner.</strong></p> <p>I find it fascinating that the Instant Blood Pressure app doesn’t let you store your blood pressure numbers. Clearly they don’t want you exporting or tracking your measurements if you have a poor health outcome.</p> <p><a href="http://www.imedicalapps.com/2015/02/apple-google-health-app-patients/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+iMedicalApps+%28iMedicalApps%29">http://www.imedicalapps.com/2015/02/apple-google-health-app-patients/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+iMedicalApps+%28iMedicalApps%29</a></p>

Apple and Google Have Still Not Removed Dangerous App Used for Checking Blood Pressure and More “Me Too Apps” Arrive

This is an interesting story here from a doctor who works in an ER and is right on top of all of this.  The big issue here is questioning th...

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TissuGlu Gets FDA Approval as Ground Breaking Internal Surgical Adhesive–Eliminates Need for Drainage Tubes!

<p>The video explains the difference between adhesives and sealants and I learned something by watching the video as well.  <a href="http://www.coheramedical.com/products/tissuglu"><img align="right" alt="image" border="0" height="74" src="http://lh4.ggpht.com/-3GLTFoAIyVg/VOoU2Lbl6cI/AAAAAAABL90/wIDunQzfuqA/image%25255B3%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="187" /></a>Not having to go home with drainage tubes as a patient, this is huge, I don’t care who you are, if that’s an option, I think everyone would be for it.  </p> <p><a href="http://www.coheramedical.com/products/tissuglu">TissuGlu</a> can now begin marketing the product to hospitals.  It is a two part material with part A and part B that need to be mixed together.  It begins to cure with moisture.  </p> <p>TissuGlu already has approval in Europe.  It looks like a glue gun to put you back together again.  TissuGlu was developed by Eric Beckman, University of Pittsburgh chemical engineering professor and it consists of amino acids which are dissolved in the body.  </p> <p><iframe style="height: 309px; width: 498px" height="315" src="https://www.youtube.com/embed/WcqXQ6S8hpE" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p><strong><a href="http://www.coheramedical.com/products/tissuglu">From the website:</a></strong></p> <p><em>“Cohera Medical’s recently completed ‘No Drain’ study confirms that TissuGlu is a clinically superior<img align="right" alt="image" border="0" height="218" src="http://lh4.ggpht.com/-Z1oLle_Wdzs/VOoU2wNutBI/AAAAAAABL98/Kwu-C75t_zQ/image%25255B8%25255D.png?imgmax=800" style="border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; float: right; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px" title="image" width="355" /> alternative to closed-suction drains in large flap procedures such as abdominoplasty. In the pivotal clinical trial, when TissuGlu was used, patients required fewer post-operative treatments and resumed normal activities, such as going to work, showering and using the stairs, more quickly.</em></p> <p><em>Currently, most patients who undergo large flap procedures have drains inserted to remove fluid that accumulates under the skin at the surgical site. Drains are often uncomfortable for the patient and can lead to additional complications. TissuGlu forms a strong bond between tissue layers, helping to reduce the space where fluid can accumulate during healing.”</em></p> <p>Cohera Medical only has 22 employees but I would imagine they are destined to grow quickly once the product is being shipped and used by hospitals. <em> </em></p> <p>This is exciting stuff and no refrigeration is required either.  BD  </p> <p> <hr />A small North Side company, newly bestowed with FDA approval for its ground-breaking internal surgical adhesive, believes it may be tapping into a billion-dollar market.</p> <p>Cohera Medical Inc.’s lead product, TissuGlu, will be used to connect tissue flaps following major abdominal surgery, eliminating the need for patients to go home with drains protruding through their skin. Earlier this month, the company received the FDA go-ahead to begin marketing the product to U.S. hospitals.</p> <p>President and CEO Patrick Daly sees the wide-scale availability of TissuGlu as a win all around: Patients won’t face the discomfort and infection risk associated with drains, while hospitals will save money as a result of lower complication rates and fewer re-admissions.</p> <p><a href="http://www.post-gazette.com/business/healthcare-business/2015/02/19/North-Side-company-Cohera-gets-FDA-approval-for-its-internal-tissue-adhesive/stories/201502190094">http://www.post-gazette.com/business/healthcare-business/2015/02/19/North-Side-company-Cohera-gets-FDA-approval-for-its-internal-tissue-adhesive/stories/201502190094</a></p>

TissuGlu Gets FDA Approval as Ground Breaking Internal Surgical Adhesive–Eliminates Need for Drainage Tubes!

The video explains the difference between adhesives and sealants and I learned something by watching the video as well.  Not having to go ...

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“The Data Exchange” Buy and Sell Data on Self Service Website, One More Reason to Index and License Data Sellers-This Appears to be Open Game for Selling Repackaged Personal Data-No Privacy At All

<h5><strong></strong></h5> <p>I know I sound like a broken record here but there’s good reason for this.  I found this site on the web a while back and it appears to be growing and more data for sale is appearing.  There are legitimate lists here for sale that we have all seen forever on the web too.  What I want to call your <img align="right" alt="image" border="0" height="93" src="http://lh6.ggpht.com/-8MkyHc_vJKs/VOkMeBnwbFI/AAAAAAABL9E/eTpNSPDUiJk/image17.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="188" />attention too is the types of lists contained here and there’s no reference to some of the origins.  This means that more than likely the data has been repackaged and re-queried with other data.  When the Anthem breach news broke, again I took the opportunity to mention again that crooks want to sell data too.  </p> <p>Amazingly enough, my <a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">campaign for licensing data sellers</a> has been re-tweeted and received comment from the Anonymous group on how this will and could take place with selling more data.  Read this link below and step into the real world of people who understand and know these skills and wake up to what’s going on today.  As a developer or programmer, all you have to do is put on your “jerk” hat for a while to pretty much figure out what the other side might be doing for money.  It’s worked for me for years and there’s a lot a lot of folks who are smarter than me too.  I just wish more would speak up more often. </p> <h5><img align="right" alt="image" border="0" height="93" src="http://lh6.ggpht.com/-ljV2UEat9qI/VOkMeroWg2I/AAAAAAABL9M/YEJM2Ndokzw/image10.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="187" /></h5> <h5><strong><a href="http://ducknetweb.blogspot.com/2015/02/anthem-data-breachcrooks-want-to-sell.html">Anthem Data Breach–Crooks Want to Sell Data Too–The Impact of the “Data Selling For Profit Epidemic” That Exists in the US With Scoring Consumers Removing Access and Human Dignity</a></strong></h5> <p>If you <a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">visit my campaign</a> you can see what I’m dealing with as now I appear on a list of “known blood thinner users” that is sold all over the place.  This is due to sloppy data work and/or bad matching from social network data, blogs, and comments.  This crap follows you and you have nowhere to go to find the source and get rid of it half the time as there’s no way to find the repackagers.  The problem here is that we are consumers are totally helpless here to fix some of this.  The <a href="http://ducknetweb.blogspot.com/2014/04/world-privacy-forum-report-scoring-of.html">World Privacy Forum</a> has also been very active in their views on the same issues, the secret scoring that takes place and you have no clue what’s gone on.  </p> <p><img align="right" alt="image" border="0" height="86" src="http://lh4.ggpht.com/-F5wTCVIuUeU/VOkMfG8SRfI/AAAAAAABL9Q/uTv5xhkFa6U/image20.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="188" /></p> <h5><a href="http://ducknetweb.blogspot.com/2014/11/online-data-brokers-persist-listing.html">Online Data Brokers Persist, Listing Consumers on Chronic Disease Mailing Lists And More–Need To License and Index All Data Sellers, Brokers, Banks, Companies, Otherwise You Don’t Have a Complete Listing of Who They Are…</a></h5> <p>In addition we have this recent story to where a woman who’s records were breached at a hospital who later found her information being used.  Below are a few lines from the <a href="https://digitalguardian.com/blog/court-finds-data-breach-not-imminent-risk-victim">full article.</a>  </p> <p><em>“In notifying current and former patients and employees, St. Joseph said that it wasn’t aware of any of the information being misused. Still, after Peters found that her Discover credit card information had been stolen some months later, and that hackers had tried to infiltrate her Amazon.com account — posing as her son — she was pretty sure what the source of her woes was. And she was determined to act.</em></p> <p><em>Peters filed a 13-count complaint against St. Joseph, alleging violations of the federal “Fair Credit Reporting Act” (FCRA). </em></p> <p><em>She alleged that her personal information had been exposed in the breach and then disseminated in the public domain, where it was being “misused by unauthorized and unknown third parties.” Hackers' attempts to use her son’s name to compromise her Amazon.com account was particularly damning, Peters </em></p> <p><img align="right" alt="image" border="0" height="90" src="http://lh4.ggpht.com/-hDRRZ7Bfuyc/VOkMf2qfyNI/AAAAAAABL9c/BNGVGM9bhWs/image13.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="187" /></p> <p><em>claimed: that information could only have been obtained from names and next-of-kin information she provided to St. Joseph before the data breach.</em></p> <p><em>Peters also asserted that telemarketers were using the stolen information – that she had been besieged with calls and solicitations for medical </em><em>products and services companies, with telemarketers asking to speak to her and with specific family members, whose contact information was part of the record stolen from St. Joseph.”</em></p> <p>You really should read the entire article above as again it goes to show how consumers can be and are left holding the bag.  Look at all the solicitations she received and I get those and I hate them as they go on forever and are more of a nuisance now than a help.  I’ll go search when I need information, thank you.  I just recently relocated and gee I can’t tell you how many phone calls I received from folks buying lists.  I asked the one person how she got my name, “it’s on a list I buy every week” she said.  She didn’t even know where she bought the list from when I asked that question!  </p> <p>Ok let’s dig a little further here and the following link will probably really get to you a bit as this company, Argus buys your credit card transactions, and then scores you with some analytics and sells that data (and the score) to insurers and banks.  Look who else is buying up your information, the Consumer Financial Protection Bureau.  I said when Richard Cordray was appointed that he would be a waste pretty much as being limited to go after low hanging fruit and he proved me correct.  He’s another one afflicted by the <a href="http://ducknetweb.blogspot.com/2014/04/secretary-sebelius-at-hhs-resigns-wrong.html">“Sebelius Syndrome”.</a>   It’s like a virus as it lives all over the White House and in Congress too.  </p> <p>These are the folks that stick with verbiage only and forget there’s code that needs to go along with their laws to make things work. <strong>Remember Healthcare.Gov?  It’s still not finished.  Want to repeal Obamacare?  Bring in some good coders ok, no matter which way things go</strong> (lol), this is the reality folks.  The short order computer code kitchen burned down years ago all of this takes time.   After you read about Argus, </p> <p><img align="right" alt="image" border="0" height="87" src="http://lh6.ggpht.com/-RFPcBnY6E7o/VOkMgqrmBfI/AAAAAAABL9k/dy0VmSJ9Fd0/image16.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="187" /></p> <p><a href="http://ducknetweb.blogspot.com/2012/08/e-scoring-credit-algorithms-invisible.html">here’s another outfit like them called E-scoring</a> who does the same stuff and skirts out from under federal laws in how they classify their business.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/argus-analytics-produces-share-of.html">Argus Analytics Produces “Share of Credit Card” Data On Consumers - Digs Up The Dirt on Your Credit Card Behavior Patterns-US Consumer Protection Agency Is A Client-We Are Paying for Richard Cordray’s Slow Education Process</a></h5> <p><strong>So again, three years ago I began campaigning to license all data sellers so we know who they are and can fix the flaws that are surmounting and nobody listened and so look at this site.  If you don’t think this is the perfect spot for stolen data from Anthem to appear</strong>, you better have your head examined as this is how it works and there’s no call for anyone to justify where the data came from and with 80 million files, they can sell on this site and others for years.  If you look at the prices here, it’s a bit better than the black market and that area is more for stolen credit card data anyway.  With data like you see here, the crooks can make it all look legal and make a lot of money, over and over and over.  </p> <p><strong>The Anonymous folks even hate hackers like this too and call them “digital criminals”, we had a short discussion on Twitter about this.</strong>  So <a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">help me out here and donate to my cause as I continue to write to the FTC and members of Congress to get them moving on this.</a>  This is a huge exposure for consumers and with repackaging us and creating new data bases, it will go on forever and wait until you see all the flawed data that appears that people will use to judge you, you won’t like it as nobody likes data that is either taken out of context or just flat out wrong used to judge them, self included!  Again just like the <a href="http://ducknetweb.blogspot.com/2009/02/kathleen-sebelius-kansas-governor-for.html">Sebelius Syndrome I called in 2009</a>, here’s another scenario of consumers being hurt and “code hosed”.  BD</p> <strong> <hr /> <p>You own the data you buy</p> </strong> <p><strong>Yes, if you have purchased a file from a Seller, you purchase ownership rights to that file.</strong></p> <p><strong>Note:</strong> the only exception to this rule is if the seller has attached a <a href="https://thedataexchange.zendesk.com/hc/en-us/articles/201013942">Custom Contract</a> to a Sale stating that full ownership rights are not transferred by sale. Buyer's have the full opportunity to read Custom Contracts before Sales are completed.esus</p> <p><a title="https://thedataexchange.zendesk.com/hc/en-us/articles/201078151-Data-Ownership" href="https://thedataexchange.zendesk.com/hc/en-us/articles/201078151-Data-Ownership">https://thedataexchange.zendesk.com/hc/en-us/articles/201078151-Data-Ownership</a></p>

“The Data Exchange” Buy and Sell Data on Self Service Website, One More Reason to Index and License Data Sellers-This Appears to be Open Game for Selling Repackaged Personal Data-No Privacy At All

I know I sound like a broken record here but there’s good reason for this.  I found this site on the web a while back and it appears to be...

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Health Insurance Companies Providing Charge Cards And/Or Coupons For Healthy Foods–More Data To Collect About You And Potentially Repackage and Sell For A Profit…

<p>We all know by now that a card or coupon is just one more way to track what you do and insurers these days can’t get enough relevant and non relevant data  to analyze.  For insurers, it works well to have these globs of data that they may not know what they will do with yet, but the complexities of building models and analytics around the users and querying with other information on file is endless.  <img align="right" height="153" src="http://lh3.ggpht.com/-oDB0Fd8z6HM/VAqXWED0TxI/AAAAAAABLQk/W0dF3GldbXE/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" width="210" /> Read the link below to see where banks, insurers and the CFPB are all buying up your credit card transactions.  This is a daily thing by the way, depending on the contract with how much data Argus will provide.  They do analytics and thus you end up with another one of those “secret scores” on your record somewhere.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/argus-analytics-produces-share-of.html">Argus Analytics Produces “Share of Credit Card” Data On Consumers - Digs Up The Dirt on Your Credit Card Behavior Patterns-US Consumer Protection Agency Is A Client-We Are Paying for Richard Cordray’s Slow Education Process</a></h5> <p>So if your grocery store card is not good enough, we have some over lap here to be sure we don’t miss any potential data about you that could be repackaged and sold.  Why don’t they just make the food more affordable and forget all of this tracking?  You think?  Of course  not as United Healthcare is either the #1 or #2 largest sellers of data in the healthcare business.  All together, it’s about a $180 billion dollar a year business when you include all entities.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/09/health-insurance-business-is-driving.html">Health Insurance Business Is Driving Itself Off a Cliff & Doesn’t Know When to Stop With Collecting, Analyzing and Processing Non Relevant Data With Little Or No Impact On Giving Good Care..</a></h5> <p>I don’t know about you but all of this is taking way too much of my time as there are other data areas I need to worry about, like the bank, work, etc. and I just flat out don’t have time for all of this, much less giving access to anymore data for goodness sakes.  BD  </p> <p> <hr />UnitedHealthcare is now the third health insurance company to provide members with a program aimed at empowering them to choose better foods when they go shopping—and hopefully improve their health as a result. The Healthy Savings program, a partnership with Wisconsin-based Roundy's Supermarkets provides potential savings of more than $150 per month on prequalified foods.</p> <p>Humana has had a grocery program for three years called Humana Vitality, which it has improved since its launch. The company reports that 40% of their health plan members are enrolled in the program, through which members can use a card to save on qualified purchases at Wal-Mart stores.</p> <p>Anthem Blue Cross and Blue Shield also has a program that provides coupons to members for discounts on food and other household products. Members access the coupons via their accounts on Anthem.com and can print them out to utilize them at "more than 90%" of all major food store chains. </p> <p>One of the keys to success to such a program is likely to be convenience; the Healthy Savings program promotes the fact that it doesn't require any printing of coupons. The program website featured each week's discounted items and shows where to find the closest participating stores, as well as other related health and shopping information.</p> <p><a href="http://www.healthcaredive.com/news/unitedhealthcare-becomes-third-major-insurer-to-partner-with-grocery-stores/362884/">http://www.healthcaredive.com/news/unitedhealthcare-becomes-third-major-insurer-to-partner-with-grocery-stores/362884/</a></p>

Health Insurance Companies Providing Charge Cards And/Or Coupons For Healthy Foods–More Data To Collect About You And Potentially Repackage and Sell For A Profit…

We all know by now that a card or coupon is just one more way to track what you do and insurers these days can’t get enough relevant and...

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United Healthcare Extending Narrow Networks in California–More Secret Scoring of Doctors in the US–Telling The Doctors If They Are “Allowed” To Be In Network…

<p><strong>Here we go again the “too big to fail” health insurer at it again.</strong>  Read some of this and see <img align="right" src="http://lh4.ggpht.com/-GPn1iE76d3k/T5D3QJ8PWFI/AAAAAAAA6jk/kMvDzt1Smc0/image_thumb%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" />why even the doctors have trouble knowing they are in network, much less patients trying to figure all of this out.  Insurers make money by making contract complex and this is no exception.  Doctors don’t even have a say here as United and their cost algorithms are calling the shots.  So if you hear you can keep your doctor, well you can’t blame this one on Obamacare, this one is all the work of United this time.  They have this algorithmic scoring system that uses some proprietary formulas and what it is, we don’t know.  Do they tell the doctors, probably not as they would have to go in depth and explain how their algorithms work.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/the-secret-scoring-of-americas.html">“The Secret Scoring of America’s Physicians” - Algorithmic Math Models For Insurance Network Contractual Exclusions, Relating to MDs Who See Medicare Advantage Patients..</a></h5> <p>Doctors don’t have an opt out option on the W500 plan, they have to terminate their underlying PPO agreements.  Now who in the heck can keep track of all of this?  United can’t keep track of what doctors they fire sometimes as they went out and bid and won a Medicare Advantage contract in Maryland, only to find out they had to give it back as they had already fired all the doctors in the area who would be seeing patients.  By the way what does the NHS and Medicare now have in common?  They are both run by former United Healthcare Executives who do everything by the algo.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/01/howard-county-school-board-in-maryland.html">Howard County School Board in Maryland Rescinds United Healthcare Contract As Retirees Didn’t Want the Medicare Advantage Plan, No Providers Available..</a></h5> <p>They have balls I must say and when you look at all of this, reflect back on a decision made by the Supreme Court that allows doctors to group to litigate and this example here might be a good reason why the court denied United for years trying to fight that, as in the past it was always one doctor up against the big corporation.  <img align="right" src="http://lh5.ggpht.com/-nyFsMPDDLgk/UDEQa31432I/AAAAAAAA86o/sscFDo2n0LE/image%25255B21%25255D.png?imgmax=800" style="float: right; display: inline" /></p> <h5><a href="http://ducknetweb.blogspot.com/2013/06/us-supreme-court-rules-physicians-can.html">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</a></h5> <p>This is what you get when insurers hire Quants to add to the Actuaries when modeling policies.  The Actuaries look for the long term goals, while the Quants come in with models that look for the short term and add the impact on their stock.  BD</p> <h5><a href="http://ducknetweb.blogspot.com/2014/10/data-scientistsquants-in-health.html">Data Scientists/Quants in the Health Insurance Business–Modeling Beyond the Speed and Capabilities of Humans To Keep Up With The Affordable Care Act–Turning Into A World of Killer Algorithms That We All Hate..</a></h5> <p>Anyway this is what’s going on with insurers and some of their Quants may in fact have been employed by the likes of high frequency trading firms and banks, so see how they want to push humans through a mechanism that resembles a stock exchange with their models?  The only problem is we are human and can’t change that fast and keep up, so something is going to have to give pretty soon.  BD </p> <p> <hr />United Healthcare has advised CMA that its new Core plan, which will be marketed to employer groups seeking lower premiums and used for its potential future exchange product, will access a significantly narrowed network of approximately 45 percent of UHC’s current PPO provider network.</p> <p>UHC plans to send amendment notices to physicians selected to participate in the Core network sometime in March. UHC also reports that the terms of each physician’s United Healthcare base contract will apply to the new Core plan.</p> <p>According to United Healthcare, physicians were selected to participate in the Core plan network based on their performance in several cost containment areas, including referrals to out-of-network physicians, average episodic cost of care and overall contractual fee-schedule reimbursement during calendar years 2012-2013. Although the cost criteria for the Core program mirrors that of the United Premium Designation program, UHC stated that the two evaluations are unrelated and that physicians achieving Premium Designation status may not necessarily be included in the narrow Core product network.</p> <p><strong>The amendment for the W500 product does not allow physicians to opt out of just the new product; rather, physicians would have to terminate their underlying United Healthcare PPO agreements in order to opt out of the new Core plan network</strong>. Physicians will have 45 days from the date of receipt of the amendment notice to notify UHC if they wish to terminate their participation prior to the April 20 effective date.</p> <p><a href="http://www.cmanet.org/news/detail/?article=united-healthcare-amendment-introduces-narrow">http://www.cmanet.org/news/detail/?article=united-healthcare-amendment-introduces-narrow</a></p>

United Healthcare Extending Narrow Networks in California–More Secret Scoring of Doctors in the US–Telling The Doctors If They Are “Allowed” To Be In Network…

Here we go again the “too big to fail” health insurer at it again.   Read some of this and see why even the doctors have trouble knowing the...

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Anthem Data Breach–Crooks Want to Sell Data Too–The Impact of the “Data Selling For Profit Epidemic” That Exists in the US With Scoring Consumers Removing Access and Human Dignity

<p>We have a somewhat new breed of hackers out there today.  I'm sure by now you have read one of the many articles about what was taken, but pretty much it was demographics on the insured or prior insured.<strong>  80 million files is a lot of data</strong>.  Today's hackers want to make money selling data too.  If there was a cause or someone felt they had been wronged someway, we probably would have seen something posted on Pirate’s Bay or some other site as such.  If that were the case the hackers would have stopped at a much smaller number of accounts.  Now we have everyone moving in to take a look, HHS is going to do their investigation and so are several states and a national insurers group as well.  We can’t leave out the lawyers here too as the firm of Hagens Berman is in there for their investigation too.  </p> <p>Listen to what data sells for on the black market, then change pace and see what it sells for in volume in the legal market…there you go why the crooks will reformat and want to get into selling stolen data to companies without them knowing it was stolen. </p> <p>You might think that's an odd statement to make but it's true. <strong>  With 80 million files, that's a lot of data to repackage and sell.</strong>  Repackaging is when a data base is sold from company A to company B who may just happen <img align="right" alt="image" border="0" height="102" src="http://lh5.ggpht.com/-TJ4cI54itOg/VNbAf1C3i2I/AAAAAAABL8E/0Qh9Z7MHGKU/image%25255B18%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="284" />to have data base C sitting around so they query and merge the two together and now you have a brand new repackaged data base.  But let's say there were errors and flaws in either or both, well those move right along with it.</p> <p><strong>There's no record of who's merging and selling data today and it's a business in the US that is worth $180 billion a year, so see why the hackers want data?  They may sit on it for months and do nothing until things cool off.</strong></p> <p>The big thing right now though is the connection with SSNs and IRS as they don't match up names and SSNs...as a matter of fact 40% of fake tax returns sail right on through and pay off.  Those who were breached will face this every year for gosh knows how long.  If you missed the news of late, due to tons of fraudulent returns filed, TuboTax has put all refunds on hold temporarily.  </p> <p><a href="http://ducknetweb.blogspot.com/2014/09/one-more-reason-to-license-data.html">See the video from 60 Minutes on the Tax Hole</a></p> <p>For three years now I have had a campaign going to index and license all who sell data.  Why?  Well for one, who are they..here's a company (link below) you have never heard of that buys our credit card data, scores and analyzes the data and sells it to banks and insurers as well as our own consumer financial protection bureau, so what's up with that one?  Ever hear of Argus?  Read the link below and see how they score and analyze your data and sell it to insurers, banks and even the good old US Consumer Financial Protection Bureau.  <strong>That last one is nuts as <img align="right" alt="image" border="0" height="246" src="http://lh4.ggpht.com/-GH8veoe1b08/VNbAg9bSOFI/AAAAAAABL8M/BD2mufpQYfI/image%25255B14%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="458" />Richard Cordray is over his head in that agency with no data mechanics logic.</strong>  </p> <p><a href="http://ducknetweb.blogspot.com/2014/08/argus-analytics-produces-share-of.html">Argus- a Big Data Seller-your credit card transactions</a></p> <p><strong>This is very serious with Blue Cross and they have other battles as well.</strong>  They also have sunk in $100 million to create what is called an HIE, a facility that allows hospitals to sore and share records between hospitals.  It's not going to be a go now you can almost best with Cal Index.  </p> <p><strong>Here's my campaign on indexing and licensing all data sellers at the link below, so we know who they are.</strong>  If the files in fact are now in China, well they could be repackaged and sold both there and here.  The danger of course is that companies without knowing could be buying breached and flawed data.  </p> <p><strong>Remember in the bulk data selling business, they don't care and flawed data gets the same price as good data.</strong></p> <p><strong>At the campaign page you can read about myself getting an offshore call about participating in a "blood thinner" clinical trial.</strong>  They had all my information when they called my but there was one big problem, I don't take blood thinners and never have at all in my life, so the data was flawed and I don't know how many times I have been sold and resold on a list of people who take blood thinners.  This is where we do not want any of this data outside of medical records and clinical data to be used.</p> <p><a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">Index and License All Data Sellers-Please Donate to the Cause here</a></p> <p>The need is now two fold for licensing, one to help us consumers track down and get the flawed data fix and this is growing all the time with sloppy data work, I see it all the time. <strong>The second reason is to make sure that data sold or linked contains a license reference so the buyer is not accidently buying breached and stolen data. Also the thieves could do all kinds of damage and flaw more of it on purpose if they wanted.  </strong></p> <p><strong>I have been beating this drum for 3 years now to pass a law that requires licensing for data selling and it goes without enough attention.  Lawyers have been out in the boondocks thinking this industry could self regulate, not when you have $180 billion made <a href="http://map.ipviking.com/"><img align="right" alt="image" border="0" height="181" src="http://lh3.ggpht.com/-EOBaV9VaWUE/VNbAhhPGbcI/AAAAAAABL8U/im_TmQAdSJo/image%25255B8%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="457" /></a>at year doing this.  Shoot Walgreens and CVS each pull in 1 to 2 billion a year just selling data and I would hate to see the huge dollars that United Healthcare and all their subsidiaries make hawking data, it would be a lot larger than Walgreens or CVS as they are like the #2 or #3 healthcare data seller entity.  You can see that all over various reports that have been on the web for the last few years.  </strong></p> <p>This is just really nasty stuff and again I hope my campaign catches on real soon as I'm making a big stink about it as I started writing the FTC and a few members of Congress three years ago.  We do need a law and the FTC needs that law to take more action as well.  This is an interesting page to look at, a visual of all the hacking going on in the world from Norse.  Take one look and you'll see how busy the hacking world is out there, screenshot on the right here.  </p> <p><a href="http://map.ipviking.com/">Live Data Attacks Happening Right now</a></p> <p>On thing for sure, Anthem might have to cut back on their Stock Buy Backs as this will prove to be very expensive.  Like I said they want some of this multi billion dollar action and they could sit on it for months or a year before they might swing into action, when the heat blows over.  This is a different type of hacker who doesn’t want to be found really, they want money and are not out pushing a cause.  You think Anthem now might give security more attention and spend money there versus buying up our credit card transactions to see what size clothes we buy (and of course any other data that’s present).</p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/insurance-companies-are-buying-up.html">Insurance Companies Are Buying Up Consumer Spending Data-Time is Here to License and Tax the Data Sellers-As insurers Sell Tons of Data, Gets Flawed Data When Data Buyers Uses Out of Context Too</a></h5> <p>Enjoy this video below …it’s game called Data Dealer….but it’s also reality…think Anthem stolen data…this is what the crooks want…and why we need to license all data sellers so we don’t have stolen data mixing in the mainstream and to give consumers an idea on where to go look to find flawed data reported about us to correct.  </p> <p><iframe style="height: 274px; width: 444px" height="315" src="https://www.youtube.com/embed/x2eCAgQ1DTo" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <div id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:3ab924fa-706a-43dc-8b00-f9035647807d" class="wlWriterEditableSmartContent" style="float: none; padding-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; display: inline; padding-right: 0px">Technorati Tags: <a href="http://technorati.com/tags/Anthem" rel="tag">Anthem</a>,<a href="http://technorati.com/tags/Breach" rel="tag">Breach</a>,<a href="http://technorati.com/tags/healthcare" rel="tag">healthcare</a>,<a href="http://technorati.com/tags/data" rel="tag">data</a>,<a href="http://technorati.com/tags/insurance" rel="tag">insurance</a></div>

Anthem Data Breach–Crooks Want to Sell Data Too–The Impact of the “Data Selling For Profit Epidemic” That Exists in the US With Scoring Consumers Removing Access and Human Dignity

We have a somewhat new breed of hackers out there today.  I'm sure by now you have read one of the many articles about what was taken, b...

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Anthem Security Breach–Take A Look At Lifelock Services to Protect Your Identity-Receive A MedicalQuack Discount

<p>The MedicalQuack officially did go broke but with the big security breach from Anthem,<a href="https://secure.lifelock.com/enrollment?promocode=QUACK"><img align="right" alt="image" border="0" height="125" src="http://lh4.ggpht.com/-GTmlzB1iuYw/VNUTTIGqN1I/AAAAAAABL7k/alELoWtyk_Q/image%25255B9%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="285" /></a> I thought this post was necessary.  We don’t know yet or at least I have not read what services Anthem will be supplying but if you want to take your identity in your own hands, here’s an option for you with Lifelock.</p> <p>Here’s a clip from Dr. Halamka, CIO Harvard Medical (<a href="http://ducknetweb.blogspot.com/2014/10/cxotalk-dr-halamka-cio-of-beth-israel.html">the entire interview can be seen here</a>) on the value of hacked and stolen data.  At the beginning he talks about the new codes doctors will be using soon, a lot.  This was done a couple months ago odd that he just happens to reference “that great Blue Cross Plan”…</p> <p><object height="271" width="460"><param name="movie" value="http://swf.tubechop.com/tubechop.swf?vurl=h9XSu3981hQ&start=1113&end=1301&cid=3721125"></param><embed src="http://swf.tubechop.com/tubechop.swf?vurl=h9XSu3981hQ&start=1113&end=1301&cid=3721125" type="application/x-shockwave-flash" allowfullscreen="true" width="460" height="272"></embed></object></p> <p>You can <a href="https://secure.lifelock.com/enrollment?promocode=QUACK">follow this link</a> and it will take you to the page where you can enroll and get a discount by using the code:  QUACK</p> <p>If you don’t use the code the discount will not apply so don’t miss that part as it’s not pleasant thinking you might need to enroll so take advantage.  </p> <p>Here’s a couple videos that explain a little bit more about LifeLock and how it works.  In addition, there’s options for a company to enroll to protect employees as well.   </p> <p><iframe style="height: 284px; width: 476px" height="315" src="https://www.youtube.com/embed/03-Z1dIMu18" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>Lifelock’s Three Layers of Service…</p> <p><iframe style="height: 277px; width: 473px" height="315" src="https://www.youtube.com/embed/R9d4qWJiy-I" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>Here’s a preview of what the 3 programs they offer…quick screenshot..</p> <p><a href="https://secure.lifelock.com/enrollment?promocode=QUACK"><img align="left" alt="image" border="0" height="127" src="http://lh6.ggpht.com/-PTmxDJxUMtY/VNUTThLabVI/AAAAAAABL7s/jIVSUgUFZp4/image%25255B8%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: left; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" title="image" width="485" /></a></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>I was looking at their website and there’s a new service just been added:  Data Breach Notifications…</p> <p>So I hope this helps and at least offers some answers and a place to go.  80 million records is huge and it’s only starting.  I have a campaign as<a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776"><img align="right" border="0" height="113" src="http://lh5.ggpht.com/-WjSMddBKiho/VAJ2n8h7WcI/AAAAAAABLOU/rTfddMqQxlU/GoFundMe%25255B5%25255D.png?imgmax=800" style="border-left-width: 0px; border-right-width: 0px; background-image: none; border-bottom-width: 0px; float: right; padding-top: 0px; padding-left: 0px; display: inline; padding-right: 0px; border-top-width: 0px" width="156" /></a> well to establish a law that will require data sellers to be licensed.  Why?  As data is breached and repackaged, just like counterfeit drugs, stolen data that companies believe to be legal will end up in the system.  </p> <p>We need a way to track data that is sold as well as a way for consumers to look up sellers and be able to locate those who have posted flawed information about them.  Read my story as I’ve been there and I have one now I can’t remove.  </p> <p><a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">Visit the Privacy/Transparency Campaign</a> and please consider a donation if you will.  I have been working on this for 3 years and even a small $5.00 contribution is really appreciated.</p> <p>Thank you!! </p> <p>Barbara Duck</p> <p>The Medical Quack! </p>

Anthem Security Breach–Take A Look At Lifelock Services to Protect Your Identity-Receive A MedicalQuack Discount

The MedicalQuack officially did go broke but with the big security breach from Anthem, I thought this post was necessary.  We don’t know ye...

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