United Healthcare Owns a Bank-Optum Bank That Will Collect Your HSA Money, Give You a MasterCard to Empty It Out-Which Enables Even More Data Mining and Selling Transactions About You

<p>How many people know that Optum has a bank?  They don’t offer any retail services outside of an Health Savings Account to the public but many companies offer this for people who have a high deductible health insurance policy.  You can <a href="http://www.yelp.com/biz/optumhealth-bank-salt-lake-city">read through Yelp</a> and make your own opinions if you want to dive in a bit more.  The bank is located in Salt Lake City and most of what one would do with this “custodial” bank would be online<img align="right" alt="image" border="0" height="90" src="http://lh3.googleusercontent.com/-iYDYa3JAfYU/VjT7b3yu4UI/AAAAAAABMkw/h3QohrR537I/image%25255B3%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="234" /> of course.  There are other Health Savings Accounts around of course to choose from.  Well here we have MasterCard who we should all know by now are just marketing and mining your data to who ever seems to have the money to buy anymore.  Here’s a company names Argus, who buys credit card information and then continues on to “score” you.  We’re not talking credit scores here, but anything they can think of where they can take data, score you with some query some Rogue software engineer came up with to make money.</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>With Ben Carson all of a sudden touting Health Savings Accounts, you kind of might wonder how much money United Healthcare could be donating to his Presidential campaign?  Why would this appear as such a high item on his agenda?</strong> </p> <p>Another firm in the Health Savings Account business, Health Equity just bought off most of Bancorp’s HSA accounts, which was 170,000 accounts, $400 million in deposit.  Pay attention to this as your Health Savings Account can be bought and sold like let’s say a mortgage.  The one benefit of a<img align="right" alt="image" border="0" height="109" src="http://lh3.googleusercontent.com/-kQhEvDBccMs/VjT7cdiSPgI/AAAAAAABMk0/ZW0Wt_LynAU/image%25255B11%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="168" /> Health Savings Account, which is why they exist is that they are tax free.  Most folks get into a Health Savings Account through their employer, although some are available outside those parameters.  If you have one at work from your employer, then if you leave, you need to transfer or close the account for the most part.  </p> <p>So how convenient is this, for United to have full on bank that provides this service, as it certainly goes to compliment all the high deductible plans they offer, right?   The high deductible policy guidelines to qualify are $1300 for an individual and $2600 for a family.  There are limits on how much money you can put in these accounts as well.  Last I read there is over $2 billion on deposit at the Optum Bank.  </p> <p>Now when you tie your account to an Optum MasterCard, here come the fees, quite a few of them, so no surprise there.  I think United Healthcare is second only to maybe IMS with being one of the largest healthcare data sellers in the US.  With around 350 subsidiaries, to include pharmacy benefit management, they have a ton of your data to score and sell on any type of model and query they decide to build.  As I recently reported, if you are insured by Cigna, you get United Healthcare now as your pharmacy benefit manager, more on that at the link below, with the impact of mass mergers and acquisitions of healthcare companies.</p> <h5><a href="http://ducknetweb.blogspot.com/2015/10/if-you-are-insured-by-cigna-guess-what.html">If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare</a></h5> <p>MedPoint is United’s (aka Optum) data selling unit that’s been around for years collecting and selling your <img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/SkL9GOgy_rI/AAAAAAAATec/4yxb2jf7CV8/image_thumb%5B5%5D.png?imgmax=800" style="float: right; display: inline" />prescription data.  As a matter of fact, they licensed and probably still collect a lot of money from this, their algorithms to companies like Express Scripts to “score” you on the flawed Medication Adherence Prediction Metrics which are totally discriminatory as the metrics are secret and you can’t see them.  The name Ingenix, at least in the US has now been changed to Optum.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5> <p>So again, there’s more data to collect and sell and more importantly “score” about you generated by using a MasterCard with your Health Savings account.  I had a conversation recently with an Apple employee and he had no clue that his Optum Credit Card data was in the arena to be sold.  How convenient is this though for United to take the Optum banking data and roll it right in to all the data scoring and metrics that are done with other areas of Optum.  </p> <p>It’s also interesting that the Optum bank of course is marketing this MasterCard for other purchases when they can and these might fall out of the qualified areas with your Health Savings Account.  It’s interesting to note that their website states that you can only withdraw $10,000.00 in a 24 hour period.  How many people have that much money in their Health Savings account?  Not many.</p> <p>The Optum Bank says you can invest your money in “mutual” funds to help save for future health expenses.  The site also lists this disclosure “<strong>Investments are not FDIC-insured, are not guaranteed by Optum Bank and may lose value”.   Guess what, another suggestion here on how to get your Health Savings Account money in the stock markets, right?</strong></p> <p>Again, you are covered with a normal Savings Account here, but not if you venture out beyond by the FDIC of up to $250,000.  How many other health insurers own a bank?  None that I’m aware of.  </p> <p>Wealth Management, is also a service offered, so again most HSA accounts are not that big for the most part, so how much wealth can be managed?  Again the big sell is getting more data transactions ramped up on the MasterCard you can use as a debit card.  United does other “card” programs, again all to collect, mine and do more scoring of your data and the flawed results can be astounding with certain data files.  </p> <p>The insurer will get you in the grocery store and with vending machines, again all to track more of what you do.  If that isn’t enough for you, look at this subsidiary of United Healthcare with their <a href="http://lacrossetribune.com/news/local/lhi-puts-knowledge-on-healthy-eating-menu-with-knourish/article_d6d23a0a-1465-5e7f-8b5c-3ffdaeb03d1f.html">vending machine that does not take cash…</a>here goes the war on cash again.  LHI is a government contractor that is owned by United Healthcare that does a lot of things from giving vets their disability physical and findings and sends it off to the VA to inoculating and performing physicals on soldiers before they are sent out of the country on duty, and that’s a lot of money made there as well.  Now LHI is out to get you using more United Healthcare cards.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/united-healthcare-finds-yet-another-way.html">United Healthcare Finds Yet Another Way to Track You At the Grocery Store–Healthy Savings Card That Will Give You Discounts and Track What You Buy..</a></h5> <p>In other Optum news, another long standing legal case of crooked algorithms created by Ignenix (now called Optum) <img align="right" alt="image" border="0" height="116" src="http://lh3.googleusercontent.com/-vAI8dKNefXs/VjT7dPeXFzI/AAAAAAABMk8/3iScXaEP4Eg/image%25255B10%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="169" />was recently settled.  Andy Slavitt, who is currently running CMS was the brainchild here and is a former Goldman Sachs banker who was the CEO and ran the Ingenix subsidiary of United Healthcare for years.  Why Obama nominated him for the job full time is beyond me, but as of now he’s “acting” as the chief administrator.  See how this all ties together with old Mr. Slavitt leading the way to connecting health insurance to banking?  The Optum bank has been around for a while and is located in Salt Lake City.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/09/another-united-healthcare-ingenix.html">Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…</a></h5> <p>Those working at banks and financial institutions probably are more likely to have an employer provided Health Savings Account.  Earlier this year the Optum bank now is now using <a href="https://www.bogleheads.org/forum/viewtopic.php?t=163140">Admiral Funds on Vanguard Funds,</a> a way to avoid fees and snare some folks into the stock market, maybe not in a large way, but that’s the incentive here.  Here’s a video plug below…on getting you into the market and funds..$2100.00 is what you need as a minimum.  Pay attention to all the “healthcare” information they want as well.  Again, combine that with MasterCard transactions and more and shortly they have one heck of a data file on you, not to mention all that rolls in from Prescription data too.  </p> <p><iframe height="315" src="https://www.youtube.com/embed/ABEelaoA5LI" frameborder="0" width="420" allowfullscreen="allowfullscreen"></iframe></p> <p>You be the judge here, are you really helping yourself with healthcare savings, or are you being marketed to dump it out with a MasterCard or get the money into the stock market?  What do you think?  </p> <p>Why does Ben Carson see this as such a good deal?  Is United a big backer of his campaign?  You can transfer dollars back to your HSA from the Mutual Funds, that is if they are doing ok.  </p> <p>In addition, this Optum bank also loans companies and doctors money, all done with funds on deposit from you.  Be careful what you sign up for with this bank and the HSA opportunities.  BD</p>

United Healthcare Owns a Bank-Optum Bank That Will Collect Your HSA Money, Give You a MasterCard to Empty It Out-Which Enables Even More Data Mining and Selling Transactions About You

How many people know that Optum has a bank?  They don’t offer any retail services outside of an Health Savings Account to the public but man...

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If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare

<p>First question out of the barrel might be “how can that be”.  It’s really not too difficult to figure out.  A short while back United Healthcare bought a pharmacy benefit manager named Catamaran, and actually took on $10 billion in debt to acquire them.  This has been in the news for a while actually, so how did you end up with United Healthcare.  It’s easy, Catamaran is the Pharmacy Benefit Manager for Cigna, so when<img align="right" alt="image" border="0" height="250" src="http://lh3.googleusercontent.com/-XHSvyCC6Ly0/Vi7i2iz25hI/AAAAAAABMkY/pP9kI46N7qE/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="219" /> United bought the company, it became a subsidiary of United Healthcare, so there you go.  The company is now a subsidiary of the huge too big to fail health insurer, who actually gets 2/3rds of their revenue from insurance policies and the rest from selling software and algorithms for a big chunk of the other third.</p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/united-healthcare-having-big-bond-sale.html">United Healthcare Having a Big bond Sale to Finance Purchase of Catamaran Pharmacy Benefit Management Company, Huge 10.5 Billion</a></h5> <p>United already has their own Pharmacy Benefit Manager called Optum RX and Catamaran is going to be merged together with them, so there you go.  In time the name Optum RX will be the only name you see.  Both Cigna and United are members of the S&P 500 and run stock buy backs.   So now, portions of your policy premiums can go to not one but two buy back programs…a two fer.  Last year in 2015 Cigna spent about $1.63 Billion in buying back stocks and of course United spent a bunch more than that as they are so much larger, although I read somewhere that United’s buybacks were reduced a bit to allow this acquisition of Catamaran.  If you keep up a little on stock news, then you’ll know how the S&P index has been diving and when stock buy backs grow to big dollars, well people lose jobs and things get cut, again all to allow the companies to buy more of their own stock back and give the CEOs a lot more money.  </p> <p>As a matter of fact, United’s CEO, Hemsley just joined the board of Cargill, and what’s one of their big focuses, <a href="http://www.cargill.com/products/pharmaceutical/index.jsp">pharmaceuticals.</a>  All this starting to make a little more sense when you connect some dots?<strong>  Cargill is Minnesota's largest privately held company.  Cargill also offers farmers services and is the evil twin brother of Monsanto, so real place for </strong>Hemsley, right?  Just like Monsanto, Cargill feeds on family farmers and Cargill is the world’s largest trader of grains, the world’s largest privately held corporation.  If you ever have any doubt United is all about money, well what do you think now?</p> <p><strong>In other news on the Pharmacy Benefit Manager purchase, Independent pharmacists filed a class action lawsuit against Catamaran.</strong>  Can you guess why?  The independent pharmacists are getting lowballed.  They might seem to fit the United Healthcare model of Ingenix, now called Optum Insights that lowballed MDs on payments for 15 years and had many law suits filed against them.  Just as a side note, Obama nominated Andy Slavitt to run CMS, and he was the CEO of Ingenix, the low balling company, do we want him at CMS?  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/03/united-healthcare-buys-catamaran.html">United Healthcare Buys Catamaran Pharmacy Benefit Manager Just As the PBM Gets Hit With A Class Action Lawsuit For Low Balling Pharmacy Reimbursements..And More Patient Data to Sell and Analyze For Profit</a></h5> <p>This might indeed have a lot to do with why Anthem and Cigna want to merge.  Neither company has an in-house pharmacy benefit manager and relies on 3rd party PBMs like Express Scripts and Caremark for their services, and some smaller PBMs that existing out there among the giants.  For Cigna, as it stands now they are pretty much “hooked” into supporting the PBM subsidiaries of United Healthcare.  It takes time and is expensive to change a few million patients over to another PBM and the rates United charges them can go up too.  Could be a big squeeze by United, which they are known for doing when the opportunities fall into their laps.  One merger and patients now get to support the stock of 2 health insurance companies.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/anthem-and-cigna-merge-whats-in-it-for.html">Anthem and Cigna Merge, What’s In It For Consumers, Nothing Really, But There Will Be a Massive Data Mess of Analytics, Budgets, and You’ll Never Get An Accurate Listing of MDs in Network…</a></h5> <p><strong>United Healthcare has already beat the crap out of Express Scripts in Florida</strong> in taking business away from them and moving it in house to Optum RX, which by the way is now the largest PBM in the country with the acquisition and merging of Catamaran, so United has 2 “large” credits to their name being the largest insurer in the US as well.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/05/optum-clinics-holdings-new-subsidiary.html">Optum Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…</a></h5> <p>So you may have heard about Cigna pulling out of Florida for Obamacare insurance and it may have had something to do with this taking place and Optum RX taking over the pharmacy benefit management of so many people in Florida.  See how this worked earlier this year.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/05/express-scripts-to-lay-off-400-people.html">Express Scripts To Lay Off 400 People Tampa As United Healthcare Moves Patients To Their Own Pharmacy Benefit Management Company-Subsidiary Watch</a></h5> <p>But when functioning with another subsidiary, United was not always a foe for Express Scripts, as Ingenix provided the algorithms for the company to begin this bogus “medication prediction adherence scoring”.  Here’s the link below and this is not to be confused with actual clinical records for monitoring, the prediction part as it is used now is pretty much junk very discriminating as the 300 metrics used have zero to do with taking meds.</p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5> <p>This occurred in 2010 and now it has evolved to the next link below…this is flawed data and if you don’t have enough they can mine, you default to non compliant..great stuff right?  Do you have kids in the home..ding..they’ll distract you from taking meds, is your partner non compliant…ding their influence will rub off on you…see the screenshots right off their site.  Of course they are not alone as you have FICO, Caremark and many others doing the same stuff and probably using those old Ingenix metrics and adding a few of their own.  Of course, United, (Optum Insights, formerly known as Ingenix) probably has a gazillion patents on these more than flaky “scoring” processes that serve up flawed data all the time.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5> <p>Check this link out too for more on the war on cash at the pharmacy too.  If PBMs can’t dig up enough data on you, again you<img align="right" alt="image" border="0" height="491" src="http://lh3.googleusercontent.com/-dclAvjnezyI/Vi7i3HcWjII/AAAAAAABMkc/j5mxORCgLmA/image%25255B4%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="350" /> default to non compliant and now are labeled an Outlier as you pay cash.  This is very common with seniors as they pay $4.00 cash at Wal-Mart and are in fact no way non compliant, it’s just a data game to give drug companies more ammo to keep their prices high by blaming consumers, doctors and pharmacists for being bad boys.  It’s a joke, but the perception deception joke keeps working as the media taunts is with it all the time.  I get tired of reading the articles that are so bogus with promises of saving money with compliance as nobody can put a precise dollar on it, so blank those stories out as they are usually some form of <a href="http://ducknetweb.blogspot.com/2015/04/news-rigging-has-arrived-astroturf-and.html">news rigging and astro-turfing.</a>  </p> <p><strong>So what do you think?  You premiums get to help support not one buy two health insurers and truckloads of false consumer medication adherence scores.</strong>  The scoring is all about selling your data.  In healthcare, United is the #2 data seller in the US as it’s more than just insurance and prescriptions, as they have over 350 subsidiaries they operate.  </p> <p>Here’s yet another reason for Cigna to maybe want to be a little less close to United…look at this new subsidiary and they want to buy up doctor practices all across the county and look what the raised to do this..another $36 million.  There’s around 350 urgent care clinics already.  Will the Optum/United Pharmacy Benefit Management be connected here, you bet it will be as it’s easy money to capture some more drugs and data to sell.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/05/optum-clinics-holdings-new-subsidiary.html">Optum Clinics Holdings, New Subsidiary Incorporated In 2015 Raises Over 36 Million (Exchange of Shares) From Investors Unknown-Form D Used to Maintain Secrecy Of Who They Are For Now…</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2015/04/optum-united-healthcare-buys-medexpress.html">Optum (United Healthcare) Buys MedExpress Urgent Care Business- 141 Full Service Clinics In 11 States–Company Advertises They Are In the Market to Buy Your MD Practice, As A “Too Big To Fail Insurer” Moves Forward With More Acquisitions</a></h5> <p>Mayo likes Optum and is an Optum Labs member and now is outsourcing all it’s revenue cycling to them as well.  So hospital folks get fired and hired back at less pay and fewer benefits, or a degradation of benefits.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/04/mayo-clinic-is-latest-to-outsource.html">Mayo Clinic is the Latest to Outsource Revenue Cycling to Optum 360, A United Healthcare/Dignity Health Company Pursuing Hospital Contracts All Over the US For Profit…</a></h5> <p>Last but not least, all this will just keep on happening as we’ll never get any help from DOJ Loretta Lynch as she used to represent United Healthcare with Anti Trust Lawsuits, so how’s that for the kicker at the end of all of this?  See the image of the letter<img align="right" src="http://lh3.ggpht.com/-cOCVFGTtmx8/UmB-R83r4zI/AAAAAAABIMY/0H4-dbr3Oeo/image%25255B7%25255D.png?imgmax=800" style="float: right; display: inline" /> United wrote to Grassley to make sure she got approved.  You almost have to laugh at when she says she’s going after Wall Street bankers who are indeed much smarter than her and can code her right under the table with her using legal verbiage only, been going on in this country for years.  The code hosers are in control.</p> <p><strong>So anyway, there’s some big news for all you folks with Cigna Health Insurance policies and a bit more on how the big gun United operates with over 350 subsidiaries,</strong> and by the way who also owns a bank with a few billion on deposit.  You get a health savings account and then the bank gives you a Master Card to use to dump it all out and create even more data about you to sell.  Check out this subsidiary…dialed in to the FDA too and some <a href="http://ducknetweb.blogspot.com/2013/10/unitedhealthcare-doesnt-want-to-let.html">low income housing investments here.</a>  </p> <h5><a href="http://ducknetweb.blogspot.com/2011/09/united-healthcare-optum-owns-consulting.html">United Healthcare (Optum) Owns A Consulting Firm for FDA Drug and Device Approvals, Clinical Trials–CanReg - Subsidiary Watch</a></h5> <p>It just doesn’t seem to get any better with United and now the CEO sits on the board of Cargill, as I said above, the evil twin of Monsanto.  Sorry to rain on the parade of all those insured by Cigna but maybe things will change early enough bit it’s a flipping 10 year contact Cigna signed with Catamaran so you may be stuck with United doing your pharmacy benefit management and selling your data for quite a while.  BD </p>

If You Are Insured by Cigna, Guess What You Have a New Pharmacy Benefit Manager Named United Healthcare

First question out of the barrel might be “how can that be”.  It’s really not too difficult to figure out.  A short while back United Health...

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The End of “Consumer Common Sense” in the US-Fueled by Excess Scoring for Profit, Sustained By Media Publications Serving To Further The Inability For Simple Every Day Life Decisions…

<p>This is topic that maybe does not get enough attention, simply due to the fact that today, consumers  are just blasted with a score for this and a score for that, basically establishing a brain washing process to where we are becoming a “Dupes of Hazard” community in the US and maybe beyond.  There have been many articles talking about the lack of common sense but most have not touched into what is causing all of this.  Stop and think, every where you read, you need a flipping “score” or you need to go search out some statistics to make a simple every day decision.  <img align="right" alt="image" border="0" height="109" src="http://lh3.googleusercontent.com/-hQwKm4C4AtE/ViuglyD14aI/AAAAAAABMjw/eSs-lXuEAAE/image%25255B16%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="291" /></p> <p>Certainly there are times when you do need research and need to read up, but those lines and simple every day decisions are becoming more gray by the day.  In addition, some of the areas you go to do research are filled with “flawed data” created by proprietary software models that are not reviewed but rather just say “trust me, I can give you the information on this website” per se.  Surveys can be helpful at times but they too are way overdone and so many of them have back end functions that are just there to mine and scam some data to sell from your response, depends on who’s doing the survey and what’s at stake.  I stay away from all of them myself as I can’t always tell what’s a data mining survey to capture data for sale or one that is just a simple survey anymore.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/05/privacy-duping-of-america-intangible.html">Privacy Duping of America-The Intangible Threat Model Has Changed Significantly-Companies Hide The Code On the Web, $180 Billion Dollar A Year Business, Welcome to The Duperville World of Inequality..</a></h5> <p>The government also is a big proponent of “scoring” as you see it everywhere and they too seem to think that “scoring” and digesting such scores are the big answers everyone needs…not so.  Look at HHS and CMS for a couple big examples.  They can’t stop scoring and think they need to offer us more scores, and in turn “score us” some more to where it becomes an area where you just turn off.  CMS scores on hospitals are pretty much useless as consumers pretty much have to go to the hospital “in network” and if it has a less than desirable score, who wants to see that.  If you need a procedure you want to think that the facility is capable and that you will have a good experience as the insurers too have scored those hospitals, so who’s right?  </p> <p>Insurers of course will tweak hospital and doctor ratings and scores to steer people to search out those in network,<img align="right" alt="image" border="0" height="67" src="http://lh3.googleusercontent.com/-O2GX98HeCEE/ViugmZmrGTI/AAAAAAABMj0/beX3ek7IOvQ/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="348" /> and thus so, if consumers want their medical bills paid with a larger dollar amount, they go there.  The research needed here is to find the doctors and hospitals who are in network.  As a matter of fact insurers make it harder for you all the time to research as their own systems are so complex, they have a hard time breaking it down for the consumer to research with firing doctors all the time with quant manufactured models that pretty function like financial models.  </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> <p>Sure there is data that makes us smarter, but how many times do you see articles on the web about stupid studies that lean on the side of making a common sense decision, all the time.  One that circulates out there a lot is about how much sleep you need.  To me, this is common<img align="right" alt="image" border="0" height="256" src="http://lh3.googleusercontent.com/-HY99L9qGYgs/Viugm-4xpdI/AAAAAAABMj8/8kaexvH1rac/image%25255B11%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="357" /> sense as if I don’t get enough, my body tells me, so what’s so difficult about that?  Sure there are real problems with people who for what ever reason “can’t sleep, but that’s a different issue all together.  Are you going to spend all this time and clutter your mind with how much sleep you need to in turn become much more insecure as all the media tells you to do this?  It’s pretty much what’s going on to where you can’t make a simple determination of whether or not you are getting enough sleep, which has pretty much been common sense. </p> <p>We have a ton of what I call “Crap Apps” out there as well with some developer writing a few queries to help with decision making.  There are a few that are worth your time with some of this but more commonly most are just crap.  All the medication apps to “help you” remember to take meds are pretty much just data miners and data selling equipped.  For years I have used Outlook, and can do it on my phone to schedule a simple reminder to take of something, be it take a pill or take care of a task..works well for me and again I can stay away from the Crap Apps and keep things simple and use technology that doesn’t invade my privacy.  </p> <p>You also have useless websites like Healthgrades that are on the web to make money with ad exposure.  This week they put out a story about how people don’t research hospitals well enough and that 1 in 6 patients could have made better choices with going to hospital that specializes in their needs.  Of course for the STAT RAT FEVER folks they are all over this,<img align="right" alt="image" border="0" height="171" src="http://lh3.googleusercontent.com/-pLbrOSew69I/ViugnZa21CI/AAAAAAABMkE/L-plUGeUIPU/image%25255B15%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" /> but it’s a useless piece of garbage report as it entails nothing about what hospitals were “available” in network or the cost..so again, dump their studies and you can read the link below as what they do is just junk outside of giving you an address and phone number for a doctor or a hospital.  I found my former MD who had been dead for 8 years listed on their site an still seeing new patients.  The use of their site for credible research is like out the window and don’t waste your time.  Word of mouth with doctors and hospital selections still seem to be at the top and for good reason.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/11/why-does-hospital-that-was-closed-by.html">Why Does A Hospital That Was Closed By The Feds In 2013, that Put “Fake” Screws In Patients Backs, Has A CEO/Owner Who Admitted Fraud/Patient Endangerment And Is Waiting Sentencing And Who Bribed A State Senator, Still Show On Healthgrades With Five Star Ratings?</a></h5> <p>So next time when you are at a simple decision making process, do some soul searching and think about what you are doing, are you running to the web to look at statistics that really have no impact on your decision as the media tells you to look at sites and to use certain apps.  Try and figure out when you are polluting the process in your own head and run to find stats, maybe just out of habit.  Watch this video below which is also in the footer of this blog of what I call 4 “should see” pieces of information.  </p> <p><strong>Are you sucking in to quantitated justifications for things that are not true?</strong>  </p> <p><iframe height="315" src="https://www.youtube.com/embed/qiQwZ6inbOM" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>And as I mention all the time, these efforts make money, big money for US corporations and we have a situation I call Excess Scoring in the US and if you buy into this over done behavior, you too will lose the ability to make every day “common sense” decisions and you’ll find yourself becoming a bit more insecure in your own abilities.  Give this some thought next time you are trying to figure out where the perfect butt is, how much sleep you need and so on.  The link below goes into more detail and how the US Government uses this process as well, be aware  </p> <h5><strong><a href="http://ducknetweb.blogspot.com/2015/09/excess-scoring-of-us-consumers-us.html">Excess Scoring of US Consumers, US Citizens-Scored into Oblivion By Proprietary Algorithms and Formulas, Never Duplicated or Tested for Accuracy-Profits of Big Business And A White House Executive Command To Continue the Abuse..</a></strong></h5> <p>If we can hang on to our ability to continue to use our common sense, a lot of the broken models and crap apps we are told we need will eventually go away and hopefully only the ones that are truly useful will survive.  BD  </p>

The End of “Consumer Common Sense” in the US-Fueled by Excess Scoring for Profit, Sustained By Media Publications Serving To Further The Inability For Simple Every Day Life Decisions…

This is topic that maybe does not get enough attention, simply due to the fact that today, consumers  are just blasted with a score for this...

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CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..

<p>You know they are going to use these flawed medication adherence scores to determine who gets what with medications.  This is horrifically flawed.  Regulation won’t work and CMS should work towards getting lower drug prices instead of this model that comes back to pound consumers again.  That is the problem and this model will fail and people will not always get the drugs they need.  If you have not read it, <img align="right" src="http://lh3.googleusercontent.com/-WTU_WavuGLg/VYjYaFce1MI/AAAAAAABMZA/DCNNtafnZm8/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" />take a look at the garbage pharmacy benefit managers are popping out there to score you.  Yes this is a secret score using 300 secret metrics that you can’t have or see, but it gets sold to guess who, drug companies and insurance companies.  Are you a male, you get a ding, do you have kids in the home to distract you from taking meds, you get another ding and so on.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5> <p>You can’t make this stuff up as Express Scripts even brags about their “scoring” metrics.  We have excess scoring in the US that produces way too much flawed data.  It’ gets better, they can take the flawed medication score of your partner and ding you for that, with being around a person they have determined is not medication compliant with this junk science.  It is junk and all of this scoring and record keeping with this data makes your drugs more expensive as it’s not free to run this stuff.  When we talk layers of “crap data” that could be removed to save money, this is one of them.  These are crap predictions and not actual monitoring records to see when you pick up your prescriptions either.  That is monitoring but Medication Prediction Adherence scoring is crap as if they don’t have enough data, guess what, you default to non-compliance.</p> <p>Now CMS of course more than likely will lean on this junk science to play God and determine who gets what meds in order to save money.  We all know our doctors are pretty good about telling us about less expensive generics so we can afford them so again this is a layer of junk science that CMS will lean on to save money, and patients may not get the medications they need.  There are times when the generic won’t work or has not worked and if you have some big fake target that says your score shows you are not “predicted” to be compliant, they may not give you the meds.  People with Medicare Part D are already feeling this and I had a conversation with a pharmacist that told me exactly how this works from their end.  All those folks scored non compliant require the pharmacists to contact them, ask they why they are not taking their meds and you know what 90% of them say?  They are taking their meds and pay cash and buy them at Wal-Mart or other places cheaper than the big chain drug stores…cash…and the pharmacists are told by the software they use, these folks are Outliers!  Nice huh?</p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-filling.html">Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “Outliers, Pharmacists Required to Fix Outliers as They Show Up As Non Medication Adherence Compliant With 5 Star Systems Full of Flawed Data…</a></h5> <p>CMS is drinking the Kool-Aid here as if you go to the first link here, look at the big page where Express Scripts<img align="right" src="http://lh5.ggpht.com/_v3zjJigoAPE/SkL9GOgy_rI/AAAAAAAATec/4yxb2jf7CV8/image_thumb%5B5%5D.png?imgmax=800" style="float: right; display: inline" /> says curing non-adherence would provide drugs for many others..what a crock of numbers nobody can predict.  FICO does this crap too with their medication adherence prediction scoring that’s a secret and states all they need is your name and address and they can give you a score and predict how compliant you will be.  This is nothing more than another score for them to sell and make money.  Drug companies love this stuff as it helps them maintain high drug prices by pushing more blame to consumers all the time.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/fico-medication-adherence-scoring.html">FICO Medication Adherence Scoring Should Be Banned As It’s Quantitated Justifications for Profit That Hurts US Consumers Using Proprietary Algorithms That Cannot Be Replicated For Accuracy or Audited</a></h5> <p>Where did all this predictive medication adherence scoring get started?  Look no further than Ingenix, now called Optum Insights as back in 2010 we had this announcement that Express was going to use their algorithms to score you.  By the way, the current head of Medicare is Andy Slavitt, former CEO of Ingenix who’s the brain child of this scoring and is a former Goldman Sachs banker who was sued all over the place for their algorithms that ripped off doctors on out of network pay.  <a href="http://ducknetweb.blogspot.com/2015/07/doctors-in-network-leave-united.html">Currently in many areas, United pays doctors around 12% less than Medicare rates</a>.  Initially Ingenix profiling was used to underwrite but it has graduated to adherence prediction profiles as that allows for a lot more data to be sold.   All the PBMS do this now.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5> <p>So here we go again, CMS drinking that United Healthcare flavored Kool-Aid with Medicare D with reducing the cost of drugs, not with better negotiating with pharma companies, but rather by taking it out of the patient’s hide once more.  What a chicken way to do business is it not?  You know they will be dragging this junk science prediction adherence scoring in there to make decisions as PBMs with regular insurance are already doing such, consumers get hurt so big corporations can continue to get rich.  Drive them crazy, pay cash for all your prescriptions.  This model will fail as the pilots will be denying access to drugs for those in the programs, while MDs get a whopping big $2.00 per month to subscribe to these methodologies and save a consumer $2.00.  This will require more time and effort than the results will show with any ROI and doctors are already buried in too much administrative mumbo jumbo.  So how many Quants did it take to design this model and from where?   BD  </p> <p> <hr />The Centers for Medicare and Medicaid's new Part D pilot for medication therapy management will offer performance payments to plans that achieve reductions in <a href="http://www.healthcarefinancenews.com/directory/fee-service-ffs">fee-for-service</a> expenditures and fulfill quality and other data reporting requirements, according to information released by CMS on Wednesday.</p> <p>Insurance plans that demonstrate reductions in Medicare Part A and B costs of care for their members by a minimum of 2 percent will receive a fixed $2 per member per month increase in the subsidy to the plan premium, which will decrease the beneficiary's portion of the premium, CMS said.</p> <p>The program is aimed at reducing medication related issues in patients as current medication therapy management has not produced the expected results, according to Minter.</p> <p>The question CMS is trying to answer is, he said: Does providing regulatory flexibility and financial incentives to stand alone Part D plans encourage more effective medication therapy management programs?</p> <p><a href="http://www.healthcarefinancenews.com/news/cms-test-performance-based-medicare-part-d-program-targets-rising-drug-prices?mkt_tok=3RkMMJWWfF9wsRovuqXMZKXonjHpfsX56e4kW6K0lMI%2F0ER3fOvrPUfGjI4IRcVjI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D">http://www.healthcarefinancenews.com/news/cms-test-performance-based-medicare-part-d-program-targets-rising-drug-prices?mkt_tok=3RkMMJWWfF9wsRovuqXMZKXonjHpfsX56e4kW6K0lMI%2F0ER3fOvrPUfGjI4IRcVjI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D</a></p>

CMS Medicare Part D Program With Medication Therapy Management–Here Comes the Flawed Medication Adherence Prediction Scores, Make Sure Jane Doe Gets the “Cheap Meds”..

You know they are going to use these flawed medication adherence scores to determine who gets what with medications.  This is horrifically f...

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EHR State of Mind” 30 Clicks for An Ambien, Crappy Software Some Vendor Made Us” Video

<p>This almost needs no introduction and I’m sure almost all the doctors today can relate to this one.  ZDogg MD<img align="right" alt="image" border="0" height="152" src="http://lh3.googleusercontent.com/-ud5He1DrZpc/ViW5ZxZLCxI/AAAAAAABMjc/OPLCWxvawZ8/image%25255B2%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" /> has another hit it seems.  This is a real doctor who does all these videos so he’s on the front line.  </p> <p><em>“EHR's suck. Let's make 'em better. Go to </em><a href="http://letdoctorsbedoctors.com/"><em>http://LetDoctorsBeDoctors.com</em></a><em> and tell the IT and government folks what's up. And check out</em><a href="http://zdoggmd.com/"><em>http://zdoggmd.com</em></a><em> for lyrics, behind-the-scenes dopeness, and all our other videos. Please SHARE...or the machines win.”</em></p> <p>He’s right “just an over glorified billing platform, with patient stuff tacked on.  <a href="http://ducknetweb.blogspot.com/2009/01/what-does-antiquated-emr-electronic.html">I wrote an EMR in the early days</a> as a developer and I get this too.  Over time the insurers took over and the tool that was meant to help doctors became the tool to help insurance companies.    </p> <p>EHRs suck:)  BD  </p> <p><iframe height="315" src="https://www.youtube.com/embed/xB_tSFJsjsw" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>Here’s a couple of his other videos, very well done too!  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/10/ebolazdoggmd-parody-songlike-lola-from.html"><strong>“Ebola”..ZDoggMD Parody Song…(Like Lola From the Kinks)…</strong></a></h5> <h5><a href="http://ducknetweb.blogspot.com/2014/10/ive-got-friends-with-low-platelets.html"><strong>“I’ve Got Friends With Low Platelets” Video Parody And Humor…</strong></a></h5> <h5><a href="http://ducknetweb.blogspot.com/2011/02/hospitalist-anthem-hard-docs-life-in.html"><strong>The Hospitalist Anthem-The Hard Doc’s Life In the Silicon Valley</strong></a></h5>

EHR State of Mind” 30 Clicks for An Ambien, Crappy Software Some Vendor Made Us” Video

This almost needs no introduction and I’m sure almost all the doctors today can relate to this one.  ZDogg MD has another hit it seems.  Th...

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“Citizen Score” in China, A Huge Warning For America About the Loss of Privacy, Lifestyle and Personal Worth As Noted by the ACLU With This Orwellian Nightmare

<p>You may or may not be aware of what’s going on with Big Data here but in China this is the deal, a Citizen Score that will determine everyone’s worth by using all sources of data available.  So this is happening only in China? Wrong..we have Excess Scoring for profit in place in the US, and maybe you just are not aware of how far the tentacles reach.  When you read through here, look at who’s controlling the data, Alibaba. <img align="right" src="http://lh3.googleusercontent.com/-gN2MvXASlnw/Vf-YlV__U5I/AAAAAAABMiQ/2Yx45ARv3y8/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" /> In China the companies are pretty much forced to work with the government.   To see how this is working in the US, use the link below to get full story on what we are dealing with.  Please pay attention to the latest White House Executive Order allowing companies to mine and harvest any data they want in the name of making things better for the government and to provide agencies information they “might’ need about all of us.   After the issue of that Executive Order as mentioned below, do you not think the US government is going in this direction?</p> <h5><a href="http://ducknetweb.blogspot.com/2015/09/excess-scoring-of-us-consumers-us.html">Excess Scoring of US Consumers, US Citizens-Scored into Oblivion By Proprietary Algorithms and Formulas, Never Duplicated or Tested for Accuracy-Profits of Big Business And A White House Executive Command To Continue the Abuse..</a></h5> <p>Think of all the information about you on the web and information collected by credit agencies, credit card companies, health apps and more, it all goes into a Big Data Pot.  Once in the pot, here comes the scores and of course those are flawed and there’s tons of algorithms that are proprietary that create some type of “score” about you.  In healthcare with HIPAA, scores can be sold about you where your actual data is not.  Don’t believe that one?  Look at the link below and see what Express Scripts brags about on their website on their Big Data Analytics.  If you have children in the household, you get a ding on the proprietary formula that calculates whether or not you will be a good patient and take your medicine.  Income not high enough, another ding.  Are you a male seeing a female doctor, yet another ding and there’s a total of 300 metrics.  These scores are “secret”, you can’t get them; however they are sold like hot cakes to insurers, drug companies and more.  Sounding like the China Citizen Score yet?  You bet it is.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5> <p>By the way, this flawed model of predicting medication adherence was created by non other than Ingenix, now Optum, that division of United Healthcare that only does healthcare by the algorithms.  Don’t forget how they <a href="http://ducknetweb.blogspot.com/2014/08/the-secret-scoring-of-americas.html">cheated with paying doctors</a> as well and there’s a ton of lawsuits on the books with settlements, so VW is not the only Code Hoser out there.  United also fires doctors by the algorithms as well, based on how they “score” them as well.  Want to keep your doctor, well this time it’s not Obamacare to blame, it’s the insurers who “score” them out of reach for you.  Doctors are no strangers to excess scoring by all means.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5> <p>1.3 billion Chinese citizens’ national ID cards are connected to this digital caste system, scoring them on their behavior <a href="http://boingboing.net/2015/10/06/reputation-economy-dystopia-c.html">and</a> activities friends in your social graph, so watch what you put on Facebook as they could stand a chance of being the Algorithms that could handle such in the US.  Oh yes and there’s a Crap App in China called “Sesame Credit” where you can view “your worth”.  The scores range from 350 to 900 and wow if your score is above $600, well guess what, you can get a loan for around $800.00 or so.  At 700 you can get a fast track permit to visit Singapore.  High scores of course are required for better jobs, so if you friend Sally or Joe puts some awful <img align="right" alt="image" border="0" height="218" src="http://lh3.googleusercontent.com/-YdHwvRHRrJE/VhngeR6t0CI/AAAAAAABMjE/WjVoLyqkGyw/image%25255B4%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="284" />stuff about you out there forget the job, you’re discriminated against.  </p> <p><strong>Oh and if you publish any information about the Shanghai stock market collapse, you’re a dead beast per se.  We all read a while back that the Chinese government was going after “short sellers and buyers” in the market news, that was pretty well publicized.</strong>  </p> <p>Back in the US, the data selling business is exploding and again stands to even grow more since our White House sees little value with any privacy for any of us.  It’s only now toying with the idea of “letting” consumers maybe sure a Data Broker.  You’ll never hear the word Data Selling come out of the White House either as they can’t seem to bring themselves to publicly admit this is taking place, and they know it is.  Check out what Argus Analytics is doing out there, buying up all your credit card data, scoring and selling some algorithmic created score about you.  They don’t care when it comes to selling time as flawed data gets the same price as good data.  Also, pay attention to the mention of Richard Cordray, the “Mr. Low Hanging Fruit Guy” over at the Consumer Financial Protection Agency, he’s buying up all your scored data too for government.  I knew he would almost be a total waste as he had to study all of this and in the meantime, algorithms fly to mine and collect data.  </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>I said this almost a couple years ago, that somebody needs to start calling foul on proprietary scoring of consumers at it stinks.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/somebody-needs-to-start-calling-foul-on.html">Somebody Needs to Start Calling “Foul” On Proprietary Predictive Algorithms When They Cannot Be Replicated For Accuracy As This Accelerates Inequality and Promotes Even More Data Selling For Profit</a></h5> <p>And hey, look at this hospital chain now pulling up all your Data Broker information from social networks and all over the web along with your credit card data, don’t you think this looks exactly like the Chinese Citizen Score model…you better take a look.</p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/oh-crap-now-hospitals-are-now-buying.html">Oh Crap, Now Hospitals Are Now Buying Data From Acxiom - Data Selling Epidemic Continues to Evade on Personal Privacy As “Algo Duped-Stat Rat” People Try to Implement Virtual Models That Won’t Work…</a></h5> <p>Here’s more on what the US government is doing here, as now HUD and HHS are working together to get your medical records before you get any HUD help to see if you are “healthy” enough and deserving enough for financial assistance.  Of course this work is being done by the Lewin group, a subsidiary of United Healthcare who’s a huge data seller and buyer.  They want to own the mental health care business in the US as well. <img align="right" src="http://lh3.googleusercontent.com/-r3DyQ8OXX8U/VWNXE79B4_I/AAAAAAABMUQ/d7p1kWV6goc/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" /> Pay attention to current CMS administrator too, Andy Slavitt who is basically nothing more than a quant and former Goldman banker who created a lot of the “scoring” algorithms and got sued for them in his days at Ingenix.  Drop a line to your Senator while I’m thinking about it to tell them to vote no on his Obama confirmation to run Medicare.  See once again you have the government of the US giving carte blanch to the creators of such algorithms that will just score you right out of access to various areas of healthcare.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/hhs-and-hud-match-housing-and-health.html">HHS and HUD Match Housing and Health Data - To Understand Needs of HUD Assisted Households-Study Contracted to Lewin Group - A Subsidiary of United Healthcare</a></h5> <p>You probably heard about the big Experian Breach in the news recently with millions more with exposed data out there.  Healthcare. Gov has them as one of their preferred partners and does credit scoring on you when you apply for insurance via the website.  What’s really almost a slap in the face to those who got breached is they get 2 years of credit surveillance services, through who?  None other than Experian, the company that just breached them, how’s that for bad apples.  Pay attention as well to the scoring going on when your get your prescriptions.  I had a great talk with a pharmacist who’s supposed to run down all the Outliers who are not taking their medications.  Real deal is that patients are taking their meds but the data is flawed and people default to non compliance.  Everyone followed up with is PAYING CASH!  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-filling.html">Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “Outliers, Pharmacists Required to Fix Outliers as They Show Up As Non Medication Adherence Compliant With 5 Star Systems Full of Flawed Data…</a></h5> <p>Wake up folks, it’s the same profession, Quants with their math models that destroyed the <a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776"><img align="right" border="0" src="http://lh5.ggpht.com/-WjSMddBKiho/VAJ2n8h7WcI/AAAAAAABLOU/rTfddMqQxlU/GoFundMe%25255B5%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" /></a>housing market that’s moved on over to healthcare and they create all those scores which in turn denies you access somewhere along the line and stick every single incident of risk to ass they can think of, real or spurious.</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>So give this some real thought, don’t you see the parallels?  First thing you can do is pay cash where ever you can.  Sure we can’t use cash exclusively today, but do it when you can to keep your hard earned money away from Algorithms that will do who knows what with it.  The start up company Samsung uses for “Samsung Pay” just got breached..there’s another warning for you.</p> <p><strong>We need to index and license all data sellers in the use as well and you can <a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776">go here to read even more</a> and watch a couple videos on how the corporate world and the government are taking over your thoughts, lifestyles, etc. on the Dupes of Hazard communities in the US.  Don’t trust all of this and be a skeptic when you need to be.</strong>  </p> <p>As the ACLU points out, we don’t want “Citizens Score” in the US at all and if something isn’t done soon, it keeps moving that way.  I had to laugh when I watched the VW hearing this week in Congress and I thought to myself, no wonder we get hacked all the time in the US as the rest of the world thinks we are all that naïve.  I about fell off my chair listening to one member of Congress asking the CEO of VW on how they could open the hood of their car and find the cheating code.  Folks it’s not how it works, it’s the background, you can’t see it but know it’s there.  The other question<img align="right" height="414" src="http://lh3.ggpht.com/-7T4N9eveehQ/U41RptrzUOI/AAAAAAABKes/I46asIKCq8o/WhiteHouse4.png?imgmax=800" style="float: right; display: inline" width="374" /> that was a side buster was the one Congressman wanting to know how we could find all those who had died from the polluting cars.</p> <p>I kind of have an idea where that dupe came from as if you visit the link below, you can see the junk science emails that float out of the White House that actually stuck numbers on how many people would not die if climate control was enacted…nobody can do that but again, at the very top, junk science and thus this person in Congress must have read that White House email to think you could put a number on and find those who died from polluting cars…a bad case of Stat Rat Fever at the White House indeed.  Pretty good junk science numbers from the White House is it not, 2300 people will stay out of the hospital..give me a break as nobody can put a number to something like that with climate control.  I wonder how many others looked at that email and laughed or were disgusted over the use of STAT RAT FEVER methods to actually get folks to believe you could predict such…nobody can.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/junk-science-appearing-everywhere-even.html">Junk Science Appearing Everywhere, Even The White House “PR Templated” Correspondence Creates Spurious Correlations…</a></h5> <p>Someone with a bit of sense at the LA Times in a VW article put that Congressional perception of nonsense to rest of being able to find those who died from the polluting cars, thank goodness.</p> <p>I agree with the ACLU on this one as I write about this all the time as I used to program and have been telling folks for years people cheat with computer code and algorithms.  They write for money most of the time and not for the “good”.  <strong>So pay cash and think about step one with indexing and licensing all data sellers.  The lawyers are in dummy land thinking you can create verbiage only that can regulate this monster that could in fact turn into Citizen Scoring in the US, it’s a real threat and take it seriously.  BD</strong> </p> <p> <hr />Gamer? Strike. Bad-mouthed the government in comments on social media? Strike. Even if you don’t buy video games and you don’t post political comments online “without prior permission,” but any of your online friends do….strike. The strikes are actually more like dings, dings to your falling credit score that is.</p> <p>Thanks to a new terrifying use of big data, a credit score can be adversely <a href="https://www.privateinternetaccess.com/blog/2015/10/in-china-your-credit-score-is-now-affected-by-your-political-opinions-and-your-friends-political-opinions/">affected by</a> your hobbies, shopping habits, lifestyles, what you read online, what you post online, your political opinions as well as what your social connections do, say, read, buy or post. While you might never imagine such a credit-rating system in America, it is happening in China and the ACLU said it serves as a warning for Americans.</p> <p>Big data is sucking in everything about citizens as algorithms evaluate that data, but the Chinese government is leveraging that data and “<a href="http://www.chinadailyasia.com/business/2015-06/09/content_15274221.html">smart data</a>” analysis that “reveals even casual relationships” in order to create a comprehensive credit score system which “<a href="https://kit.se/2015/09/25/11823/sa-blir-du-en-kinesisk-monstermedborgare/">determines your opportunities for life</a>.” Yes the score does measure the ability to pay, but “this is the most staggering, publicly announced, scaled use of big data I've ever seen,” <a href="http://www.volkskrant.nl/buitenland/china-rates-its-own-citizens-including-online-behaviour~a3979668/">said</a> Silicon Valley entrepreneur Michael Fertik; he is also the author of <em>The Reputation Economy</em><strong>. “It certainly feels about as Orwellian as your nightmares would have it be.”</strong></p> <p><a href="http://www.computerworld.com/article/2990203/security/aclu-orwellian-citizen-score-chinas-credit-score-system-is-a-warning-for-americans.html">http://www.computerworld.com/article/2990203/security/aclu-orwellian-citizen-score-chinas-credit-score-system-is-a-warning-for-americans.html</a></p>

“Citizen Score” in China, A Huge Warning For America About the Loss of Privacy, Lifestyle and Personal Worth As Noted by the ACLU With This Orwellian Nightmare

You may or may not be aware of what’s going on with Big Data here but in China this is the deal, a Citizen Score that will determine everyon...

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Excess Scoring of US Consumers, US Citizens-Scored into Oblivion By Proprietary Algorithms and Formulas, Never Duplicated or Tested for Accuracy-Profits of Big Business And A White House Executive Command To Continue the Abuse..

<p>If you read here often enough then you know I address this topic from time to time as companies and people do cheat<img align="right" alt="image" border="0" height="197" src="http://lh3.googleusercontent.com/-xYedW7-NsGY/Vf-Ykm7sk0I/AAAAAAABMiM/505DI8wzOgg/image%25255B15%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="335" /> with their software.  If you watch the markets you see folks like Nanex post charts every day giving out visuals on where the cheating is.  Unfortunately the “honest” folks that are putting out information on where the cheating takes place don’t seem to get enough attention out there.  On markets, look at old Mary Jo White for example.  Anyone who writes code just rolled when we had the Congressional hearings on markets not being rigged.  In case you missed that one, here’s a link from the archives…</p> <h5><a href="http://ducknetweb.blogspot.com/2014/04/markets-are-not-rigged-spoken-like-true.html">“Markets Are Not rigged” Spoken Like A True Data Mechanics Novice, It’s Like Sebelius at HHS All Over Again, Looking For Algo Fairies at The SEC, One More Government Agency Wrapped Up in “The Grays”…</a></h5> <p>It just seems the consumers (I’m in here too) are just never going to get any kind of a break.  Excess Scoring is around everywhere and particularly in healthcare to where it’s out of control.  I’m sure like me you read some “goofy” study that is pretty spurious on what is being correlated together and what do you know, next month some company is using it to score you as it’s called a “study”.  If this is going to persist, we need better studies published as companies again determine that they have some form of contextual accuracy when they don’t.</p> <p>In the last couple of days, yet another big blow for consumers with the newest executive order that says “the government knows what’s best for you”, which I tend not to agree with most of the time.  This is really bad as it’s giving data sellers a license to go hog wild.  In the health care area, many get around selling your actual data and will sell one of their proprietary formula scores about you.  This helps them get around HIPAA and it gets used in some risk assessment or resold again.  Here’s the first two paragraphs of the <a href="https://www.whitehouse.gov/the-press-office/2015/09/15/executive-order-using-behavioral-science-insights-better-serve-american"><strong>Obama Executive Order on Behavior Science Insights</strong></a> and it’s certainly more than enough to make your hair stand on end. </p> <p>I have said many times in all the White House meetings on privacy, not once could they mutter the words “data sellers” at all.  White House would always dance around it and followed the same old failed routine of having lawyers write verbiage that any old coder could work right around the interpretation.  It happens the time.  I think also they made up this name: “ behavioral science insights” and I almost expect them to begin calling health insurance a science pretty soon.  Actually a couple years ago I wrote a post to that effect as well.</p> <p><em>“A growing body of evidence demonstrates that behavioral science insights -- research findings from fields such as behavioral <img align="right" alt="image" border="0" height="181" src="http://lh3.googleusercontent.com/-gN2MvXASlnw/Vf-YlV__U5I/AAAAAAABMiQ/2Yx45ARv3y8/image%25255B3%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="335" />economics and psychology about how people make decisions and act on them -- can be used to design government policies to better serve the American people.</em></p> <p><em>Where Federal policies have been designed to reflect behavioral science insights, they have substantially improved outcomes for the individuals, families, communities, and businesses those policies serve. For example, automatic enrollment and automatic escalation in retirement savings plans have made it easier to save for the future, and have helped Americans accumulate billions of dollars in additional retirement savings. Similarly, streamlining the application process for Federal financial aid has made college more financially accessible for millions of students.”</em></p> <p>Added to this we all know that United Healthcare has big stakes in Behavioral Health with ownership of many subsidiaries in that business.  Actually the company has a subsidiary just about in the Silicon Valley in California that other companies like Kaiser, who was fined for lack of behavioral health services contracts with for one example.  United through their former Ingenix subsidiary, now called Optum Insights has been pushing this for years with extreme “scoring” of patients and finding risks and reasons to deny payment in some areas.  Right now the company is being sued over some of this.  </p> <h5><a href="http://ducknetweb.blogspot.com/2013/03/class-action-lawsuit-filed-against.html">Class Action Lawsuit Filed Against UnitedHealthGroup and Their Various Subsidiaries There Of Relative to Mental Health Claim Denials & Violation of Parity Laws</a></h5> <p>A few years ago it was Ingenix (who’s CEO was Andy Slavitt who’s currently running Medicare) that brought in this obscure metric system of predicting and scoring people on who they “think” would take their medications.  Keep in mind this is all proprietary and prescription records when not obtained from a HIPAA complaint entity are open game to be “scored” and sold.</p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html">Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</a></h5> <p>If you move forward with this a few years, you can see today how bad the metrics and data are and if you pay cash, the software pharmacists are required to use for follow up, you get “scored” as an Outlier if there’s not enough data.  In other words, you get one star if the metrics can’t fulfill the query so there you go, flawed scoring.  Again I don’t know what’ wrong with the White House and this case of Stat Rat Fever they have,<img align="right" alt="image" border="0" height="153" src="http://lh3.googleusercontent.com/-r4DiSFryNM0/Vf-Yl8HgQLI/AAAAAAABMiU/ZLUJfKKVkx4/image%25255B11%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="321" /> but this is flat scoring people with metrics that have nothing to do with taking medications.  If you are male, you get a ding, if you have kids at home, another ding as they might distract you.  Again this is the insanity being promoted by the White House.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-filling.html">Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “Outliers, Pharmacists Required to Fix Outliers as They Show Up As Non Medication Adherence Compliant With 5 Star Systems Full of Flawed Data…</a></h5> <p>There’s a lot of Excess Scoring going on with doctors.  I’ve heard some stories directly on that on how it happens.  The truth of the matter here is that again, doctors are algorithmically scored and dropped from network.  Cost is the item here, not how good the doctor is by all means.  Some doctors have tried to negotiate to be back in networks so they are not having to drop patients, but with United, there’s no discussion, algorithms says you are gone.  Again we come back to Andy Slavitt running CMS as this is what he did with math business models at United Healthcare, he’s an Algo Man and a one time Goldman banker.</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>Seriously I thought when I read the so called “Behavior Sciences Insights” Executive Order, it really sounds like Mr. Slavitt wrote it for the President.  You read enough of old United reports and studies and it sounds just like them.  Here’s another one of his lawsuits just now setting from the Ingenix Algo Days.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/09/another-united-healthcare-ingenix.html">Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…</a></h5> <p>So our President has give the OK for big business and banks to scrape and sell our data and they get to use the name<img align="right" alt="image" border="0" height="196" src="http://lh3.googleusercontent.com/-cS6dHxWcbH8/Vf-YmvEqa3I/AAAAAAABMig/QECzqDgiGYI/image%25255B16%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="333" /> behavioral science insights.  Behavior belongs in the area of psychiatry or neurology but we have all these amateur data scientists with lots of spurious correlations that will twist and spin their formulas into being in this category.  I have seen apps that come out and use some ancient NIH study and use a dated study that’s no longer relevant as the science for their app and this it totally wrong.  We end up with a huge problem in the use which I call Operation Perception Deception and you know I can’t hardly listen to the White House sit up there and belt out flawed numbers any more and based on all I see on the web, I’m not alone.  We’re not stupid and we just shake our heads.  This is not the first time that the White House dove into the area of what I call “junk science” as I saw in one of their emails on Climate Control, using numbers nobody could predict.  It’s all about context and how much you can be convinced to believe, even when the information is erroneous and flawed.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/junk-science-appearing-everywhere-even.html">Junk Science Appearing Everywhere, Even The White House “PR Templated” Correspondence Creates Spurious Correlations…</a></h5> <p>I fully understand the precision and detail with genomic research and that’s not what this is about, this is rather about address the Junker so called data scientist that creates some spurious correlation with a number crunch and calls it “science” when it’s not.  You read that crap in the news all the time and it’s so rampant that a Harvard Student created a site to exploit it called<strong> </strong><a href="http://ducknetweb.blogspot.com/2014/05/spurious-correlations-per-capita.html"><strong>“The Spurious Correlations Site”</strong></a> where you can make your own and mock the ridiculous number crunch studies that are called science.  I said a couple years ago, time to call foul on Proprietary Predictive Scoring Algorithms that can’t be replicated as it’s killing consumers to have gazillions of “scores” finding something wrong with you or having you at risk at almost every walk of life.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/somebody-needs-to-start-calling-foul-on.html">Somebody Needs to Start Calling “Foul” On Proprietary Predictive Algorithms When They Cannot Be Replicated For Accuracy As This Accelerates Inequality and Promotes Even More Data Selling For Profit</a></h5> <p>Time for a video break as this “game” promotion explains exactly what the new Executive Order from the White House is allowing..Open market on your personal data so they can study and try to predict your every move.  </p> <p><iframe height="315" src="https://www.youtube.com/embed/x2eCAgQ1DTo" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p> <p>The full post on this is at the link below from a couple of years ago, explaining how this activity keeps inequality growing  at an accelerated pace in the US.  No other country runs as many algorithms and “scores” their consumers abusively like the US does.  It’s all about money, $180 billion<img align="right" height="197" src="http://lh5.ggpht.com/-4dAaL3F8HHA/U6L3-VlNoGI/AAAAAAABKo4/_oLHb_h1n6E/image%25255B3%25255D.png?imgmax=800" style="float: right; display: inline" width="324" /> a year in round figures with selling personal data.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/06/data-selling-and-direct-correlation-to.html"><strong>Data Selling and the Direct Correlation To Accelerated Inequality - Epidemic Spreading Like A Virus Moving Money Keeping Corporations Cash Rich and Consumers Cash Poor</strong></a></h5> <p><a href="http://www.youcaring.com/other/help-preserve-our-privacy-/258776"><strong>Here’s my somewhat passive campaign</strong></a> to get a law passed to index and license all data sellers as who in the hell are they?  How do you find them when they are reporting flawed data about you when your data has been repackaged?  You don’t and consumers live with flawed profiles they can’t fix and are denied access to something.  <strong>This is what our President thinks is so great it appears.</strong>  </p> <p>This is why we are not “great” any more as consumers are absolutely pounded into the dirt with risk assessments (many of which don’t even apply to them) and other “scores” that are flawed.  What a huge injustice and the really bad thing here is that flawed data gets the same price as good data.  People and companies do cheat with code and math models.  If you read the news today, <a href="http://fortune.com/2015/09/20/vw-winterkorn-apology-emissions/">VW blatantly cheated with their emissions software</a>, folks it’s all cheating code.  You have companies like Nanex that point out cheating code on the stock market every day as well, but does government do anything? No, instead we get this, more abuse with flawed data bought and sold and we don’t even know who’s doing it.  Check this out below with credit cards…see how all your 100-200 line items on everything you charge is sold, MasterCard making gazillions doing this.</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>Here’s where you’ll end up for sale once you have been repackaged and by who, you’ll never know.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/02/the-data-exchange-buy-and-sell-data-on.html">“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</a></h5> <p>Our President just flat turned his back on US consumers with this order and again no wonder in the White House why<img align="right" src="http://lh3.googleusercontent.com/-r3DyQ8OXX8U/VWNXE79B4_I/AAAAAAABMUQ/d7p1kWV6goc/image%25255B8%25255D.png?imgmax=800" style="float: right; display: inline" /> they could never come to use the words “Data Sellers” in any of their privacy meetings.  Again don’t be a Dupe of Hazard, be aware that companies do cheat with their computer code for profit and our President thinks this is ok.  </p> <p>How much confidence do you expect a person to have with all this excess scoring?  Everywhere you turn, you have a risk for something, some risks you have never even heard of but some study shows that less than 1% is the risk and next thing you know the “junker data scientists” are modeling around it like it has statistical value when it does not with some really ridiculous correlations.  </p> <p>So the White House appears to be of the philosophy of keep fooling people from what I am reading.  See the image to the left, Mark Twain.  Sadly, Operation Perception-Deception is in full swing today and it starts right at the White House.  I think Congress is too overwhelmed to even react or know what they should react to as well.</p> <p>This President has turned his back on any dignity, privacy, etc. there is to offer to the common citizen.  Is he that naïve or is this a plan to turn us all in to serfs that eventually will become convinced we are that flawed data model that’s being created?  I think people will get mad and take some kind of action before that really happens.  White House is definitely with this Executive Order pretty much just calling all of us the <strong>Dupes of Hazard.</strong>  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/06/operation-perception-deception-into.html">Operation “Perception-Deception” Into Full Swing in the US, With Killer Algorithms, Algo Fairies, Algo Duping, The Grays, and Of Course, Flags As Consumers Confuse Virtual World Values With the Real World…</a></h5> <p>So next week maybe we’ll have more “selfies” from the White House?  That seems to be a great way to keep 5th graders distracted and maybe some adults too.  As soon as those starting rolling out, I knew the administration had crossed over into virtual values and would probably never return to the real world.  </p>

Excess Scoring of US Consumers, US Citizens-Scored into Oblivion By Proprietary Algorithms and Formulas, Never Duplicated or Tested for Accuracy-Profits of Big Business And A White House Executive Command To Continue the Abuse..

If you read here often enough then you know I address this topic from time to time as companies and people do cheat with their software.  I...

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Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…

<p>This settlement was a long time coming and it appears now it’s on the way for over $9 million.  You may or may not remember when this lawsuit was filed against United Healthcare/Ingenix subsidiary six years ago so you can use the link below to read up.  This lawsuit was filed after the big lawsuit was filed against United Healthcare/Ingenix by the AMA which also settled a couple years ago.  Andy Slavitt, a one time Goldman Sachs banker ran Ingenix for years and we had a lot of history on that in the news as well.  </p> <p><em>“The </em><a href="http://www.health-law.com/Downey_AmendedClassAction.pdf"><em>lawsuit</em></a><em>, which the Downey Surgical Clinic and Tarzana Surgery Center are pursuing in federal court on behalf of ASCs<img align="right" alt="image" border="0" height="122" src="http://lh3.googleusercontent.com/-36aOCKLMdhY/VfTGZgRZoOI/AAAAAAABMhw/RPwj1tJ75W0/image%25255B5%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="267" /> nationwide, alleges <strong>that UnitedHealth calculated its usual, customary and reasonable rates for out-of-network claims through the use of in-network or Medicare rates and an arbitrary multiplier, instead of through geographical comparisons and its Ingenix database, as it had reported.</strong> This violates federal health benefits and anti-corruption laws as well as California business codes, say attorneys, and hurts surgical facilities.”</em></p> <h5><a href="http://ducknetweb.blogspot.com/2010/05/outpatient-surgery-centers-file-class.html">Outpatient Surgery Centers File Class Action Lawsuit Against UnitedHealth and Ingenix for Underpayments</a></h5> <p>The banking impact is pretty thick over at HHS and CMS right now with Secretary Burwell running HHS and she was a former director for Bob Rubin, a former Secretary of the Treasury and both a Goldman and Citibank executive.  I keep referring to her leadership as being the equivalent of the “six degrees of Bob Rubin” as about all we hear from her are stories about making numbers and stats and then we get “selfies” with bicycle helmets on for some extra variety.  Burwell of course has brought over folks from both Citi and Wal-Mart, so Stat Rat Fever can live on, but care and cost doesn’t get any better.  The monopoly of United versus other insurers has been a long time effort and area of growth as you can go back a number of years for this story below and see even back then HHS/CMS what giving Ingenix big strokes, while others were suing them.  </p> <p>Is is any wonder that Burwell went the exceptional length to give Andy Slavitt legal and government protections from all these suits?  It makes you wonder how she thinks as well with having such confidence in a former Goldman banker being able to run CMS?  She wants an Algo Man to make her numbers and as I said a while back, HHS/CMS is on the same Stat Rat Fever path of virtual perceptions that has just about killed the VA…numbers come first before lives.  You can see the similarities in the models being created.  By the way, former CMS employees have told me that’s it’s been an understatement for years to ask United Healthcare for help in building their models if they got stuck.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/06/for-top-program-combines-prototype-from.html"><strong>"Reach for the Top" Program Combines Prototype from Ingenix (A Wholly Owned Subsidiary of United Healthcare) for Public/Private Community Health Data on HHS.Gov Site</strong></a></h5> <p>Here’s the big settlement that was uncovered by then AG Cuomo in New York to where the data base was low balled with low charges to calculate what customary out of network fees would be.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/12/ama-announced-settlement-of-class.html">AMA Announced Settlement of Class Action Suit of $350 Million with Ingenix (United Healthcare)</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2012/02/ama-announces-doctors-and-patients-can.html">AMA Announces Doctors And Patients Can Expect To See the UnitedHealthCare/Ingenix Class Action Settlement Checks In the Mail Soon - Out of Network Short Payments–Attack of the Killer Algorithms Chapter 19</a></h5> <p>In addition other major insurers licensed and use the Ingenix data based, controlled by current CMS director Andy Slavitt, and they too got hit up with lawsuits, lots of them.  They all were using that data base and software to create bigger profit and stuck it to the doctors and patients as well on out of network visit charges.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/08/ingenix-data-base-has-some-long.html"><strong>Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana</strong></a></h5> <p>Even Safeco car insurance with subrogation efforts filed a lawsuit as well against Ingenix.  You can look up Andy Slavitt and Ingenix on the web if you like and see all the connections.  What is also interesting is how cagey United Healthcare was in moving Andy Slavitt from Ingenix as well.  They did a name change, now called “Optum Insights” as every knew the bad law suit connections of Ingenix and moved him over as CEO of QSSI, another United Healthcare subsidiary.   QSSI as we all might remember ended up being somewhat of a hero with insurance exchanges in being able to create them and as a contractor to fix Healthcare.Gov.  </p> <h5><a href="http://ducknetweb.blogspot.com/2011/04/unitedhealth-group-announced-re.html">UnitedHealth Group Announced Re-Branding of Business Units-Focus on “Optum”–Changes Ingenix Name to OptumInsight</a></h5> <p>When you think of it, it is pretty amazing how United worked this relying on the fact that nobody would remember or realize who and what Andy Slavitt was and what he did.  He’s an Algo Man who received early training at Goldman Sachs who learned how to manipulate business models with math and that’s what’s running CMS today on a temporary basis.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/04/class-action-lawsuit-against-safeco-car.html">Class Action Lawsuit Against Safeco Car Insurance Continues – Alleged Use of Ingenix Payment Algorithms for Shorting Claim Payments With Medical Expenses Related to Car Accidents</a></h5> <p>In Connecticut a few years ago before the name change, it became so bad with the Ingenix <img align="right" alt="image" border="0" height="166" src="http://lh3.googleusercontent.com/-uuzyVSRz_IM/VfTGae8FaFI/AAAAAAABMh4/mSVtCunbYcc/image%25255B9%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="301" />subsidiary demanding information from doctors that the medical society has to take them on.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/02/connecticut-state-medical-society.html"><strong>Connecticut State Medical Society Demands that United Healthcare/Ingenix Stop The Requests For Patient Records</strong></a></h5> <p>Here’s another example of a class action lawsuit that was filed against Ingenix, using that same data base to pay chiropractors less as well.  In addition, some patients before the Affordable Care Act was passed had to to to battle against Ingenix as well.  It’s those math models and algorithms that calculate the access and the charges.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/10/chiropractor-files-class-action-breach.html">Chiropractor Files Class Action Breach of Contract Lawsuit Against Safeco Car Insurance – Use of Ingenix Data Base Claimants Were Paid Less</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2009/06/one-womans-battle-with-ingenix-who-has.html">One Woman’s Battle with Ingenix Who Has Cancer</a></h5> <p>We were bombarded with studies and reports from another company called Lewin about saving money in healthcare.  They got to be so obnoxious when they started using the “T” word on how they felt trillions could be saved with healthcare.  Those Lewin reports were everywhere and wouldn’t you know that Lewis is yet another subsidiary of United Healthcare.  Here’s digging back a little bit on an Ingenix model relating to “Episode Treatment Groups”.  That one didn’t work too well in practice as the model wasn’t good. </p> <h5><a href="http://ducknetweb.blogspot.com/2009/03/ingenix-publishes-episode-treatment.html"><strong>Ingenix Publishes Episode Treatment Groups Methodology – Recreating themselves?</strong></a></h5> <p>Under Slavitt’s rule at Ingenix, we had this report sent out telling Oncologists they were not following rules with treating cancer.  Again, the rules were created by Ingenix.  </p> <h5><a href="http://ducknetweb.blogspot.com/2010/02/united-healthcare-sends-oncology.html">United HealthCare Sends Oncology Reports to Doctors – Assessing Cancer Treatment Rules Compiled by Ingenix</a></h5> <p>It even got better (worse) and bolder under the Slavitt CEO regime with stating we needed “cheaper” doctors.  You can read more at the link below.  Reducing hospital visits has not reduced the cost of healthcare, it’s reduced the number of hospital visits.  </p> <h5><a href="http://ducknetweb.blogspot.com/2009/05/united-health-care-says-cheaper.html">United Health Care Says Cheaper Efficient Doctors and Reducing Hospital Visits by the Elderly Would Help Reduce the Cost of Healthcare</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2015/07/doctors-in-network-leave-united.html">Doctors In Network Leave United Healthcare–Tired of Getting Paid At Rates 12% Less Than Medicare…</a></h5> <p>It was less than a year ago that a Blue Cross insurance firm finally quit using the flawed Ingenix data base!  I thought this was pretty wild as most all were pretty anxious to settle or took steps in that direction but this company held on and kept using the “flawed” numbers, to again pay doctors less.  </p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/ingenix-optum-united-healthcare.html">Ingenix (Optum-United Healthcare) Lawsuits Still Bouncing Around Out There–One Recently Settled in New Jersey With Horizon Blue Cross Blue Shield That Was Still Using the Flawed and Corrupt Data Base for Out of Network Payment Calculations</a></h5> <p>It might also help to note that in many areas and states, doctors are currently getting paid as an average about 12% less than Medicare rates.  You can see where Mr. Slavitt’s direction is headed here at Medicare and it will serve to get worse as more scoring makes it harder for patients to get care.  Now I realize some stats and numbers are needed but the quant mentality now at health insurers is just like it is at the banks except people can get hurt and not get the care they need based on flawed data in flawed algorithms.  </p> <p>A couple years ago, a <strong>little publicized Supreme Court Ruling</strong> gave doctors the ability to group together to litigate with insurers and Oxford, another subsidiary of United Healthcare, fought this for years and years with a lot of money.  When this ruling changed by the Supreme Court, it was no longer required to be one doctor up against an entire insurance company when complains and issues came up.  </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>When United starting firing doctors all across the country, this new ruling was used right away by medical organizations to file suit against the insurer and of course we had the secret scoring of doctors using mathematical algorithmic formulas making the decisions.</p> <h5><a href="http://ducknetweb.blogspot.com/2014/08/the-secret-scoring-of-americas.html"><strong>“The Secret Scoring of America’s Physicians” - Algorithmic Math Models For Insurance Network Contractual Exclusions, Relating to MDs Who See Medicare Advantage Patients..</strong></a></h5> <h5><a href="http://ducknetweb.blogspot.com/2015/02/united-healthcare-extending-narrow.html"><strong>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…</strong></a></h5> <p>Andy Slavitt and the Algo Man processes of math go back beyond just medical care as well.  You can look at this article below and see how this flawed system of “medication adherence prediction scoring” got started.  This is a dangerous guy with his numbers as he really forgets about the human side of care and look what he did at Express Scripts before he left.  He sold them some Ingenix algorithms to start this flawed scoring game.  The metrics used have little to do with taking medications and focus on your “other behaviors” that they “think” will impact you taking a glass of water and swallowing pills.</p> <h5><a href="http://ducknetweb.blogspot.com/2010/10/express-scripts-new-program-to-contact.html"><strong>Express Scripts- New Program to Contact and Predict Patients Who May Not Be Taking Their Medicine Based On Ingenix Algorithms–We Want the Revenue Please Don’t Stop</strong></a></h5> <p>It gets worse too as Express Scripts has doubled down on this and even “brags” on their website about this flawed model that is proprietary and nobody can re-produce.  This is garbage in any area of psychology as mental health algorithms that are used to “score” people can be unfair, biased, and discriminating.  Check out both of these links and remember the basis for all of this again goes back to the Algo Man Andy Slavitt, former CEO of Ingenix and current temporarily in charge at CMS.  Do you want him running CMS permanently?  He’s there to make Burwell look good in meeting her stats and that’s about it, and maybe help some other subsidiaries of United Health, like the their military subsidiary cash in bigger with Gov.  United has a military subsidiary that focuses on contracts and along with the west coast Tri-Care contract they also have LHI that does Vet evaluations before the Vets get entered into the VA system.  LHI also does big inoculation programs for US troops before they are deployed overseas.  <img align="right" height="153" src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQK0RlHWvimeF8D0WCCjjcjtXPpUcav1Ph--W7JCspiO38Op5WT" style="float: right; display: inline" width="366" /></p> <h5><a href="http://ducknetweb.blogspot.com/2015/06/medication-adherence-predictions-enter.html">Medication Adherence Predictions Enter the World of Quantitated Justifications For Things That Are Just Not True, Members of the Proprietary “Code Hosing” Clubs Out There Destroying Your Privacy</a></h5> <h5><a href="http://ducknetweb.blogspot.com/2015/07/patients-who-pay-cash-when-filling.html">Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “Outliers, Pharmacists Required to Fix Outliers as They Show Up As Non Medication Adherence Compliant With 5 Star Systems Full of Flawed Data…</a></h5> <p>So coming back around here, this is yet one more Ingenix law suit to settle over short paying doctors again.   Keep in mind all these creative Algos at Ingenix (now renamed Optum Insights” were under the realm of Andy Slavitt, who runs CMS now and is that what you want, more of these?  If not tell your Senator to vote NO on his confirmation as our Algo Duped President Obama has nominated him to run CMS and bomb us continuously with more “Stat Rat Fever” so his boss, Secretary Burwell can too meet her numbers.  This is awful and it’s the reality of what’s happening today and what’s been going on for years with manipulating risk to gain profits.  No money’s being saved at all but rather just being shifted around by a bunch of models and algorithms.  </p> <p>So this is yet one more example of Mr. Slavitt’s handiwork as an Algo Man and and cutting pay for MDs seems to be top on his list as well as what patients are covered for.  Don’t be fooled by the new CMS program called Value-Based Insurance Design as you will be “scored” and some of that data sold just to enable you to by pass a copay here and there.  That’s the way it works with quants modeling healthcare, just like they do with banks and stocks.  I often wonder how many quants health insurers have hired from banks and high frequency firms…you know they have and if you can’t get your head around that one, you might end up in the growing group of consumers I call “the dupes of hazard”.  Plain and simple we don’t have access to the technology, math and models being used against us and especially the algorithms with all the excess scoring taking place.  A little at a time, just like in the markets with exchanges, one algorithm is programmed to search out and interact with another one and query a response for something to execute to deny or allow access.  </p> <p>Also of interest is the Optum 360 subsidiary which is a partnership with Dignity Health.  This is a subsidiary that is organized to outsource hospital billing and revenue cycling and pretty much fires current hospital billing folks and brings in contracted help at a lesser pay and worse benefits to take over that portion of the hospital’s business.  Pay attention here as this is what Mayo is doing and yes there’s some data selling profit that goes along with this as well.  </p> <h5><a href="http://ducknetweb.blogspot.com/2015/04/mayo-clinic-is-latest-to-outsource.html">Mayo Clinic is the Latest to Outsource Revenue Cycling to Optum 360, A United Healthcare/Dignity Health Company Pursuing Hospital Contracts All Over the US For Profit…</a></h5> <p>Here’s part of the press release below and the link at the bottom will take you to the full release to read.  The nightmares of Ingenix of days past will continue if Andy Slavitt is confirmed as head of CMS, so please tell your Senator to vote NO.  BD  </p> <hr />LOS ANGELES--(<a href="http://www.businesswire.com/">BUSINESS WIRE</a>)--On behalf of<b> </b>out-of-network<b> </b>California<b> </b>Ambulatory Surgery Centers (ASCs), Hooper, Lundy and Bookman, PC, (HLB) is pleased to announce that it today filed a motion for preliminary approval to settle a class action complaint it filed more than six years ago. <p>The parties estimate that there are approximately 250 ASCs that could qualify to participate in the settlement. Assuming that the court preliminarily approves the parties’ settlement, notice of the settlement and further instructions outlining how to participate in the settlement process will be sent to all potential class members.</p> <p>“After a long battle, we believe that we have reached a fair settlement that will adequately compensate the class of surgery centers whose claims were underpaid,” said HLB Attorney Daron Tooch, lead attorney representing the ASCs. “We would particularly like to thank our class representatives, Downey Surgical Clinic and Tarzana Surgery Center, for their patience and persistence in this litigation.”</p> <p><a href="http://www.businesswire.com/news/home/20150910006679/en/Hooper-Lundy-Bookman-Settles-Out-Of-Network-Surgery-Center#.VfRaaFNtfEQ">http://www.businesswire.com/news/home/20150910006679/en/Hooper-Lundy-Bookman-Settles-Out-Of-Network-Surgery-Center#.VfRaaFNtfEQ</a></p>

Another United Healthcare (Ingenix) Lawsuit Settling Over 9 Million-Short Paying Ambulatory Surgery Centers-Current CMS Director and One Time Goldman Sachs Banker, Andy Slavitt was CEO of Ingenix for Years…

This settlement was a long time coming and it appears now it’s on the way for over $9 million.  You may or may not remember when this lawsui...

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Zero days–Security Leaks for Sale (Documentary) Code Wars…Aka Attack of the Killer Algorithms…

<p>Here we go again and another great documentary from the folks at VPRO.  Scroll down to the bottom of this page to watch the Quants of Wall Street as well.  If you are in healthcare, you should have an interest here as insurance companies have hired armies<img align="right" alt="image" border="0" height="151" src="http://lh3.googleusercontent.com/-kOTD1WcbyZI/Ve_BTuuHwwI/AAAAAAABMhU/xUHK40TBp2w/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="300" /> of them and their models are not that far off from what the banks and shadow banking business does.  </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>This is great as they use the Norse website, which I have shown to many over the years on how you can see who’s hacking in real time.  Pay a visit if you have not seen it.   They talk about the motivation of “money” so nothing new there.  Hackers can sell the flaw but they may or may not be responsible how the buying party uses it.  So you have a hack that can expose all kinds of information to include credit cards and more…what do they do?  Remember the Anthem security leak?  Read below and see how crooks can repackage and sell that data just like new and legal data.  BD </p> <h5><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></h5> <p> </p> <p><iframe height="315" src="https://www.youtube.com/embed/4BTTiWkdT8Q" frameborder="0" width="560" allowfullscreen="allowfullscreen"></iframe></p>

Zero days–Security Leaks for Sale (Documentary) Code Wars…Aka Attack of the Killer Algorithms…

Here we go again and another great documentary from the folks at VPRO.  Scroll down to the bottom of this page to watch the Quants of Wall S...

Read more »