Friday, December 16, 2022

#MulgrewCare Update: COLLUSION as Mulgrew promotes MedAdv, There are Calls To Abolish Private Medicare Advantage Plans as Scandals Mount

It is fairly clear that Mulgrew’s negotiations have been all about protecting the health – not of our members and retirees – but of this [stabilization] fund (p.16):.... Jonathan

Scheinman is basically a scribe for the City-MLC, not an independent arbitrator.... James, ICE Blog

More from Jonathan:

Collusion: I have made the case before: Mulgrew, Nespoli, Garrido, the whole MLC, Scheinman, Adams, and the City’s financial administration, starting with the OLR, plus the insurance companies – they are all working in concert. They are colluding. And they leave the evidence all over the place ...I am absolutely convinced that Scheinman worked with the City and the leadership of the MLC unions, including Mulgrew’s people, in creating his 12/15/22 “Opinion and Award.”  JD271Collusion and Bullying by OLR/UFT/MLC (Mulgrew et al)

UFT Ex Bd member Nick chimes in at New Action on the brewing UFT/MLC/Adams/Scheinman Scandal: 

UFT Members Take Note: Medicare Advantage is a Consequence of Backroom Bargaining -

 Nick homes in on the vote for the 2018 contract which is a factor in this mess: 

this all comes down to the 2018 (and 2014) contract(s). Scheinman only has the right to intervene here, because Mulgrew promised healthcare savings to the City that he couldn’t make happen (and without the informed consent of membership).

And there was not informed consent -  Was 2018 the Worst Bad Deal Ever?

Nick has also been pointing out that Mulgrew and Unity try to paint the thousands of people who opted out and support the battle to preserve our healthcare as the bad guys:

The only ‘villains’ in the official story are a “small group of unaffiliated retirees,” (p. 19), i.e. the retired left-opposition. This substantiates what we’ve been saying all along, that the people who have been fighting for better healthcare will be scapegoated by the people in power who destroyed it. Don’t get me wrong, that ‘small group of retirees’ has said some things I disagree with. Grandfathering is NOT a solution here. We must preserve traditional Medicare both for current AND future retirees. 

And never lose site of MedAdv scandals:

Portside: As Scandals Mount, So Do Calls To Abolish Private Medicare Advantage Plans ...the private health insurance program that a recent Senate report said is "running amok" with "fraudsters and scam artists." "In reality, so-called 'Medicare Advantage' is neither Medicare nor an advantage."... 

Scandal ridden healthcare is what Mulgrew, another scam artist, is trying to put us into. And he claims going with Aetna, owned by CVS, will save money.

Nothing like overbilling to save money. And this:

I reported on the Scheinman decision at ed notes yesterday:

There will be blood - er Lawsuits - UFT Leadership Joyful as Crooked - er Biased Arbitrator Scheinman Issues 25 day Ultimatum: Sign with Profit making Aetna (owned by CVS) and change Admin code or Medicare Disadvantage here we come 


Scheinman is not an independent arbitrator here. He has been chairing the Tripartite City-MLC commission on healthcare. How does he have jurisdiction in this matter as the City and union leaders are basically in agreement here?

Jonathan agrees with James about Scheinman having no jurisdiction:

Scheinman’s decision-making power as the arbitrator for the Tripartite Health Insurance Policy Committee arises in the case of a dispute

(From the 2018 letter referred to within the UFT as Appendix B)

Where is the dispute? Does Scheinman actually have any authority here? There are no positions for the parties, because the parties appear to be not in dispute. Everyone agrees about who needs to get screwed (me, and you).

Scheinman NOT designated arbitrator for Medicare Advantage issue

Oh, and oh no. Scheinman has been named to resolve disputes on items 1-4 in Appendix B. But the current issue, Medicare Advantage, comes from item 5. The agreement doesn’t cover point 5. Maybe that’s why Scheinman does not begin by establishing his authority? Point 5 only calls for recommendations.


And here is the full piece on MedAdv Scandals from Portside:

As yet another scandal involving Medicare Advantage made headlines this week, progressive U.S. lawmakers and advocates renewed calls to abolish the private health insurance program.

Brett Wilkins

Common Dreams
As yet another scandal involving Medicare Advantage made headlines this week, progressive U.S. lawmakers and advocates renewed calls to abolish the private health insurance program.

Photograph Source: Molly Adams – CC BY 2.0 (CounterPunch),


As yet another scandal involving Medicare Advantage made headlines this week, progressive U.S. lawmakers and advocates renewed calls to abolish the private health insurance program that a recent Senate report said is "running amok" with "fraudsters and scam artists."

"In reality, so-called 'Medicare Advantage' is neither Medicare nor an advantage."

In a new Nation article written with health insurance reform advocate Wendell Potter, Reps. Ro Khanna (D-Calif.) and Mark Pocan (D-Wis.) contend that one of the most confusing things facing elders while choosing their Medicare plans "is a scheme by private insurance companies to prey on seniors and profit off of the Medicare brand, all in the name of padding their corporate profits and shareholder returns."

"The scheme is called Medicare Advantage. But in reality, so-called 'Medicare Advantage' is neither Medicare nor an advantage," wrote the lawmakers, who earlier this year introduced legislation that, if passed, would ban private insurance plans from using the Medicare name.

"It's actually just private insurance that uses the trusted Medicare name to trick seniors and people with disabilities into enrolling, then profits by denying coverage for necessary medical care," Khanna and Pocan added. "It is long past time for Congress to end this scam and ensure that consumers get accurate information about their healthcare options."

On Monday, Kaiser Health News detailed how insurance companies selling Medicare Advantage plans "have repeatedly tried to sidestep regulations requiring them to document medical conditions the government paid them to treat."

The KHN report said that government auditors "uncovered millions of dollars in improper payments—citing overcharges of more than $1,000 per patient a year on average—by nearly two dozen health plans."

This follows a Senate Finance Committee report published last month that found insurance companies and other brokers are making false or misleading claims to dupe senior citizens into purchasing Medicare Advantage plans.

An investigation published in October by The New York Times found that insurance companies are exploiting Medicare Advantage plans to rake in billions of dollars in excess profits.

In April, the inspector-general's office at the U.S. Department of Health and Human Services published a report revealing that Medicare Advantage plans deny medically necessary care to tens of thousands of enrollees each year.

Nearly half of Medicare's 60 million beneficiaries are currently enrolled in Medicare Advantage plans, and the majority of U.S. seniors are expected to be signed up by next year.

The ACO-REACH program, a Trump-era scheme set to take effect on January 1st that would shift some Medicare recipients to private insurance plans without their knowledge or consent, is also raising eyebrows and ire.

Hundreds of advocacy groups, as well as the Arizona Medical Association, the Seattle City Council, the Texas State Democratic Executive Committee, and the Austin AFL-CIO Council have called on the Biden administration to end ACO-REACH.

Common Dreams reported Monday that 21 progressive lawmakers led by Sen. Elizabeth Warren (D-Mass.) and Rep. Pramila Jayapal (D-Wash.) urged Centers for Medicare and Medicaid Services Administrator Brooks-LaSure to investigate ACO-REACH, which the signers said "provides an opportunity for healthcare insurers with a history of defrauding and abusing Medicare and ripping off taxpayers to further encroach on the Medicare system."

[Brett Wilkins is a staff writer for Common Dreams.]

Licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.


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