Thursday, December 15, 2022

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


 Initial Analysis from a Retiree Advocate member on today Scheinman ruling

It looks like he's trying to establish the status quo ante, from before the lawsuit. It's a crass ploy to pressure the City Council to amend the Code. 
  • He's ordering the City & MLC to reach an agreement with Aetna, within 25 days, to administer the old Alliance plan. 
  • He's threatening that if the City Council doesn't amend the Code within 45 days he will end Emblem Senior Care.
  • He will allow the City to offer other options to retirees, as long as there is no cost to the City.
  • In the above case, retirees would pay the full cost of any other City plan we chose (so we would presumably still receive our Medicare Part B reimbursements if we chose a City plan). Would the City's offerings include a Medigap plan? I don't know.
  • Which is exactly where we were before Judge Frank's ruling.
It seems to me that Scheinman is threatening to do some things that he might not have the power to do, which will result in lawsuits. By the way, Scheinman is the one who is threatening our collective bargaining rights, not Judge Frank....

Let's be clear -- Mulgrew et al is moving us out of a publicly managed option into this private corp monster where profits come before our health. 

CVS Plans $10 Billion Share Buyback -

CVS Health: Signify As Growth Catalyst, 8% Buyback Yield, And Cheaply Valued

Dec. 08, 2022 4:26 AM ETCVS Health Corporation (CVS)

 CVS Health is a healthcare company known for its CVS Pharmacy. In addition to CVS Pharmacy, CVS Health owns CVS Caremark and Aetna, among others.

Third quarter 2022 results were strong. During the quarter, revenues increased 10%, free cash flow increased 73%, and earnings per share increased 9%.

Analysts on the Seeking Alpha CVS ticker page expect the dividend to grow 5% for fiscal 2023 and fiscal 2024.

Check quick: Does Scheinman own stock in CVS because this can be a $38 billion windfall?

  • when Unity was hard-selling this deal, in an unexplained rush, they clearly said there were no health care give backs. And then they did not provide Appendix B.
  • Appendix B is about health care cuts.... Jonathan Halabi, Was 2018 the Worst Bad Deal Ever?
Can you tell me how there are no conflicts here when the #arbitrator who is supposed to be #neutral is having dinner poolside with the lawyer for the #local731HarryNespoli, the #MLC ??

The arbitrator also said that unless the City Council amends the New York City Administrative Code within 45 days, GHI SeniorCare and all other current “pay-up” plans will no longer be offered once the premium‑free Medicare Advantage plan launches.
So here we are ---- either chance the admin code so the wealthier retirees can pay to opt out, thus furthering inequity, or being forced into MedAdv run by Aetna -- note Scheinmann forces them to deal with Aetna. See my opening question.
Let's look at CVS/Aetna as a profit making company:

2017 - Aetna Doubles Dividend, Boosts Stock Buyback Plans- Insurer’s moves come days after walking away from $34 billion merger deal with Humana

Aetna was bought by CVS in 2018. Amazon shark jaws are open:
Here's a fun fact: 
CVS Health is the parent company of the health insurer Aetna, which Amazon has reportedly reached out to, among other insurers. The move suggests that Amazon is moving along with Amazon Care — its on-demand health service that has at-home care aspirations — quicker than what may have been expected.
Will my Walgreen's prescriptions still be allowed?
CVS turned Amazon down  - for now -- but when can we look forward to having our healthcare managed by Jeff Bezos?

The American Medical Association (AMA) was disappointed in DOJ’s decision, standing by its stance that the merger will harm patients. “We now urge the DOJ and state antitrust enforcers to monitor the postmerger effects of the Aetna acquisition by CVS Health on highly concentrated markets in pharmaceutical benefit management services, health insurance, retail pharmacy and specialty pharmacy,” AMA President Barbara L. McAneny, M.D., said in a statement.

Karen S. Lynch President and Chief Executive OfficerTotal Cash $7,045,167Total Compensation $20,388,412
Shawn M. Guertin Executive Vice President and Chief Financial OfficerTotal Cash $4,323,636Total Compensation $14,339,230
Average CVS Health Executive Director yearly pay in the United States is approximately $187,259, which is 133% above the national average.   See more
Nice pay - go ask the clerks at your local CVS what they make.
Here's the good news: 

Mulgrew buddy, so-called "impartial" arbitrator Scheinman, should immediately disqualified. The UFT chose him in 2014 and 2018. 
The UFT statement below dovetails with the Scheinman decision.

UFT: For Immediate Release – Thursday, December 15, 2022

UFT Statement on Arbitrator’s Decision on new Medicare Advantage program

An independent arbitrator has ordered the city to negotiate a new Medicare Advantage program with the Aetna insurance company in the next 25 days.  He also determined that if an agreement is reached, the city’s unions would have a choice of either approving the deal or facing the necessity of paying premiums for health care.

UFT President Michael Mulgrew said:  “In the last decade the cost of health care has been rising dramatically and over the long term only action by the federal government can solve this national crisis.”

“In the meantime, the municipal unions have been negotiating with the city on how to preserve our health care benefits.  Most importantly, we want to maintain plans that do not require our members to pay the thousands of out-of-pocket dollars that most workers now typically have to pay for health insurance.”

“A new Medicare Advantage plan will be  negotiated to keep that premium-free status, and we will make sure that it meets our retirees’ needs, even while saving hundreds of millions of dollars that will be dedicated to other health care services.”

Arbitrator Martin F. Scheinman issued his findings December 15, 2022.  Scheinman, who played a key role in city/union health agreements in 2014 and 2018, has been appointed by the parties to arbitrate any potential disagreements over interpretation of the pact and to enforce its provisions. Scheinman also chairs the Tripartite Health Insurance Policy Committee, consisting of the city and the MLC, which was formed in 2018 to consider how city health care could be restructured to preserve quality while stemming the rising cost of its delivery.

A copy of the full decision is here:

(Scheinman's conclusions start at page 28)
More excerpts from Jonathan:

Was 2018 the Worst Bad Deal Ever?

Here’s the link to the MOA:

Appendix B, as you might guess, is not attached.

In fact, when Unity was hard-selling this deal, in an unexplained rush, they clearly said there were no health care give backs. And then they did not provide Appendix B. James found it. But because the leadership hid it, and most members rely on the leadership for their information, there is no way of knowing how many of those who voted yes on the contract knew there were givebacks. Probably very few, in light of Unity’s brazen lies. Arthur provides a good summary of the Unity rush to get the 2018 contract passed without revealing the health care give backs.

Appendix B is a letter. Here’s a link to the whole of Appendix B (4 pages).

So, we already know, agreeing to cutting health care is a bad deal. But worst deal ever? Let’s look at 1.a, and focus on 1.a.iv

First, a reminder: “savings” are savings for the City of New York and the Stabilization Fund. “Savings” for you and me mean less health care, harder to access health care, or more costly health care.

So Appendix B is about health care cuts.

Let’s focus on line iv. $600 million per yer – on a recurring basis. That means, even though that contract is over, the health care cuts need to continue forward. And worse. Any fool knows, health care costs are going up. So whatever cuts were good enough to amount to $600 mil a year ago, they are not enough today. Unity has put us on the hook for never ending cuts in health care. That’s what makes this perhaps the worst negotiated deal, ever.

Our contract is expired. But the health care cuts continue.

The health care cuts are permanent.

And Appendix B promises more cuts every year that health care costs rise.


More from Mulgrew:

You have my promise that the UFT will not move forward with the new plan until we have agreed on a high-quality plan our retirees deserve.
Where we go from here
During the next 25 days, we will push Aetna hard on these fronts:
  • increase the size of its provider network in parts of the United States where large numbers of UFT retirees live with the goal of getting 98% of the doctors that UFT retirees use in Aeta’s network.
  • ensure that out-of-network doctors who provide services to our retirees are reimbursed by Aetna at the traditional Medicare rate without our retirees being billed.
  • create a real accountability system that ensures that Aetna delivers all rights and benefits to retirees as agreed upon in the agreement; and set up a clear, fast process to rectify any issues.
  • ensure there is an expedited appeals process for denial of care where specialists in the particular field/procedure make the final determination.
  • ensure every retiree, regardless of pre-existing conditions, is accepted in the new plan.

Municipal Labor Committee

55 Water Street, 23rd Floor / New York, NY 10041 / (212) 815-1474


Local 831, I.B.T. Uniformed
Sanitationmen’s Association, AFL-CIO


District Council 37, AFSCME, AFL-CIO


United Federation of Teachers, AFL-CIO


Local 237
City Employees Union, I.B.T., AFL-CIO

MLC Members:


Council of School Supervisors & Administrators


Uniformed Firefighters Association

Correction Officers’ Benevolent Association

S.E.I.U. New York City Local 246

ROBERT CROGHAN Organization of Staff Analysts

New York State Nurses Association

Detectives’ Endowment Association

District Council of Carpenters, AFL-CIO

International Union of Operating Engineers Local 30, AFL-CIO

JOSEPH MANNION Sanitation Officers Association

Local 854, Uniformed Fire Officers Association, AFL-CIO

Local 1180, NYC Administrative Employees, CWA, AFL-CIO

FRANK PROSCIA, M.D. Doctors Council

Local 508, NYC Lifeguard Supervisors, AFSCME, AFL-CIO

Lieutenants Benevolent Association

Local 1407, NYC Accountants, Statisticians & Actuaries, AFSCME, AFL-CIO

Local 371, Social Service Employees, AFSCME, AFL-CIO

Executive Secretary


To: From: Re:

December 15, 2022

Municipal Labor Committee Members Harry Nespoli, Chair
Martin Scheinman Decision

Arbitrator Martin Scheinman has issued a decision regarding ongoing health matters. As we had informed you, in light of the delay in implementing the Medicare Advantage Plan and the hastening draw down of the Stabilization Fund, the City had applied to Scheinman to enforce the 2018 Health Agreement. In the attached award, Scheinman finds that the Stabilization Fund has effectively run out of money and that the City and MLC should proceed to negotiate appropriate terms for an MA plan with Aetna within the next 25 days. Assuming terms are agreed upon, he directs that the MLC put that agreement to a vote. The City had argued that a vote was unnecessary because of the arbitration but Scheinman agreed with us that MLC procedures require a vote for a program of this nature. Should the MLC not approve the Aetna program, the matter would revert to him for consideration of how benefits provided for by the Stabilization Fund including the provision the GHI-CBP premium-free are to be paid for, including the imposition of premiums on actives and pre-65 retirees. Finally, he, once again, implored the City Council to amend the Administrative Code to allow for “choice” in retiree plans but directed that if the City Council does not act to restore the ability of the City and MLC to offer pay-up options for retirees, Senior Care (and the vast majority of the other options) will be discontinued.

As you will recall, a group of retirees initially challenged the MLC’s ability to bargain healthcare and the City’s ability to adopt a Medicare Advantage plan. While Judge Frank affirmed the MLC’s role and the implementation of the Medicare Advantage plan, he read the Administrative Code to preclude offering optional retiree pay-up plans until the cost surpassed that of the actives plan. The appellate court agreed with Judge Frank, including noting that the City need not offer alternative plans. The delay resulting from these challenges and the restriction on the MLC’s ability to negotiate to continue Senior

Page 2.... Martin Scheinman Decision

Care as a pay-up, have prevented the savings lifeline needed to bridge the Stabilization Fund and the many benefits it supports until MLC and City can complete a thoughtful process (now underway) to bid out and restructure the larger health benefit program. The MLC had insisted upon the maintenance of choice when implementing the Medicare Advantage program and fought to preserve that choice, but the matter was forced to an unfortunate decision by outside groups, foot dragging by some and the inaction of the City Council.

As always, the MLC will face the current challenges and work to create the best outcome possible. The work to vet a possible agreement with Aetna informed by past experience with the Alliance is underway and we will continue to press to protect our members and retirees as we navigate the needed changes.



BLT said...

This is disgusting. What can we do?

ed notes online said...

Keep up the agitation - make Mulgrew pay politically and also use the courts.

Anonymous said...

Seems to be standard New York politics , not suporting the retirees who worked many years to maintain the city

Anonymous said...

Sheinman has no jurisdiction to make a ruling . He is an independent person and has no jurisdiction to do so in regards to us . We know an arbitrator is used when the 2 parties cant come to an agreement. We know the city and the MLC want to put us into a MAPP Plan so we dont understand why this even went to him . Hence this is why this whole debacle as I said is a facade and the stuff within it is a lot of poppycock. He's a bully making threats and on the first page it says its his opinion and award between them too. This is his opinion and his so-called award. Even on page 1 it says "opinion"