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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 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.
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 Officer
Total Cash $7,045,167
Total Compensation $20,388,412
Shawn M. Guertin Executive Vice President and Chief Financial Officer
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 thatifan agreementis 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 nationalcrisis.”
“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 negotiatedto
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 toother 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.
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.
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
CHAIRPERSON
HARRY NESPOLI
Local 831, I.B.T. Uniformed
Sanitationmen’s Association, AFL-CIO
CO-CHAIRPERSON
HENRY A. GARRIDO
District Council 37, AFSCME, AFL-CIO
EXECUTIVE VICE-CHAIR
MICHAEL MULGREW
United Federation of Teachers, AFL-CIO
SECRETARY
GREGORY FLOYD
Local 237
City Employees Union, I.B.T., AFL-CIO
MLC Members:
TREASURER
MARK CANNIZZARO
Council of School Supervisors &
Administrators
VICE CHAIRPERSONS
ANDREW ANSBRO
Uniformed Firefighters Association
BENNY BOSCIO, JR. Correction Officers’ Benevolent Association
JOSPEH COLANGELO
S.E.I.U. New York City Local 246
ROBERT CROGHAN
Organization of Staff Analysts
JUDITH A. CUTCHIN
New York State Nurses Association
PAUL DIGIACOMO Detectives’ Endowment Association
MARTIN A. LYDON
District Council of Carpenters, AFL-CIO
WILLIAM M. LYNN
International Union of Operating Engineers
Local 30, AFL-CIO
JOSEPH MANNION
Sanitation Officers Association
JAMES MCCARTHY
Local 854, Uniformed Fire Officers
Association, AFL-CIO
GLORIA MIDDLETON
Local 1180, NYC Administrative
Employees, CWA, AFL-CIO
FRANK PROSCIA, M.D.
Doctors Council
PETER STEIN
Local 508, NYC Lifeguard Supervisors,
AFSCME, AFL-CIO
ANTHONY WELLS
Local 371, Social Service Employees,
AFSCME, AFL-CIO
Executive Secretary
ELLEN MEDWID
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.
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"
4 comments:
This is disgusting. What can we do?
Keep up the agitation - make Mulgrew pay politically and also use the courts.
Seems to be standard New York politics , not suporting the retirees who worked many years to maintain the city
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"
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