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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:
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:
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:
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
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.
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.
