Chinese Flu Crib Sheet

September 23rd, 2021

The survival rate of “Covid” is over 99%. Government medical experts went out of their way to underline, from the beginning of the pandemic, that the vast majority of the population are not in any danger from Covid.

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HMS

September 23rd, 2021

We make healthcare work better for everyone. By reducing costs and improving health outcomes, HMS advances the healthcare system.

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340b Benefits Who?

September 23rd, 2021

The 340b program has become a huge revenue generator for health systems, PBM’s, and other intermediaries.

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Grab Your Share of $345,000,000 Today!

September 22nd, 2021

“We getting a refund Bruno? That’s cool!”

There is a class action lawsuit settlement of $345m reached between the plaintiffs (Pfizer & King Pharma) and any person or entity that purchased brand or authorized generic Epipens between 8/4/2011 and 11/1/2020.

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2022 Onsite Employee Health Clinics Summit

September 22nd, 2021

Onsite employee health clinics have proven to be an effective way to significantly reduce healthcare costs, and ultimately, have a positive impact on the company’s bottom line.

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Direct Primary Care Rocks

September 22nd, 2021

Primary care physicians can treat 90% of what ails you. Direct primary care is a model that makes sense and saves money, provides better personal service grounded upon a holistic health care approach.

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Mike Dendy on Reference Based Pricing

September 22nd, 2021

By Mike Dendy

Reference based reimbursement (RBR or RBP) has evolved over the past 10 years and there are now many more players in the space.

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Doctor Arrested For Prescribing Ivermectin

September 21st, 2021

Dr. Jean-Paul Theron was arrested for prescribing Ivermectin from his home. He was targeted by a complaint from the Council of the Order of Physicians……..                                           Read the rest of this entry »

Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans

September 17th, 2021

“Patients on membership plans act like insured patients and come in as much as insured patients, but they pay less for coverage while dentists get paid more,” said CEO Dave Monahan. “All we are doing is cutting out the middleman,” he said.

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Sex Sells – Winning Sales Quota by Banging Doctors?

September 17th, 2021

In 2012, Insys hired a new sales executive: Sunrise Lee, a Florida escort service manager and former strip club dancer with no academic degree, according to Guzman’s complaint. Burlakoff allegedly defended the decision, claiming, “Doctors really enjoyed spending time with her and found Sunrise to be a great listener.” He added, “She’s more of a closer.”

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Dallas Risk Management

September 17th, 2021

Dallas Risk Management (DRM) is a Managing General Underwriter, or MGU, for health insurance policies.

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Key House Democrats Block Biden Drug Price Controls

September 17th, 2021

Key House Democrats Block Biden Drug Price Controls – Lunch Alert! – DickMorris.com at DickMorris.com

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Embodiment of Corruption: Your Health Insurance Network

September 16th, 2021

Secret network pricing helps render patients defenseless against price gouging. It’s as absurd as grocers being permitted to keep the price of milk secret……………..

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Texas Hospital Faces Closure Over COVID-19 Vaccine Mandate: CEO

September 15th, 2021

“What happens to individual choice and medical decisions between the patient and their doctor, which is all of the things that we’re trying to support.”

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TRS ActiveCare Will Remain The Choice of +90% of Texas School Districts

September 15th, 2021

For the first time in 20 years TRS ActiveCare member districts will be allowed to opt out of the program effective September 1, 2022. In our opinion most member districts will remain in TRS ActiveCare.

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Why Most Public School Districts Get An “F” In Health Care Management

September 13th, 2021

By Bill Rusteberg

School districts are entitlement based bastions whose decision making processes heavily weight social considerations at the expense of prudent business practices.

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Fellow Health Care Disruptor Shares Personal Experience

September 12th, 2021

A friend,  fellow health care disruptor and collaborator shared his personal experience navigating the American Health Care System in an email sent us this afternoon.

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U.S. v. Teva Pharmaceuticals USA Inc et al

September 12th, 2021

Lawsuit alleges the company illegally paid two purportedly independent charitable foundations $328 million from 2006 to 2015 to cover co-payments of Copaxone patients, while Copaxone’s price quadrupled to $73,326 a year.

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Paul Keckley – Trusted Advisor

September 12th, 2021

Paul Keckley is an intense observer of that change, diving deep into the trends, tipping points, intended and unintended consequences to bring clients and opinion leaders the unvarnished truth.

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Customers Get Fired Too…………

September 11th, 2021

By Dan Meylan

“In 5 decades of operating agencies and other businesses….we always looked for ways to remove unprofitable clients….”

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Pissed Off Plan Sponsor Has Had Enough!

September 11th, 2021

Pissed off plan sponsor has had enough! Their TPA has not lived up to expectations and a warning shot has been fired across the TPA’s bow……………

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American Health Care System Drives Man To Drink

September 10th, 2021

Called for an appointment……………………

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Employee Benefits International

September 9th, 2021

Employee Benefits International is headquartered in Phoenix, Arizona, and covers the entire United States with health insurance and employee benefits programs for businesses – large and small. EBI has experts in-house that have worked with most business sectors including: healthcare, law firms, construction, manufacturers, nonprofits, auto dealerships, Realtors, and many others.

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Legendary Insurance Agents You Never Heard Of

September 9th, 2021

“Rosengard is known for putting together what was for a long time the world’s largest life insurance policy, still recorded by Guinness Book of Records.”

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CPO Centric Health Plan

September 9th, 2021

By Bill Rusteberg

A CPO (Cash Pay Option) centric health plan removes all financial barriers to health care while saving money at the same time. Cash beats insurance everytime.

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Selecting a Third Party Administrator

September 8th, 2021

By William Rusteberg

With the growing suggestion that the BUCAs are inflexible third party administrators unwilling and unable to administer Reference Based Pricing plans and other strategies in the market today, more brokers are seeking new partnerships with independent third party administrators (TPA). An independent TPA can offer much more than a traditional carrier model.

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La Joya ISD Shit Show Continues………………..

September 6th, 2021

FBI agent and a law enforcement officer from the Texas Department of Insurance watched quietly from the gallery as the the never ending La Joya Shit Show Continues…………….

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Politicians Begin Watering Down Efforts To Lower Drug Pricing

September 6th, 2021

Senate drug pricing bill may not apply to those with job-based insurance

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Rx Rebates 101

September 6th, 2021

The role of rebates in drug coverage decisions and insurer finances…………

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What Ever Happened To………………………?

September 3rd, 2021

Apr 12, 2018 · An insurance broker who admitted paying bribes to land lucrative health insurance contracts at area school districts and the now-defunct water utility was sentenced to 37 months in prison.

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Medicare Is Running Out of Money

September 2nd, 2021

Medicare is running out of money. That’s not news to plan sponsors. They too are running out of money to fund the American health care beast. Some propose “Medicare for All” as the solution. Others say “Let the free market handle the problem!” The problem is there is no free market in health care and Medicare is running out of money because government doesn’t know how to solve health care either. Meanwhile, a few plan sponsors have solved health care the old fashion way using traditional American business practices based on common sense, reason and logic.

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Medical Debt Collector or Patient Assistance? Nonprofit’s Model Raises Ethical and Legal Questions

August 31st, 2021

Hospitals are donating unpaid debt to a Tulsa-based not-for-profit that claims to connect patients with social services including housing help, food assistance, transportation, addiction treatment or credit counseling.

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Participate In Stop Loss Profits

August 31st, 2021

Trucking coverage is tough right now. Thanks to nuclear verdicts and low interest rates, premiums are climbing. This is happening to all companies, regardless of their loss experienc

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You Can’t Fix What You Don’t See

August 30th, 2021

candle

By William Rusteberg

Has your company tried, over and over again, to solve ever increasing health care costs?  “Yes, of course we have, but nothing seems to work!” is a common answer. “We bid out our employee health insurance every year through multiple brokers, we reduce benefits to offset rate increases, and we even light a candle 24 hours before year-end renewal!”

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The Klement Letter

August 29th, 2021

“As an outsider looking in and not having all the political implications and considerations that board members face, I’d like to give you our perspective and advice for consideration on your choices.” – Greg Klement

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Mike Keogh

August 29th, 2021

“Don’t bother doing something unless you’re radically different from the competition” – Richard Branson

By Bill Rusteberg

Mike Keogh was an extraordinary man. A former BCBSTX salesman in the 1950’s, he later built  an independent brokerage in San Antonio with great success. I met Mike in the early 80’s and did quite a bit of business with him.

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United States Health Care Pricing Is Insane

August 28th, 2021

Does anyone with health insurance really care what health care costs? After all, with copays and deductible/s the same cost to the consumer no matter where they go for care because other people’s money pay most of the cost……………..

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Trends in Hospital Lawsuits Filed Against Patients for Unpaid Bills Following Published Research About This Activity

August 28th, 2021

The findings of this study suggest that research leading to public awareness can shift hospital billing practices. Translation: Hospitals don’t like sunlight……………

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French Citizens: “Screw Covid Passports”

August 28th, 2021

A single photo persuaded bureaucrats to drop face mask mandates during the 1918 Spanish Flu pandemic…………Will a 2021 French picnic picture bring back bureaucratic sanity?

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Schuessler’s Band Of Renegades Poised To Solve Health Care

August 27th, 2021

Carl Schuessler, Inventor of The Schuessler Stick™

Mitigate Partners with 30 independent offices across the United States act as the problem-solvers, consulting with businesses on employee benefits……………..

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Cash Pay Health Insurance Is The Future (and the future is now)

August 27th, 2021

Insured members pay for health care with cash provided by insurance plan funds and paid directly to medical caregivers at the point of service. No patient responsibility and no balance billing. Everyone wins, the plan, plan members and medical caregivers…………Meanwhile under traditional status quo health plans……………

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Insurance Payments Tied to Medicare Intrigue States, Employers

August 27th, 2021

Hospital Administrator Reacts To News

Montana’s state employee plan went from a projected $9 million deficit to $112 million in reserves by the end of 2017.

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BUCA Earns “F” In Health Care Cost Containment

August 26th, 2021

A +4,000 life Texas school district self-funds their medical plan using a BUCA as plan administrator and PPO network provider. How has their plan performed in the last seven years?

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Long Live Primary Care

August 22nd, 2021

“If we increase the spend on primary care so that primary care doctors can holistically manage their patient’s health, quarterbacking to specialists and coordinating care as needed, we can achieve lower overall spend on healthcare.”

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TRS ActiveCare Eager To Provide Claim Experience?

August 20th, 2021

After years of refusing to provide member districts their own claim experience, TRS officials now are eager to provide it. Why?

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Tyler, Texas Chamber Against Hospital Pricing Transparency Rules

August 19th, 2021

Plaintiffs Chamber of Commerce of the United States of America (“U.S. Chamber”) and Tyler Area Chamber of Commerce (“Tyler Chamber”) (collectively, “Plaintiffs”), bring this action for declaratory and injunctive relief against the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, the Department of Labor, the Employee Benefits Security Administration, the Department of the Treasury, the Internal Revenue Service, and the current heads of those agencies in their official capacities (collectively, “Defendants”), alleging as follows:

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Man Sentenced To Death For Refusing Vaccination

August 19th, 2021

Transplant patient taken off list for refusing to take the Chinese Flu vaccination……

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Dallas ISD Offers $500 Vaccination Incentive

August 18th, 2021

Coach Joe Sixpack and his pals are planning to get vaccinated at least ten times just to be sure. “We’re gonna use the money to help pay for our TRS ActiveCare we can’t afford to use” said Coach Sixpack.

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Commission Relationships in Health Care

August 18th, 2021

 

The Healthcare Industry is Filled with Commission Relationships Where Money Is Paid, But It Is Not Always Obvious.

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Decision Time: TRS ActiveCare or Commercial Health Plan?

August 15th, 2021

Senate Bill 1444 brings districts to a fork in the road. One takes them out of the health insurance business and the other puts them smack dab into it…..

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The Duopoly That Controls Your Pharmacy Benefit

August 13th, 2021

Dear Plan Sponsor, do you think you control your Rx plan? Think again…………..

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Dead People Paid By Government Health Plan

August 12th, 2021

Dead people have been known to vote, now we learn they get health care while dead too…..Next thing you know we’ll elect dead people to Congress………….

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Why a $60 Hospital Bill From 1955 Went Viral

August 12th, 2021

Babies cost $59.95 back in the 1950’s. I was almost free in the decade before that. Babies are worth a lot more these days………….

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You’ve Got The Body Now You Want My Soul

August 12th, 2021

You’ve got the body now you want my soul………….Ill do almost anything you want me to do but I cant do that, no, no, no………………Ain’t accepting any balance billing baby!

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Court Finds Charter School Benefit Plans Fall Under ERISA’s Governmental Plan Exempt

August 12th, 2021

“Because the state not only funds the charter schools but also approves their establishment and continued existence, it is not appropriate to treat them as private institutions subject to public regulation.”

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TRS ActiveCare or Commercial Health Plan?

August 11th, 2021
“When you come to a fork in the road, take it” – Yogi Berra

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The Kind Of Prospect We Want To Do Business With

August 11th, 2021

Yesterday’s meeting with a prospect was memorable. The group’s in-house risk manager listened politely, then towards the end of the meeting got up and started drawing a diagram on the board, while narrating at the same time.

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August 9th, 2021

Welcome to Global Health Management, Canada or as we refer to ourselves: GHM Canada.

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Public Consulting Group

August 8th, 2021

We believe in the power of the public sector…………………….

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Where is the medical cost trend headed in 2022?

August 8th, 2021

Healthcare spending is expected to return to pre-pandemic baselines with some adjustments to account for the pandemic’s persistent effects.

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TRS ActiveCare Flips: Will Release Claim Experience

August 8th, 2021

Can an employer access claims data to compare TRS-ActiveCare to other options for employee health benefits?

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Easy Issue Life Insurance With Return of Premium Benefit

August 7th, 2021

If They Want to See A COVID “Passport” – Show them This!

August 7th, 2021

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How Banning Surprise Billing Changes MultiPlan’s Business

August 6th, 2021

Political winds threaten the stability of MultiPlan’s core business……..

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Question for Health Insurance Experts

August 6th, 2021

Plans have been known to exclude coverage for “risky” behavior………

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The Robin Hood Risk Adjustment Program

August 4th, 2021

To protect against potential effects of adverse selection and help stabilize premiums in the individual and small group markets, the (Robin Hood) risk adjustment program transfers  funds from plans with relatively low-risk enrollees to plans with relatively high-risk enrollees.

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What European Country Is This?

August 3rd, 2021

National Ambulance Service reach all over the country within 15 minutes…………

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Government Considers Onerous Punishment For Renegade Hospitals

August 2nd, 2021

Government bureaucrats consider upping punishment for non-compliant hospitals…….

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Consumers Blame Insurers Surprise Medical Bills

August 2nd, 2021

Blame Game In Health Care

Whatever happened to individual responsibility?

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Hospital Price Transparency – Not a Cure for the Disease

August 1st, 2021

Transparency has revealed just how absurd the current contracting process is, and has in many ways caused more confusion and obfuscation……………….Costs could very likely rise in many markets as systems learn about higher prices being charged by their competitors – the definition of ‘unintended consequence………….

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The Most Outrageous Salesman I Ever Filmed

July 30th, 2021

By David Hoffman

This is a clip from my first documentary feature film called King Murray. It won the Cannes Film Festival Critics Prize in 1970. Murray King was a most amazing character and ended up selling me life insurance….. at 27 years old!

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Aflac Faces a Tight Labor Market

July 30th, 2021

AFLAC facing distribution pressures due to the Chinese Flu………..

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Former Healthcare Executive Insider Seeks Redemption

July 30th, 2021

The author’s message is clear. And it’s real. But there is something else within the article that’s a condemnation of our current health care system of finance in this country – If You Can’t Pay Your Gonna die.

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Cheech & Chong Insurance?

July 30th, 2021

Insurance Agents Cheech & Chong Out Making Cold Calls

Cheech & Chong, in their best dreams of years gone by, would have never thought possible mainstream insurance brokerage would ever promote a canabis benefits captive. Their idea of “captive” was that it was really bad and something to avoid.

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Government Bureaucrats To Cut 258 ASC Procedures?

July 28th, 2021

With the magical stroke of a bureaucratic pen a list of the procedure codes may be removed from the ASC payable list, including several heart and spine procedures…………….

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