NC State Treasurer Displays Big Brass Cojones

Now we know where Texas lost it’s cojones (Has Texas Lost It’s Cajones?)………..in North Carolina. Mr. Folwell, please bring them back! The upcoming Texas  biennial session needs them…..

“I’m calling for the United States Department of Justice and the North Carolina Department of Justice, on behalf of the State Health Plan, to recover the potentially hundreds of millions overcharged to consumers by hospital management from this illegal activity.” – Dale Folwell

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How To Charge $1.6 Million For a New Drug And Get Away With It

Call it a warning shot: last week an Indian patent court shocked the $600 billion global pharmaceutical business by ordering Bayer, the German health care giant, to allow a tiny Indian generic drug company to sell cheap copies of the blockbuster cancer drug Nexavar – even though everyone agrees that the drug is protected by a patent…………………..

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Why Self-Funding is A Better Way To Finance Health Care

Milliman White Paper Shows How Self-funding Gives Employers More Control Over Medical Insurance Programs

MyHealthGuide Source: Jennifer Janvrin, CEBS, 11/2018, Milliman White Paper (full text)

Editor’s Note (Ernie Clevenger): This excellent White Paper by Milliman provides key values of self-funded and statistical tables to illustrate risk and risk management.

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How to Defend an ERISA Lawsuit

Firestone deference – Many ERISA plans use plan document language stipulating the plan administrator has the authority to interpret plan terms and resolve any ambiguities. The United States Supreme Court has held that when a plan contains this language, courts must show deference to the administrators and review their decisions under an arbitrary and capricious standard…………….

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How do you know if your surgeon is the best of the best or the worst of the worst? Unfortunately most patients play Russian Roulette when it comes to picking one………………….the results can be hazardous  to your health…………..

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Employers Are Becoming More Active in Healthcare Claims Management

“Employers are cutting out insurers completely and contracting directly with providers and/or creating near-site or on-site health clinics for primary care……………….More traditional cost management techniques are simply running out of gas. Employees, who have borne half of recent-year cost increases, simply can’t afford anymore,”

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