UnitedHealth to Buy Patient Care Group; Group Not to See Patients with UnitedHealth

UnitedHealth Group Inc. announced Wednesday December 4 that it is spending $5 billion to purchase "hundreds of clinics," many of which are disallowing patients covered by UnitedHealth to be seen in the coming year. The announcement came days "rival Aetna announced a tie up with CVS Health Corp."

The Minnesota-based UnitedHealth's Optum segment is expected to close the deal to purchase DaVita Medical Group from DaVita Inc. next year, according to an AP article in the Tampa Bay Times ("UnitedHealth ventures deeper into patient care with $5B deal").

DaVita "runs nearly 300 primary and specialty care clinics in several states," including Florida, while Optum currently operates more than 1,100 primary, urgent care and surgery centers.

However, patients in at least one Florida county are finding it increasingly impossible to continue to see their primary care physicians employed by DaVita Medical Group while insured by UnitedHealth.

Disclaimer: This writer, along with at least one family member, were insured through UnitedHealth through December 2016; I write this from experience.

During the 2016 open enrollment period for Medicare, DaVita Medical (then called JSA Medical) contacted patients covered by UnitedHealth, informing patients that they needed to change from UnitedHealth to another Medicare Advantage Plan or find another primary care physician. A contract between UnitedHealth and DaVita was not signed until shortly after the open enrollment period ended. Those patients who opted to stay with UnitedHealth found themselves in the position of then staying with both their insurance of choice and retaining their primary care physicians in DaVita. Those who changed insurance plans to stay with DaVita were at least able to find comfort in staying with their primary care doctors.

However, not all plans are the same. Some patients (again, this writer and my family member(s)) would that many of their specialists were not covered with new advantage plans. When the 2017 open enrollment began, patients who had fled UnitedHealth (UHC) the previous year found that if they switched back to UHC, they could either see their DaVita physicians as an out-of-network doctor, or not be allowed to see their physicians, even as out-of-network, depending on who one spoke with. (Out-of-network refers to doctors who are not technically part of one's insurance plan, but who can still be seen, usually at a slightly higher co-pay.)

As of December 7, the last day of open enrollment for the 2018 coverage year, only those patients who remained with UHC in 2016 were allowed to see their DaVita doctors, being "grandfathered" in. Those patients who changed to UHC during open enrollment - including those who switched out of UHC last year due to too-late contract negotiations - would have to change doctors.

According to a customer satisfaction representative at the St. Petersburg (Fla.) corporate office, while UnitedHealth Group is poised to close the deal to buy DaVita Inc. in 2018, Medicare patients wanting to switch back to UHC can not do so and stay with DaVita.

"That might change next year, if everything falls into place in time," the representative stated. "If not, it might be during the 2019 open enrollment before a patient could change back."

VA Evacuation Halted, Lack of Ambulances, Disagreement Sited

Up to 30 patients who were scheduled for evacuation from the C.W. Bill Young V.A. Medical Center prior to Hurricane Irma were not moved due to a disagreement between the medical center and Pinellas County officials.

While Young medical center officials claim that the county "promised ambulances that never arrived," county officials disagree, saying that while some patients were moved, patients could not be moved to facilities that the VA wanted the patients moved to, according to the Tampa Bay Times ("Hurricane Evacuations Halted for Lack of Ambulances at VA' Young Center"). County officials claim that Young officials requested patients be moved to facilities in Gainesville and Lake City.

In all, 110 patients and 56 staff members were moved to other locations, with 96 patients and 400 staff members remained behind.

Of the patients who needed to be evacuated, 30 were left behind due to a lack of ambulances, according to the article.

To read the article in its entirety, check out "Hurricane Evacuations Halted for Lack of Ambulances at VA' Young Center".

FDA Panel: "Living Drug" Approval Recommened For Leukemia Treatment

A Food and Drug Administration panel unanimously recommended approval for a treatment that "genetically alters a patient's own cells to fight leukemia," turning them into what is being called "a living drug" to help stop the disease, according to The New York Times ("F.D.A. Panel Recommends Approval for Gene-Altering Leukemia Treatment"). The recommendation came down Wednesday and is likely to be accepted by the F.D.A.

The treatment, which will be the "the first gene therapy ever to reach the market," is expected to be followed by other gene therapies. Novartis is expected to be the first to drug company to market a "living drug" with its treatment for a type of leukemia. Drug companies and researchers "have been engaged in intense competition for decades to reach this milestone."

To read the Times article in its entirety, click here.

Sen. Marco Rubio Supports Bare-Bones Health Care

A just-released GOP health care bill that would "allow insurers to sell bare-bones policies that do not meet standards of the Affordable Care Act" has the support of Florida Sen. Marco Rubio.

In a Facebook Live address, Rubio said that “People should have the right to buy the kind of insurance they want at a price they can afford. Not everyone wants or needs the same kind of insurance,” according to The Tampa Bay Times ("Rubio on board with plan to offer bare-bones health care policies"). Rubio added, “Why can’t you just insure against a serious illness or a bad accident but allow primary care or something else to either be covered by a separate but limited policy or through a health savings account or if you have enough money, out of pocket.”

Click here to read the Times blog post in its entirety.

Medicaid Cuts to Adversely Affect Fla. Hospitals

In a decision that will adversely affect many of Florida's hospitals, state lawmakers decided Thursday "to cut $521 million from hospitals." Nearly one-fifth of those hospitals affected are in the Tampa Bay area.

According to Tampa Bay Times ("Lawmakers are cutting $92 million from Medicaid in Tampa Bay. Which hospitals are hardest hit?"), the cuts will "mostly impact the facilities that take on the largest number of Medicaid patients, including the state’s safety net hospitals." Under this plan, hospitals in the Tampa Bay area will lose $91.7 million.

This plan is expected to pass the state House and Senate today.

To read the article in its entirety, including the list of hospitals (which includes Tampa General, All Children's, Bayfront Health-St. Petersburg, and Moffitt Cancer Center), click here.

NC 'Bathroom Bill' Reset Leads to Uncertainty

Negotiations to overturn North Carolina's "bathroom bill" Friday have given way to uncertainty. According to a report by the Associated Press, while House Bill 142, titled "An Act to Reset," was signed by Gov. Roy Cooper on Thursday, critics say that this is not "a true repeal" of the law created by House Bill 2. Critics say that "it still exposes gay and transgender people to discrimination."

To read the AP article, which gives also gives background on the law, in its entirety, check "North Carolina Future Uncertain After 'Bathroom Bill' Reset."

Trump U. Settlement: $25 Million

A judge has approved an agreement that would settle lawsuits over President Donald Trump's now-defunct Trump University to the tune of $25 million. The agreement ends "nearly seven years of legal battles with customers who claimed they were misled by failed promises" of learning real estate success, the Associated Press reports.

According to the AP, U.S. District Judge Gonzalo Curiel's ruling on Friday will settle two class-action lawsuits, as well as a civil lawsuit. Under the settlement's terms, Trump admit no wrongdoing.

Curiel, an Indiana-born judge, was repeated assailed by Trump, who insinuated that the "judge's Mexican heritage exoposed a bias."

Two former students objected to the settlement.

To read the article in its entirety, check "Judge Approves $25 Million Trump University Settlement."

FL DCF Under-Performing in Foster Kids' Help

The Florida Department of Children and Families has been given 90 days to figure out how to improve care for foster kids after a study by a federal agency found it "underperforming in critical areas."

The Tampa Bay Times reported that a study "compiled by the Children's Bureau", titled "Children and Family Service Review", found in more than half of the 80 foster care cases handled by DCF from April 1 to September 30, children were removed "from homes without first providing appropriate services and were lax in following safety plans."

The Children's Bureau, which rated DCF's performance as "needing improvement in 11 of 14 categories," is part of the U.S. Department of Health and Human Services.

Click here to read the article in its entirety.

Florida Polytechnic Has First Grad Class

Florida Polytechnic University held its first commencement Tuesday afternoon for fifteen students. The school, which has yet to achieve accreditation, splintered off from the University of South Florida in 2012.

The school is "Florida's first university dedicated to science, technology, engineering and math," according to the Tampa Bay Times.

The students were offered free tuition, while others saw a "chance to shape a new school."

The Southern Association of Colleges and Schools was expected to decide on Florida Polytech's accreditation last year, but couldn't get all the information it needed. While a SACS campus visit is scheduled for February, "a final decision likely won't be made until December 2017." However, accreditation would cover Tuesday's group.

To view the article ("Florida Polytechnic celebrates an early milestone as first grads turn their tassels") in its entirety, click here.