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    As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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As the Health Care Vote Passes

Another Troubling Insurance Story

By Marian Wang, ProPublica – March 17, 2010 2:03 pm EDT

[picapp align=”none” wrap=”false” link=”term=health+insurance&iid=8337843″ src=”c/e/5/3/President_Obama_signs_baf7.JPG?adImageId=11734822&imageId=8337843″ width=”380″ height=”484″ /]

Reuters filed a stunning report [1] recently about a health insurance company that targeted policyholders with HIV to drop their coverage. It opens with the case of Jerome Mitchell:

Patient Jerome Mitchell

Previously undisclosed records from Mitchell’s case reveal that [health insurance company Fortis [now known as Assurant Health] had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators ….

Insurance companies have long engaged in the practice of “rescission,” whereby they investigate policyholders shortly after they’ve been diagnosed with life-threatening illnesses. But, government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

The Three Minute Rule

A South Carolina judge who ruled on the case noted that in the meeting in which the rescission committee [2] reviewed Mitchell’s case and decided to cancel his policy, there were more than 40 other customers whose cases were up for review, and “an average of three minutes or less” was spent per customer. Assurant Health told Reuters [1] it doesn’t comment on individual customer claims, while a spokesman added the company disagreed with “certain of the court’s characterizations of Assurant Health’s policies and procedures.” 

Link: http://www.propublica.org/ion/blog/item/as-health-care-vote-nears-another-troubling-insurance-story


As the story notes, it’s not just this one insurance company that has been engaging in aggressive rescission. In California, state regulators fined five major health insurance providers—Health Net, Anthem Blue Cross, Blue Shield of California, PacifiCare and Kaiser Permanente—for dropping more than 6,000 sick policyholders. The terms of those settlements, reached in 2008 and 2009 [3], have yet to be implemented in most cases, according to news reports [3] from last week.

Industry Indignation Index: 39


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5 Responses

  1. Unhappy Doctors

    Recently, Athenahealth and Sermo released their Physician Sentiment Index (PSI). With over 1,000 physicians polled, the national survey is thought to be the largest of its kind. While many of the findings come as no surprise to physicians in practice, and ME-P readers, the message is nevertheless alarming; doctors are currently not happy campers.


    Read full PSI survey results (PDF): http://www.sermo.com/sites/www.sermo.com/files/images/product/Athenahealth_PSI_Condensed_Complete_Sermo.pdf



  2. Economics of Provider – Health Insurance Interactions

    The cost of interacting with insurance plans averages a whopping $68,274 per year per physician in America’s clinics according to a study funded by the Robert Woods Johnson Foundation and the Commonwealth Fund, and published in Health Affairs.

    Administrative costs in general — and particularly those related to dealing with insurance — have been the subject of much attention in the current debate on health care reform.




  3. More on Voting Politicians

    House Democrats just asked health insurers to immediately stop canceling plans because a patient gets sick, even though that provision of the federal health overhaul that doesn’t take effect until September.

    The request comes on the heels of news that WellPoint Inc. was targeting breast cancer patients with the intent of canceling their coverage – a practice called “rescission” that the reform law will ban except in cases of fraud.




  4. More on the Patient Protection and Affordable Care Act

    Here is the latest Kaiser Health News column on The Patient Protection and Affordable Care Act [Obama Care] by Austin Frakt PhD.

    It continues the American tradition of privately provided, publicly subsidized health insurance. And, is how most Americans’ health insurance is financed today.

    But, despite its advantages, there is a hidden cost to this arrangement: insurers have more information about health care coverage, spending and utilization than the taxpayers that help fund them. And, the system’s opacity gives insurers the upper hand in debates over government payment rates.




  5. Forget the Health Insurance Compliance Police – Use Some Common Sense Instead

    Dr Marcinko, and the ME-P, did you know that Cobb County Georgia was the first law enforcement agency in Georgia, and one of a few nationwide, to be accepted into the federal 287(g) program?

    The program is an agreement with immigration officials to check the status of everyone taken into the jail. Three other Georgia law enforcement agencies and the Georgia State Patrol also participate in the program. Cobb just renewed its contract with the federal government last October.

    So, when someone shows up at an [expensive] hospital emergency room for treatment – uninsured – why not just check the patient’s immigration status?

    Then, the Obama administration wouldn’t have to hire the proposed 18,000 health insurance “police” – mandated in the new law – as part of a national employment plan.

    Makes some sense, doesn’t it.



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