Monday, April 28, 2008

I Stand Corrected...

Dr. Woody Myers is a "health administrator." He only plays a doctor in his ads. Ipopa didn't do the research. But now I have, and I have to say that, while I always keep an open mind to new information, I find the information being circulated about his company denying legitimate claims less than conclusive. Here's what my research reveals.

In October 2000, Dr. Myers joined WellPoint as executive vice president and chief medical officer.

Dr. Myers was charged with managing WellPoint's health-care services division, including medical policy, clinical affairs and health services operations. The release on his appointment also states, “He will also be responsible for strategic initiatives designed to enhance the health-care experience for the company's members and to simplify administration and improve communications with physicians and other health-care professionals.”

Well, I’m not sure we can say he “improved communications” with physicians in the sense that 70,000 of them sued his company.

On July 15, 2005, Wellpoint (a/k/a “Anthem”) settled a lawsuit filed by 70,000 California doctors that alleged that Wellpoint and a bunch of other insurance companies, including Aetna, Prudential, Cigna, Healthnet, United Healthcare, and Coventry Healthcare “downcode” services performed by physicians so that proper reimbursements were not provided.

In December of 2005, Dr. Myers was no longer working with Wellpoint. Causation? Correlation? Termination? Indignant resignation? I don’t know the "real" story.

But as an aside, what happened at Wellpoint seems decidedly different than denying a proper request for preauthorization. Admittedly, if a physician knows a major procedure is not covered he/she might not do it. But for most medical care, doctors provide the service and grumble after the fact that they don’t get their REAL cut like they did in ths lawsuit. Yeah, cry me a river in your next sand trap.

Moreover, the situation with the Tenet Hospitals ought to have us all realizing that it’s not always black-and-white when we’re talking about the “necessity” of medical care.
The short of it is that criminal indictments were handed down against some Tenet officials for alleged bribing physicians for patient referrals. Government probes were undertaken in six other Tenet hospitals to study the allegedly unnecessary surgeries performed at Tenet’s Redding Medical Center and Western Medical Center.

In mid-year 2003, Dr. Myers stated that an independent review of 52 heart bypass operations performed at Redding showed 85% of them were inappropriate. Dr. Myers then pronounced that Wellpoint would not provide payments any longer. Dr. Myers made the same claim against Doctor’s Medical Center in Modesto, CA, which responded with a nice little defamation lawsuit. Ultimately, the order rescinding payment authorizations for Doctor’s was rescinded itself (translation: Wellpoint “punked out” under legal pressure from physicians).

So, in summary, who the hell knows whether it’s (a) Wellpoint hosing the patients; or (b) physicians hosing the patients with Wellpoint saying we’re not coming along for the ride?

If anybody has some “concrete” information on this, I’ll be glad to share it. But I’m not going to traffic in innuendo.



Wilson46201 said...

Checkout the 3-part filing against BlueCross:

Wilson46201 said...

By the way, Dr. Myers was the "company doctor" for Ford in the 90s

Wilson46201 said...

"Myers spent four years as the medical director for the company once known as Blue Cross/Blue Shield of Indiana. He spent five years in Detroit managing the employee health care and insurance needs of Ford Motor Co. That led him back to California for a five-year stint as chief medical officer at WellPoint before its merger with Anthem."

"These days, Myers lives in a 21st-floor condo in the Conrad, a luxury hotel in Downtown Indianapolis. His wife, a doctor, lives at their home in California.

Myers' diverse portfolio includes a pizza chain in California, a telecom company that serves the Spanish-speaking world, banks in Greece and Ireland, and gas companies in Brazil.

In television ads and campaign speeches, Myers has said getting rid of the "George Bush tax cuts for big oil and gas" could help reduce the high price of gas. And the ads have noted the record profits oil companies have enjoyed.

But Myers has enjoyed some of those profits, too, from stocks he owns in Conoco Philips, Occidental Petroleum and Marathon Oil."

Anonymous said...

Woody Myers is a hypocrite.....but at least he can return to live in California when he loses and wont have to pretend any longer that he lives in Indiana.