The company says it is protecting nursing home residents by curbing unnecessary hospital transfers. Whistleblowers allege cost-cutting tactics have endangered the elderly
We told you there’s no law that dictates a rebate for all unspent money. Even if they follow the 80/20 law to the letter, they’re still going to try to maximize profit, and would strive to spend not a single cent over that 80%.
We told you there’s no law that dictates a rebate for all unspent money.
Yes I know you all told me that, which is why I said I was baffled at how many of you tried to answer the question without knowing the basic subject matter.
I never told you that you were hallucinating. You said that yourself.
Oh, I assumed that’s what you were getting when you were telling me that Obamacare isn’t real.
I saw the link. It doesn’t outline a law that does what you’re stating. Try again.
Is this not what I was stating?
The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs.
The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.
Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.
If your insurance company doesn’t meet these requirements, you’ll get a rebate on part of the premium that you paid.
There is only a rebate if the government can prove they spent less than 80% or payments and more than 20% on management. They will still deny coverage so they make more money.
The claim is that they use the DDD tactic to legally game the system and make more money. You’re making a claim about fraud. These are vastly different topics.
They do the same math fraud that movie producers do as well as 20% is a lot of profit.
Hold up, you told me the law doesn’t even exist…
We told you there’s no law that dictates a rebate for all unspent money. Even if they follow the 80/20 law to the letter, they’re still going to try to maximize profit, and would strive to spend not a single cent over that 80%.
Yes I know you all told me that, which is why I said I was baffled at how many of you tried to answer the question without knowing the basic subject matter.
Show us that law, then. Show us where they have to rebate us all of our premiums and take in zero profits.
This is actually wild…
Just scroll up this exact thread a bit and open the link that femtek posted.
How did you even get to this point of the thread without seeing it…?
You’ve got so many splintered threads going, you can’t keep track of then all.
I never told you that you were hallucinating. You said that yourself.
I saw the link. It doesn’t outline a law that does what you’re stating. Try again.
Oh, I assumed that’s what you were getting when you were telling me that Obamacare isn’t real.
Is this not what I was stating?
Nope. Maybe you hallucinated that.
Did you even read what you copied? That’s not all of the money. They’re still clearly able to profit.
There is only a rebate if the government can prove they spent less than 80% or payments and more than 20% on management. They will still deny coverage so they make more money.
The claim is that they use the DDD tactic to legally game the system and make more money. You’re making a claim about fraud. These are vastly different topics.
DDD is also fraud.