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Ascension Wisconsin, UnitedHealthcare reach deal to restore in-network access

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Ascension Wisconsin, UnitedHealthcare reach deal to restore in-network access


Patients with UnitedHealthcare insurance once again have in-network coverage at Ascension Wisconsin hospitals and doctors’ offices.

United and Ascension Wisconsin announced Tuesday that they reached a new multi-year agreement to give United members access to Ascension’s hospitals and providers in Wisconsin.

According to United, the deal is effective immediately and retroactive to Oct. 1, the day the insurer’s members lost coverage when the two sides failed to reach an agreement in a dispute over reimbursement rates.

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According to an Ascension Wisconsin spokesperson, services that patients received from Oct. 1 to Oct. 13 will be covered at in-network rates and patients should not be billed for out-of-network costs.

In a statement, Dustin Hinton, CEO of UnitedHealthcare Wisconsin, said the agreement restores access for people enrolled in United’s commercial, Medicare Advantage and Medicaid plans.

“Our top priority throughout the negotiation was to reach an agreement that was affordable for consumers and employers, and this agreement helps accomplish that goal,” he said.

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UnitedHealthcare said it is mailing letters out to members to let them know that Ascension Wisconsin is back in-network.

Daniel Jackson, CEO of Ascension Wisconsin, described the agreement as “more than just a contract” in a statement issued Tuesday. 

“It is a reaffirmation of our Mission to serve all with dignity and compassion,” Jackson stated. “By securing fair and sustainable reimbursement, we are able to continue supporting our caregivers, strengthening our ministries, and providing high-quality, compassionate care across the communities we serve.”

In its announcement, the health system also said that it was grateful to patients, providers and partners for their patience throughout the negotiation process. 

Ascension Wisconsin said it is not providing interviews with health system officials at this time.

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Before reaching a deal Ascension and United had been locked in a months-long contract dispute. Ascension argued United was not offering reimbursement rates that covered rising health care costs, while United argued Ascension was asking for large price hikes that would raise costs for customers and employers. 

Other negotiations between Ascension affiliates and UnitedHealthcare had gotten close to the deadline before the dispute in Wisconsin. Ascension Florida had to reach a short-term agreement with United to stay in the network during negotiations earlier this year before both sides came to a multi-year agreement.

Dan Sacks, an associate professor of risk and insurance at the University of Wisconsin School of Business, said contract disputes are a normal part of the negotiation process between health care providers and health insurers.

He said their contracts dictate what insurers pay hospitals and influence how much patients pay. But he also said it’s rare for talks to break down like they did in this case.

“It’s costly for Ascension if patients end up canceling scheduled visits. It’s very costly for patients if their care is disrupted,” Sacks said. “It ends up being costly for United if some people decide that they would rather go to a different insurer.”

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Sacks said both sides reaching a deal is “absolutely good news” for United members and Ascension patients, but it’s not such good news for those who began looking for alternative providers or canceled visits.

“For the patients who arguably did the prudent thing and rescheduled visits or canceled visits and looked for an alternative provider, they really have no recourse,” he said. “They lost a chance to get health care that they thought they were entitled to when they signed up for insurance, and now that care is delayed or it may never happen.”



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Wisconsin, former basketball coach Marisa Moseley ask court to dismiss lawsuit

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Wisconsin, former basketball coach Marisa Moseley ask court to dismiss lawsuit


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  • Former University of Wisconsin women’s basketball players are suing former head coach Marisa Moseley for alleged psychological abuse.
  • The defendants, including Moseley and the UW Board of Regents, have filed a motion to dismiss the lawsuit.

MADISON – In August, a group of former University of Wisconsin women’s basketball players sued former head coach Marisa Moseley, alleging psychological abuse.

The civil case, which also lists the University of Wisconsin Board of Regents and former UW senior associate athletic director Justin Doherty as defendants, seeks compensatory and punitive damages.

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Monday, Dec. 8, the attorney representing the defendants filed a motion in the District Court for the Western District of Wisconsin to dismiss the complaint entirely.

In an 86-page brief, attorney Anne Bensky writes that her clients deny the allegations but that even if they’re taken as true do not contain facts that show a violation of the Constitution or federal laws.

“The Plaintiffs want the federal court to award damages to players whose basketball coach yelled at them,” she wrote. “But because these allegations plainly do not violate the Constitution or federal civil rights laws, the relief they request is outside the Court’s authority.”

The complaint was filed by former Badgers Alexis Duckett, Krystyna Ellew, Mary Ferrito, Tara Stauffacher and Tessa Towers on Aug. 15. The amended complaint filed Sept. 25 included another former Badger, Tessa Grady.

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Among the allegations in the 55-page document:

*  Moseley “unconstitutionally toyed with the mental health of her players, including Plaintiffs, as a means of exerting control over every facet of their lives, including retaliating against them based on their protected speech and expressive acts and discriminating against them based on their disabilities or perceived disabilities.”

* Moseley interfered with her players’ mental health treatment, something she accomplished by threatening to take away playing time or scholarships.

The complaint alleges Doherty, who was the administrator for women’s basketball and retired in April, knew about the allegations but did nothing to stop them.

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Moseley resigned as Wisconsin’s coach March 9 after four seasons as head coach.

After a denial of the allegations, the defendants’ response to the complaint focuses on the legality of the case being heard by the courts. It also argues the case against Doherty should be dismissed because he was not personally involved.

Bensky’s brief for the defendants focuses on six factors as reasons for dismissal of the case. They included a failure to meet the standard for a Fourteenth Amendment substantive due process claim and the idea that First Amendment claims, in the context of college athletics, receive minimal protection. In the case of Duckett and Stauffacher, there was the passing of the statute of limitations to file a complaint.

Wisconsin athletic director Chris McIntosh mentioned the lawsuit at the October athletic board meeting, but said there wasn’t much information he could share.

“Our initial response to the court is due on or before Dec. 8 and we are actively defending against those allegations, many of which lack full context or are simply false,” he told the board.

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“The athletic department must adhere to strict federal laws requiring educational institutions to maintain privacy of student records and medical records therefore we cannot provide specifics to the media or general public absent authorizations for release of that information. If the litigation progresses in a manner that requires us to present the full factual record to the court we will be ready and look forward to providing that information.”



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Cinnabon franchise immediately fires Wisconsin worker who went viral for racist rant | Fortune

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Cinnabon franchise immediately fires Wisconsin worker who went viral for racist rant | Fortune


A Cinnabon worker in Wisconsin has been fired after a racist outburst directed at two customers went viral, the Georgia-based cinnamon roll chain said.

Cinnabon posted a statement on social media that the worker, who it did not identify, was “immediately terminated” by the franchise owner over a “disturbing video” of the incident.

“Their actions and statements are completely unacceptable and in no way reflect the values of Cinnabon, our franchisees, or the welcoming environment we expect for every guest and team member,” the company added in a follow-up statement to The Associated Press on Sunday.

The video was posted on TikTok and showed a white, female employee cursing at and taunting the customers from behind the counter as one of them recorded the encounter. At one point she is seen on video uttering a racial slur and saying, “I am racist and I’ll say it to the whole entire world. Don’t be disrespectful.”

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The employee also is also recorded giving an obscene hand gesture at customers and exchanging expletives with one of the persons at the store.

The TikTok user who posted video said the incident happened while she and her husband were taking a break from shopping Friday at a mall in Ashwaubenon, a suburb of Green Bay.

The customer said she ordered a caramel pecan cinnamon roll and had asked the worker to add more caramel as it didn’t appear to have enough.

She said she began recording after the worker snapped at her and derided her hijab.

An online fundraising campaign to support the customers described them as a “black Somali Muslim couple” that’s been “traumatized” by the incident.

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A competing campaign to purportedly benefit the fired worker, meanwhile, has raised tens of thousands of dollars. That effort appears on the same Christian crowdfunding platform where hundreds of thousands of dollars were raised for a Minnesota woman who admitted to using a racist slur against a Black child at a playground earlier this year.



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Wisconsin’s Most Wanted: Geraldo Gomez sought for workplace shooting

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Wisconsin’s Most Wanted: Geraldo Gomez sought for workplace shooting


A workplace argument leads to a shooting. It happened nearly three decades ago. Police say the man who pulled the trigger has been on the run ever since. 

Search for Geraldo Gomez

What we know:

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“We’ve spent tireless days on this, and it’s gone through a lot of different hands in our time,” the U.S. Marshal on the case said.

In March 1998, investigators say Geraldo Gomez was like a ticking time bomb when he confronted a co-worker on the job.

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“They proceed to argue,” the marshal said. “They go back to work. Everything seems to be OK.”

The backstory:

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Gomez was 27 years old at the time when investigators said he marched into his boss’s office and quit. When he walked out the door and straight into the parking lot, his co-worker walked out behind him.

“He followed him out there to ensure that nothing was going to happen to his vehicle,” the investigator said.

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A criminal complaint says that’s when Gomez ambushed the man and fired four shots at him.

What they’re saying:

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“The victim was actually struck in the hand and the upper torso during that incident,” the marshal explained.

The victim was rushed to the hospital and survived, but U.S. Marshals say Gomez went on the run. He was charged in the case. The now 55-year-old has avoided the law for nearly three decades. Over the years, authorities have tried tracking leads from Waukegan, Illinois to Mexico.

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“There are no geographical boundaries for us,” the marshal said. “We will find you and justice will be served.”

Gomez is described as being 5’4″ tall and weighing 140 pounds. 

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Call with tips

What you can do:

U.S. Marshals encourage anyone with information about him to call the tip line at 414-297-3707. You will remain anonymous.

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The Source: Information in this post was provided by the U.S. Marshals Fugitive Task Force.

Wisconsin’s Most WantedPleasant PrairieNews



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