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After cyberattack, Minnesota health care groups struggling with UnitedHealth financial aid

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After cyberattack, Minnesota health care groups struggling with UnitedHealth financial aid

Emily Benson can see UnitedHealth Group’s headquarters from her office in Edina, but this close proximity hasn’t made it easy for her clinic to find emergency funding from the company.

Benson’s mental health practice submits bills through a UnitedHealth Group subsidiary that shut down its systems more than three weeks ago because of a cyberattack.

That’s left Benson and eight other therapists at Beginnings and Beyond Counseling with basically no revenue and reliant on a $40,000 loan she took out this month from UnitedHealth.

She resorted to this financing, which includes a $780 fee, because the company’s initial no-fee assistance program following the hack offered just $1,100 per week — a small fraction of the clinic’s claims total.

“They’re offering us money, but it’s such an insubstantial amount — such an unhelpful amount,” Benson said, while stressing that she values her relationship with both UnitedHealth and its beneficiaries. “I want to be honest about how much we’re struggling.”

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Beginnings and Beyond is one of three Minnesota health care providers that told the Star Tribune this week they haven’t been able to use UnitedHealth’s financial aid programs to fully bridge a cash crunch that’s hitting thousands of hospitals and clinics across the country.

The cyberattack targeted Change Healthcare, a UnitedHealth subsidiary that runs a widely used clearinghouse for electronic claims data that processes 15 billion health care transactions annually and is involved in one out of every three patient records in the U.S. UnitedHealth Group is cooperating with a federal investigation into the cyberattack while scrambling to restore Change Healthcare systems that it shut down to contain the threat.

By week’s end, there were some signs of improvement for providers seeking financial help after the Star Tribune contacted Minnetonka-based UnitedHealth about all three situations.

For two small independent clinics in the Twin Cities, a UnitedHealth temporary assistance program launched March 1 evaluated need based on an assessment of historical claims that was far from complete. As a result, the sums offered were paltry compared with the need — a mismatch that has been reported in recent weeks by some other health care providers in Minnesota and across the country.

“We didn’t even bother to apply,” said Gretchen Moen, clinical director at Dakota Child and Family Clinic in Burnsville.

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Late last week, UnitedHealth launched a new “last resort” funding program that’s designed to provide more help, particularly for small and regional health care providers.

“We are currently engaged with several thousand provider organizations to help them with their cash flow challenges, from large regional health systems to small, rural independent physician practices,” UnitedHealth said Friday in a statement to the Star Tribune.

At Robbinsdale-based North Memorial Health, where hundreds of millions of dollars worth of claims are in limbo, negotiations over financial assistance have been ongoing.

“The amounts offered … have been insufficient to resume normal cashflow operations,” the health system said in a Tuesday statement.

On Thursday, North Memorial added: “The conversations are fluid; we are hopeful for short-term, temporary resolution in the days ahead.”

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The frustrations voiced publicly by some small clinics, and privately by some large health systems, reflect UnitedHealth’s challenge of quickly standing up assistance programs for the subset of health care providers that have been profoundly impacted. This includes health care providers and insurers that used on an exclusive basis the claims processing clearinghouse from Change Healthcare.

After the American Hospital Association slammed the company’s initial assistance program as insufficient, UnitedHealth responded March 7 with improvements including the last-resort funding mechanism, which offers help on a case-by-case basis for health care groups with no other options.

“We are determined to make things right as fast as possible,” UnitedHealth Group chief executive Andrew Witty said in a statement.

Amy Tannahill, a nurse practitioner with the Rosenberg Center in Roseville, said UnitedHealth’s initial program offered her practice a loan of just $90 per week — an amount she called “ridiculous,” since it wouldn’t even cover the cost of one standard office visit.

In lieu of the UnitedHealth offer, Tannahill and her fellow clinic owners are considering everything from dipping into personal savings to finding a lender that can provide more help. Closing temporarily is one option, but Tannahill says the clinic feels an obligation to keep taking care of patients.

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Rosenberg Center offers services for children with developmental and behavioral needs.

“I would like to see [United] take serious ownership of this issue and advance payments immediately [for] providers and support staff who deserve to be paid for their work,” Tannahill said Tuesday via email. “This seems reasonable given that [United] had a profit of $22 billion last year.”

On Thursday, Rosenberg Center received a call from UnitedHealth offering more help.

“I told the rep that we have approximately $170,000 in claims and requested that amount,” clinic manager Mary Thissen Thompson wrote in an email Friday. “He took the information and said if it was approved we would see it … within five days.”

She added: “We would be completely shocked if they came through with that amount.”

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At Beginnings and Beyond Counseling, Benson said her UnitedHealth representative contacted her Thursday about a $40,000 no-interest loan. She mentioned how she’d already borrowed that amount from a UnitedHealth loan program that’s been available for many years.

“I asked him to waive the [$780] fee I’m being charged for it in lieu of his offer. He said he’d have to escalate that request,” Benson said via email.

Benson’s first loan will only go so far. Another company representative on Thursday encouraged her to also apply for help through the new last-resort program, Benson said, but she provided a screenshot to the Star Tribune of the “Something went wrong” messages she received Friday morning when trying to do so.

“The page kept rejecting my request,” she said. “I tried three times.”

Some health care providers don’t have much patience for snags because they’ve already invested so much energy in recent weeks trying to use the claims submission “workarounds” that UnitedHealth has been touting.

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Revenue at Benson’s practice has gone from about $70,000 per month to “basically zero,” because her health record system relies exclusively on the Change Healthcare clearinghouse for submitting bills. UnitedHealth Group has encouraged practices like hers to use alternate systems, but Benson says they aren’t viable.

She would have to download information on each patient visit and then submit data through a combination of electronic and manual steps depending on the health insurer. Benson tried doing this and found the process for submitting just one claim took about six to seven minutes.

“I’m a single mom with eight practitioners. It’s not feasible for me to do that,” she said. “I don’t have an administrative staff because I’m too small.”

An even bigger problem, she said, is that once the Change Healthcare system is restored, claims submitted through a workaround could trigger her health record to send a duplicate bill to patients for what they owe in cost-sharing. For now, Benson is not submitting any claims, saying she’ll wait for Change systems to resume, even though patients might then receive multiple bills for their cost-sharing all at once.

“We had to send out a letter to everybody we serve, which is about 250 clients, saying: ‘Hey, this is what’s happening right now, please be prepared for really large bills once this gets resolved because we’re not going to be able to stagger your payments,’” she said.

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At North Memorial, the Change shutdown effectively halted all claims submissions and many electronic payments to the health system, said Nate Dell, the vice president of revenue cycle management.

Some funds are arriving based on claims submitted before the Feb. 20 attack, but this revenue is “declining precipitously,” Dell said.

“We’re sitting on hundreds of millions of dollars in unbilled accounts receivable,” he said in an interview last week.

Those bills carry values that are significantly larger than the sums that ultimately get paid, since insurers negotiate steep discounts off health system charges.

At North Memorial, patient care generates about $18 million in revenue per week. Financial reserves at the end of last year exceeded $300 million, according to a Star Tribune review of financial statements.

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Even so, Dell said the systems outage has been “tremendously disruptive” for the health system, which employs about 5,000 people across two hospitals, more than a dozen clinics and a large EMS service.

“This is a hundred-year storm that no one plans for — that you can’t really insure yourself against,” he said.

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How to fix the finance flows that are pushing our planet to the brink

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How to fix the finance flows that are pushing our planet to the brink

Comment: Commercial banks are financing a huge amount of fossil-fuel and industrial agriculture activities in the Global South – they must turn off the tap

Teresa Anderson is global lead on climate justice for ActionAid International.

Last month, from Bangladesh to Kenya to Washington DC, over 40,000 activists in nearly 20 countries hit the streets calling on banks, governments and financial institutions to “#FixTheFinance” pushing the planet to the brink. 

It’s clear that we can’t address the climate crisis unless we fix the finance flows that are failing the planet. When we know that we have hardly any time left to avoid runaway climate breakdown, it’s absurd that so much of the world’s money is still being poured into fuelling climate change, while barely any is going to the solutions. 

Let’s face it – the climate crisis is really about money, and our choices to use it and make it in really stupid ways.  

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G7 offers tepid response to appeal for “bolder” climate action

Many of the world’s most powerful private banks are holding their Annual General Meetings over the next weeks. Banks like Barclays, HSBC and Citibank are pumping billions into fossil fuel expansion, knowing full well that their decisions directly lead to climate chaos and devastating local pollution, particularly for communities in Africa, Asia and Latin America. At their AGMs they will undoubtedly celebrate their profits, self-congratulate on miniscule policy tweaks, and try to ignore the clamour of climate criticism.   

ActionAid research last year showed that these banks are financing an astonishing amount of fossil-fuel and industrial agriculture activities in the Global South, causing land grabs, deforestation, water and soil pollution and loss of livelihoods – all compounding the injustice to communities also getting routinely hit by droughts, floods and cyclones thanks to climate change.  

HSBC, for example, is the largest European financer of fossil fuels and agribusiness in the Global South. Barclays is the largest European bank financier to fossil fuels around the world. And Citibank is the largest US financier of fossil fuels in the Global South. The banks have so much power, and so much culpability, much more than most people realise. But they want us to forget the fact that they are working hand in hand with, and profiting from, the industries that are wrecking the planet.  

The banks can actually turn off the taps. They can end the finance flows that are fuelling the climate crisis. So to avert catastrophic climate change, the fossil-financing banks must start saying no to the corporations destroying the planet.  

But it’s not only private finance that is flawed – public funds are being misused as well. Governments are using far more of their public funds to provide subsidies or tax breaks for fossil fuels and industrial agriculture corporations, than they are for climate action. This is ridiculous – it’s hurting the planet, and its hurting people.  

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Public funds instead need to be redirected towards just transitions that address climate change and inequality.  

There is growing appetite for climate action. But this just isn’t yet matched by willingness to pay for it. Or even to stop profiting from climate destruction. 

COP29 finance goal

This year’s COP29 climate talks will be a critical test of rich countries’ commitment to securing a liveable planet. The world’s poorest countries are already bearing the spiralling costs of a warming planet. So far they have only received begrudging, tokenistic pennies from the rich polluting countries to help them cope. The offer of loans instead of grants in the name of climate finance is just rubbing salt into the wounds. 

If we want to unleash climate action on a scale to save the planet, rich countries at COP29 will need to agree a far more ambitious new climate finance goal based on grants, not loans. 

Because if we want to save our planet, we will actually need to cover the costs. 

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Tensions rise over who will contribute to new climate finance goal

Last month the International Monetary Fund and the World Bank held their Spring meetings in Washington DC. These institutions are powerful symbols of the planet’s dysfunctional finance systems which urgently need fixing. The World Bank is financing fossil fuels yet being extremely secretive about it. The IMF is pushing climate-devastated countries deeper into debt that often requires further fossil extraction for repayment.

Even as they brand themselves as responsible channels for climate finance, the world’s most powerful financial institutions are pushing our planet to the brink. Their stated aim to get “bigger and better” really amounts to all-out push to get “bigger” but only token tweaks to get “better”.  The Spring meetings ended with business-as-usual backslapping. But if they were taking climate change and its consequences seriously, at the very least, the IMF and World Bank would stop financing fossil fuels and cancel the debts that are pushing climate-vulnerable countries into a vicious cycle.  

Will blossom of reform bear fruit? Spring Meetings leave too much to do

All of these finance flows need fixing. At the moment, the global financial system is better designed to escalate – rather than address – climate change, vulnerability and inequality. The activists, youth and frontline communities who filled the streets last month hope that their calls to stop financing destruction will be heard in the boardrooms and conferences on the other side of the world. 

They say that money talks. This is the year that the climate movement is going to make sure it listens.  

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Sagar Doshi of Nuvama recommends buying these three stocks tomorrow

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Sagar Doshi of Nuvama recommends buying these three stocks tomorrow

Stock Market News: The Indian stock market benchmark indices, Sensex and Nifty 50, began the financial year 2024-2025 on a positive note. Both the frontline indices gained over a percent in the month of April.

On Tuesday, the domestic equity indices succumbed to fag-end selloff and ended lower for the day. The benchmark Nifty 50 and Bank Nifty hit their record high on April 30.

The Sensex ended 188.50 points, or 0.25%, lower at 74,482.78, while the Nifty 50 settled 38.55 points, or 0.17%, lower at 22,604.85.

Investors now watch out for the US Federal Reserve meeting outcome for further clues on interest rate cuts. 

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The Indian stock market is closed on Wednesday, May 1, on account of Maharashtra Day.

Read here: Share market holidays 2024: Is Indian stock market closed on 1st May?

Nifty 50 Outlook by Sagar Doshi

Nifty hit a fresh all time high on the last trading day of calendar month – April 2024 ending with MTD gains of 1.24%. A huge round of short covering was seen on index futures from the FII desk, where they cut the short position from 99,000 to less than half of 45,000 contracts. 

Initial targets of 22,700+ have been complete and Nifty could consolidate between 22,550 and 22,800 for this truncated week. Any breakdown below 22,550 is likely to allow further negative views on the index. For now a range bound view is likely to play out for the week to come while broader markets are likely to steal the show on the buying front, said Sagar Doshi, Senior Vice President- Research, Nuvama Professional Clients Group.

Also Read: April Market Review: Nifty 50 soars for 3rd straight month, gains 1.2%; metal index top performer

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Bank Nifty Outlook

Bank Nifty dropped close to 750 points from its intraday highs in the last hour of trade on Tuesday, negating its outperformance of this week over the Nifty. Yesterday’s price action suggests that an underperformance of Bank Nifty over the Nifty is likely to continue for the next couple of trading sessions which is likely to drag the index lower towards 48,600 odd, Doshi said.

Erosion of futures premium in the start of fresh derivative series is also suggesting some cool off on long positions for the index. Bank Nifty has also completed its Fibonacci Extension targets of 49,800 and faced rejection from the same. All of these point towards an underperformance for the coming week on the index, he added.

Also Read: Stocks to buy or sell: Sumeet Bagadia recommends 5 breakout stocks for tomorrow

Top Stock Recommendations by Sagar Doshi

On top stock recommendations, Sagar Doshi has recommended three stocks for tomorrow – L&T Finance, Prestige Estates Projects and Lupin.

L&T Finance | BUY | Stop Loss: 161.00 | Target: 179.00

L&T Finance shares witnessed a change in trend early 2023 as the stock gave a breakout from the trendline active since the all-time high. Since then, all swing breakouts have resulted in a favorable trade. L&T Finance stock has also been an outperformer in the sector. A swing breakout with a rise in volumes indicates the reinforcement of bullish momentum.  

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Prestige Estates Projects | Buy | Stop Loss: 1,330 | Target: 1,475

Prestige Estates Projects shares have registered a fresh all time high close for itself. Momentum indicator has also crossed its previous swing high indicating bullish momentum in the stock.   

Lupin | Buy | Stop Loss: 1,587.00 | Target: 1,760

Lupin share price ended its 1 month consolidation as prices closed above 1,640 for the first time since mid-March. A positive cross over in momentum indicator affirms this bullish swing is likely to continue further.

Disclaimer: The views and recommendations made above are those of individual analysts or broking companies, and not of Mint. We advise investors to check with certified experts before making any investment decisions.

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Published: 01 May 2024, 08:08 AM IST

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Litigation Finance Limits Advance in Louisiana With New Governor

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Litigation Finance Limits Advance in Louisiana With New Governor

Two Louisiana bills that put the brakes on the burgeoning litigation finance industry have advanced through initial hurdles, as lawmakers hope to take advantage of a change in governors after last year’s effort fell short with a veto.

One bill requires parties to disclose litigation finance agreements within 60 days after filing a civil action. The state House approved that measure, and it is pending with the Senate Judiciary Committee.

The second bill requires parties to disclose the presence of litigation finance in lawsuits if a foreign entity is the source of funding. That legislation cleared the state Senate and the House Committee on Civil Law and Procedure and needs approval by the full House.

The bills are part of a push in several states to restrict the practice of investors paying for the cost of lawsuits in return for a piece of the proceeds in successful cases. The US Chamber of Commerce is pushing for legislation, saying the $15.2 billion litigation finance industry encourages frivolous lawsuits.

Democratic Governor John Bel Edwards last year vetoed legislation sent to him by the Republican-controlled House and Senate in Louisiana, saying the bill to require disclosure of litigation finance favored large corporations in civil suits. Republican lawmakers, who again hold majorities in both state bodies, hope for a different result this year with a member of their party, Jeff Landry, as the governor.

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Republican Representative Emily Chenevert this year has modeled her disclosure bill (HB336) on the one Edwards vetoed. It allows parties to redact the dollar amount financed, makes the contracts subject to discovery and bars funders from directing or influencing litigation.

“The appetite was there already within the legislature and so now it’s like, let’s attempt this and let’s see with a new House and some new senators what could happen,” Chenevert said in an interview. “Let’s do this again, give it another shot.”

Chenevert’s bill was deferred in the Senate Judiciary Committee after the chairman announced that there were 56 proponents and 67 opponents in attendance in line to speak at a hearing. A new date has not yet been scheduled.

The second bill (SB355), introduced by the state Senate majority leader, Jeremy P. Stine, requires disclosure of litigation financed by governments in foreign countries of concern to the state Attorney General, such as China, Russia and Iran. It mirrors legislation brought forward at the federal level last year by Senator John Kennedy (R-La.) and House Speaker Mike Johnson (R-La.).

Other bills

Litigation finance bills have faced mixed results in state legislatures. Earlier this year, Indiana enacted legislation into law that blocks foreign entities from funding lawsuits.

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West Virginia updated an existing law to include litigation finance. The statute requires investors to provide a copy of contracts to consumers and does not allow firms to assign or securitize a contract to another party, among other regulations.

In Florida, a bill requiring disclosure of litigation finance agreements and of foreign investments stalled in the House. A bill in Kansas is pending and would allow discovery of litigation funding agreements.

The US Chamber backs the state efforts and earlier this month warned of the risks of litigation finance.

With outside funding, “plaintiffs face minimal risk in bringing forward claims, legitimate or not,” Matt Webb, a senior vice president for the Chamber’s Institute for Legal Reform, wrote in a post. “This dynamic often pressures businesses to settle out of court to avoid the costs and uncertainties of protracted litigation, even when the claims against them lack merit.”

In Louisiana, the Chamber backs Chenevert’s bill though calls Stine’s proposal “under inclusive.” The Stine proposal “addresses foreign funding only, but there are plenty of ways frankly that foreign dollars could be put into US investment vehicles and influences litigation,” said Nathan Morris, a vice president at the Chamber’s legal reform institute.

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Litigation finance has defenders in state houses.

“The Chamber’s intentionally approaching states where there is not litigation financing, such as Louisiana, in an attempt to pass a bill that can then be used as a domino in support of national regulation,” said Dai Wai Chin Feman, managing director at funder Parabellum Capital.

He spoke out against Chenevert’s bill as a representative of the industry’s trade group, the International Legal Finance Association, but described Stine’s bill as “acceptable to our industry.”

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