wellpoint's unit refers every part b case to the medic and wellpoint has the second highest number of referrals. what have we seen from that? >> that's one of the issues we have with the medic. we're very collaborative with them. often refer cases over-but then we are never advised as to what type of action is ever taken. >> so, that's something that needs to be fixed as well. >> that would be very helpful to us. >> mr. blum, that would you think of that? >> i think a small fraction of those cases that get referred to law enforcement are taken. often times there is a beneficiary who is complicit and i think we all on the federal government are hesitant to take action against by-riz who are complicit, and i think it's time we share the information and hold the part b medic to a higher degree of accountability, and part of the issue is that the process relies on referrals be taken by law enforcement and that's not sufficient. >> just because i choose not to prosecute doesn't mean somebody didn't violate the law. >> right. >> doesn't mean somebody should be banned from having medicare pr

she joined wellpoint in 2000 -- 2004. after 24 months of service with the fbi -- just kidding -- 25 years of service with the fbi including service fighting health care fraud and bioterrorism. she also serves as the chair of the national heritage -- health care antifraud association which brings together the private and public sectors. she is eminently well-qualified to testify. we are grateful to you for being here today. others of ourd, panel will join us throughout the afternoon. by 5:30 we will be done good i will ask you to take about five minutes to summarize your testimony. >> good afternoon, on behalf of the men and women of the drug enforcement administration, thank you for the opportunity to discuss the epidemic of pharmaceutical abuse. the abuse of prescription drugs continues to plague the nation crossing all age, gender, and socioeconomic boundaries. studies showed substantially high levels in the abuse of these drugs and the adverse consequences. according to the most recent 2011, therealth in were approxima

secondly, i want to reiterate and point out that the paradigm is changing for wellpoint. we no longer want to pay and chase. in doing so, we get 20-30 cents back on the dollar. the paradigm for us is prevention and to stop the dollar's from ever going out the door. with that, i want to point out that with the medical loss ratio, we are only allowed credit for collections which is counter intuitive to our new paradigm of savings. it actually encourages recoveries because that is the only credit we get. with our new paradigm, we hope that there may be some changing activities in mlr that will give us credit for the work we do. >> thank you for that. >> in closing, i want to make three points -- it is extremely important to follow through and implement the recommendations made by our office. i would specifically mention recommendations aimed at the sponsors. for example, we have recommended the sponsors be required to refer fraud and abuse cases to the medic. current like, that reporting is on a voluntary. there is a series of recommendations aimed specifically at the americ

>> we are extremely honored to have the opportunity to work with wellpoint.with us to establish a preference based benefits which is a new form of benefit that pretty much guarantees savings in cost. to make a long story short, after an analysis of prices in a certain area we would establish a price point which guarantees an enormous amount of providers of high-quality below the price. you will have access to those physicians at no cost to yourself. if you decide deliberately to go above that price then you will have to pay out of pocket. so it's a way of empowering the consumer, enabling choice, offering the best service. it's one of those situations which is a win-win-win for everybody. david: once the consumer sees the difference in prices and realize they can benefit, they will pursue a lower price. and just curious, and this will be the last question. as we go into a new regime, obamacare, there is some concern that the choice on the part of the consumer will be limited. does that affect your deal in any way? how do you incorporate the new changes of oba

>> stuart gordan from wellpoint. alissa did a good job to highlighting the wellpoint successes but one with the final caller they changed the risk adjustment in such a way that it will impact particularly the low income and chronic needs folks that are in wellpoint's chronic care special needs plans and dual eligible special needs plans. in fact, it looks to our actuaries as though the, the impact will be a reduction in reimbursement almost equal to the, to the growth factor increase that got ballyhooed in the press. dr. miller, has the medpack staff had a chance to look at the impact of the risk adjustment calculations on the dsnips and the csnips? >> what we've done there, when cms made, put out its caller, we had a comment on that change and we were concerned about it too. we felt that cms had kind of mixed the coding adjustment with the risk adjustments. we always think risk adjustment should be as accurate as possible and all of that but we felt there was some mixing of the coding change. so we suggested that th

. >> stuart gordon from wellpoint. alyssa did a great job of , butighting the successes one of the things that happened is that they changed the risk adjustment in such a way that it will impact particularly the low income and chronic needs people that are in wellpoint special needs plans. it looks to our actuaries as aough the impact will be reduction in reimbursement almost equal to the growth factor increase. , has a staff had a chance to look at the impact of that risk adjustment calculations? >> what we have done their is when cms put out its call letter, we have a comment on that change. we were concerned about it. we felt that they had kind of mixed coding with risk adjustment. we feel it should be accurate but there felt there was some mixing of the coding change. we suggested they step back and not of lament that right away. right implement that away. what we have done -- this is talked about in our june the 12 report -- we think there does need to be some improvements to the risk adjustment system for these t

. >> united health, wellpoint, stocks have held up so well.e are starting to really get ready for at fordable care act and profit from it. >> we'll see. tomorrow a big hearing on the hill in which they'll look at medicare and specifically also some of the provisions of obama care, as others call it. >> some guys who are -- hate it still? >> it's on the house side. >> oh the house side, yeah. >> fireworks there. >> wow. look at that move up on vanguard. >> that is sensational. >> yeah. is it a big move up. not high multiple. they have a big presence in michigan, particularly detroit. we'll talk to trevor fetter about that later. the bigger deal, cable deutsche land. doed vodafone has a lot -- kabul. >> what malone said, call the whole thing off. >> liberty global. vodafone trading at five times ebida paying 13.8 times. that's a multiple disparity. >> wow. >> think about the wireless business in europe it's a commodity and becoming more so. mobile termination rates that continue to go down. >> right. >> you've got this need for convergence, many

look at wellpoint up three-quarters of 1% and the group is "the shining" star.up off the lows in areas are picking up steam but will point* and humanity and cigna hit the all-time high but they are showing highs in the s&p 500 we were down over 200 points these reveal the names of all street hitting notable highs. health care is often viewed as a safe haven sector and that plays into that with the payout that is less than expected. tracy: obama just making comments after meeting with the immigration reform also the snowden case am peter barnes has all the details. >> edward snowden has left hong kong now we believe he is in russia and moscow the and in this meeting with business leaders on immigration reform they ask the president if he has spoken to russian president vladimir pugin and he said we are following all appropriate legal channels to work with all countries to ensure the rule of law is being followed. i refer all other questions to the department of justice. on immigration reform he says that legislation is at a critical juncture meeting with the of b

. >> ellis said it is great job i'm sorry i am from wellpoint. she did a great job to compile the successes but one of the thing of the final call was to change the risk adjustment that it will impact particularly the low income and chronic needs folks that will need chronic care special needs to the eligible plans. and to the actuaries the impact is a reduction and reimbursement almost equal to the growth factor increase that was ballyhooed in the press. has the medpac had a chance to look at the impact of the risk adjustment calculations ? >> we have done when cms put out the call letter we had a comment on that change and we were concerned about it to we were concerned cms had mixed the coating adjustment with the risk adjustment and really thinks that should be as accurate as possible and we felt there was mixing of the coding changes so we suggested they step back to not implement that right away and what we have done we have not gone to that analysis but to talk about in the june 2012 report we think there does need to be improvement for th

i was talking with someone from wellpoint yesterday. even though they're a health plan, they have a third party vendor do this as well for their workforce. >> okay. s there is a question here about the incentives in the 20 and 30% rule. the person asked based on karen's comments about the 20 to 30% incentive being paid by workers on top of premiums, if they didn't participate, doesn't the person ask, doesn't, don't incentive programs reduce workers spending? and it, it actually, raise a question in my mind about the numbers that you displayed in your slide. the $1100 potential incentive, whether it is a penalty or a reward, even under the 20% rule, is 3 or 4 times higher than the average size, as i understand it, of the incentives in the programs that are now in operation. so is increase from 20 to 30 such a big deal if nobody is bumping up against the 20? >> that's a fair question. it makes you wonder why, you know, at one level the employer community was pushing so hard for that, for that, when this, affordable care act was being cons