Denial

Blog readers will know a) over half of the Medicare-eligible population is now in privatized Medicare Advantage plans, and b) at one time UCOP pushed to have all folks under retiree health insurance in Medicare Advantage, but pulled back when there was resistance, c) Medicare Advantage premiums for retirees tend to be cheaper than traditional Medicare-plus-supplement arrangements.

Medicare Advantage plans often offer extras such as gym memberships to attract participants. But the issue is what happens when someone has a serious health issue and needs expensive care. Newsweek finds high denial rates in Medicare Advantage plans, but persistent appeals will often reverse the denial:

Private Medicare plans are denying requests for specialized medical care at widely varying rates. In some cases, denial rates were strikingly high, especially for some of the largest Medicare Advantage companies: CVS Health/Aetna, Humana and UnitedHealth Group, according to a new inspector general report.

Some of these insurers, while being some of the most prominent in the U.S., routinely reject requests for post-hospital care such as rehabilitation and long-term treatment

• Check plan rules carefully for post-hospital care
• Be prepared for prior authorization requirements
• Consider appealing any denial, as reversal rates can be high
• Compare plans not just on premiums—but on coverage rules and approval patterns...

Full story at https://www.newsweek.com/medicare-plans-compared-based-on-denial-rates-for-specialized-care-12075121.

What this story is saying is that when a health crunch occurs under a Medicare Advantage plan, you may get treatment denial - although after a hassle, the negative decision might be reversed. It would be worth tracking whether that has been the experience under the Medicare Advantage offerings of UC.

Straws in the Wind - Part 383

From the Daily Princetonian: Clinicians in the University’s mental and behavioral health Exclusive Provider Network (EPN), a network of local clinicians subsidized by the University to provide counseling to Princeton students, will see cuts to their rates for their services. Starting August 1, rates will decrease by 48 percent for psychiatric diagnostic evaluations, and by 7 percent for 60-minute follow-up sessions. The reduced rates will be lower than 2019 EPN rates for most services and treatments.

This decision comes amid budget cuts driven by lower endowment return projections. Of the roughly 228 clinicians currently in the EPN, 76 percent have confirmed they will remain in the network for the upcoming year...

Full story at https://www.dailyprincetonian.com/article/2026/06/princeton-news-adpol-slashes-reimbursement-rates-external-mental-health-clinicians-epn.

An illusion of prudence?

As blog readers will know, yours truly often cautions about the verbiage attached to state budget accounting. Words such as deficit and surplus are often used in "flexible" ways that obscure what they actually mean.

California has a budget reserve often referred to as the "rainy day" fund. The state legislature is now considering a bill that would allow more money to be deposited into the rainy day fund.* That sounds like a prudent idea. But as we have pointed out in prior budgetary analysis, there are several reserves associated with the state's general fund. What matters is whether total reserves are rising or falling.

Thus, when politicians point to putting money into the rainy day fund as a Good Thing, it is always necessary to find out what is happening to total reserves since the rainy day fund is only a part of the total. If the rainy day fund goes up while the total is going down, that is a deficit.  

Just keep that in mind. And note that it would take a two-thirds vote of both legislative houses to pass the bill and put the issue on the ballot. Voters would then have to approve it.

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*https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260ACA20.

Want of a Horse

Faithful blog readers who follow our coverage of Regents meetings, and public comments therein, will know that a brouhaha at Davis has developed over the discontinuation of the equestrian program there. From the Chronicle of Higher Education: 

This academic year, the women’s equestrian team at the University of California at Davis completed a dominant season, winning all five of its conference matches and its third conference championship. But in January, with no warning, the university announced it was cutting equestrian as an intercollegiate sport. The decision came too late for team members to transfer to another program. Some incoming students who’d been recruited as athletes were denied regular admission to UC-Davis, several parents said, leaving them with no college to attend at all.

To justify their decision, university officials used a faulty report, supporters allege, riddled with errors and written by a consulting firm that recently stirred controversy for a similar analysis at another university. What’s more, administrators privately signaled nearly a year ahead of the announcement that they were planning to eliminate equestrian, according to emails obtained by the supporters’ group via a public-records request and shared with The Chronicle. At the same time, athletics officials continued to recruit athletes and solicit donations to support the team until shortly before they announced the team was being cut.

...Advocates are pursuing legal remedies — including a lawsuit in state court alleging that the athletics director and others engaged in fraudulent activity by misleading the recruits and assuring coaches, families, and students that the program was continuing. A parent with close knowledge of the situation told The Chronicle that a detective with the university’s police department was also investigating possible wire fraud, because the university continued to solicit donations for the team after it had effectively chosen to shutter it.

And a lawyer has warned the university that cutting the equestrian team could run afoul of Title IX, which requires gender equity in athletic expenditures and participation. The lawyer, Arthur Bryant, won a landmark settlement in April against San Diego State University for failing to provide as much in athletic scholarships to women as it paid to men. A university spokesperson declined to make anyone available to discuss the equestrian team because of the legal challenges. An earlier university statement said campus leaders believed they followed the proper procedures, but they were conducting a review “to evaluate financial records and reporting practices to determine whether expenses were accurately represented to decision-makers and other appropriate authorities.”

At a time when many colleges are considering cuts in athletics, UC-Davis is a case study in how missteps and poor communication can lead to legal risks and tense conflict with athletes and their parents, who have spent years and small fortunes pursuing dreams of intercollegiate sports...

Full story at https://www.chronicle.com/article/a-university-halts-its-top-ranked-equestrian-team-spurring-an-uproar.

Straws in the Wind - Part 382

From Inside Higher Ed: The state of Minnesota this month launched the SELF Grad Loan program, a new low-interest loan option for grad students that offers fixed rates based not on their credit score but on whether the loan has a co-signer and which repayment term the borrower chooses: 10, 15 or 20 years. Officials created the program in direct response to the federal government’s elimination of Grad PLUS loans and caps on certain other federal loans, which go into effect July 1. 

“The elimination of the Federal Grad PLUS Loan, which offered loans that covered up to the full cost of attendance, and lower caps for all Federal loans indicated a need for a new, low-interest loan option for graduate students,” a spokesperson for Minnesota’s Office of Higher Education wrote in an email. “Our SELF Grad Loan was launched to provide that option to students.” Minnesota is now the second state, after Connecticut, to devise its own loan program to help fill funding gaps for graduate students. As of Tuesday, 35 colleges and universities in Minnesota had joined the state’s program...

Full story at https://www.insidehighered.com/news/quick-takes/2026/06/17/minnesota-launches-graduate-student-loan-program.

Berkeley Swim Case On Again

Remember that lawsuit about abuse of the women's swim team at Berkeley?* After an earlier ruling that the statute of limitations had run out, a higher court has now reinstated the suit. Big bucks could be involved. A reminder that UCLA athletics provides a significant subsidy to Berkeley athletics, pursuant to a decision of the Regents after UCLA switched athletics conference. From the Daily Cal:

A lawsuit from 18 former Cal swimmers alleging former women’s head coach Teri McKeever verbally and psychologically abused them was granted a second life after a California court of appeal ruled last week that the statute of limitations did not bar their claims. The suit, Touhey v. Regents of the University of California, alleges that the university failed to protect them from McKeever’s abuse despite numerous complaints from swimmers and family members to administration throughout nearly all of McKeever’s 30-year tenure as coach.

“Given how much Coach McKeever was promoted within the swimming community and the constant reminders of Cal’s Olympic heritage, Plaintiffs felt that enduring her abuse was the price they paid to be on an elite team,” the original complaint alleges. “Plaintiffs began to believe that they (were) subjected to degrading treatment because they were not living up to the Cal standards of excellence.”

UC Berkeley filed a demurrer on Touhey v. Regents to claim the two-year statute of limitations expired when the lawsuit was filed in 2023, as the plaintiffs were members of Cal women’s swim and dive at various times between 2000 and 2020. A demurrer is a response in a court proceeding in which the defendant does not dispute the truth of the allegation but claims it is not sufficient grounds to justify legal action.

While originally sustained by the court, it was overturned June 16 on appeal due to the discovery rule, because UC Berkeley administrators allegedly signaled to the swimmers McKeever’s coaching was praiseworthy. The court claims this, along with the coach-athlete power dynamic, led the athletes to think that abuse was standard — albeit challenging — coaching, meaning the swimmers could not reasonably identify her actions as abuse...

Full story at https://www.dailycal.org/news/campus/administration/court-revives-former-cal-swimmers-lawsuit-alleging-coach-s-abuse/article_35360890-98e6-4be4-b0d5-5fc4c3d1895c.html.

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*https://uclafacultyassociation.blogspot.com/2025/06/bad-pr.html; https://uclafacultyassociation.blogspot.com/2023/12/swimming-in-scandal-part-10.html.

Together

From the UCLA Newsroom: The 24 educators from the Middle East arrived at UCLA with two objectives: to share their experience building school communities where students can thrive amid turmoil, and to immerse themselves in the innovative centers of learning that Los Angeles has to offer.

The delegation came from the Amal Educational Network, which enrolls 30,000 students representing Jewish, Muslim, Druze, Christian and Bedouin communities across Israel. The network prioritizes academic excellence in settings that build personal resilience, civic responsibility and democratic values that bridge cultural divides.

“These schools are building peace through education. And so far, the data show it is working, even during war,” said Ron Avi Astor, professor of social welfare at the UCLA Luskin School of Public Affairs, who has a joint appointment with the UCLA School of Education and Information Studies (SEIS). Astor organized the May 31–June 7 educational exchange in partnership with Mona Khoury, professor and vice president of strategy and diversity at Hebrew University of Jerusalem, and Karen Tal, superintendent and CEO of the Amal network.

A long-term research project led by Astor and Khoury is measuring the impact of the network’s 50 middle and high schools, and how its model can be scaled up across the Middle East. These case studies highlight Amal’s holistic curriculum weaving core academic subjects together with the arts, cutting-edge technology and volunteerism. It’s a formula that brings students of different backgrounds together more effectively than one-off cultural events or dialogues, the researchers found.

The visiting principals and professionals came from the Jewish, Muslim and Druze communities, but their schools represent the rich diversity of cultures across Israel. They shared challenges and success stories that held lessons not just for schools in conflict zones but for any campus seeking to create a stable and supportive climate free of violence, bullying and bias.

One case study focused on a remarkable partnership between two schools: Achva Gilboa, which is largely Arab Muslim, and Emek Harod, which serves students from Arab Muslim and Christian communities, secular and Orthodox Jewish traditions, and kibbutzim.

The schools host joint classes that bring students and teachers together on robotics projects, 3D printing and hackathons, and a documentary filmmaking option offers students the opportunity to express feelings of identity and belonging. Problem-solving with the most sophisticated technological tools draws students together, no matter what their backgrounds are, the educators said.

Amal schools also address polarization within cultural groups. Different Palestinian Muslim communities have distinct traditions, for example, and at Achva Gilboa, hundreds of grandmothers have come to campus to speak about their values and rituals. Students are now visiting the villages they learned about through their elders.

Technology and science education are prized at Amal schools, and the delegation’s itinerary included several treks to hubs of innovation including NASA’s Jet Propulsion Laboratory, the Getty Center, UCLA Lab School and Milken Community School.

In keeping with UCLA’s commitment to expand its global reach, the exchange invited leaders from schools across Southern California, as well as from groups including Holocaust Museum LA, Jewish Federation Los Angeles and the Holy Land Democracy Project, to join scholars and students in the cross-border dialogue.

Added Amal Falah, an administrator at an Amal school serving the Druze community, “We arrived as visitors and leave as partners in a shared mission: shaping a better future through education.”

“This was a transformative week,” Astor said as the exchange wrapped up. “These educators got to know each other as professionals, friends and partners in using their academic settings to educate the next generation toward peace rather than polarization, demonization and hate.”

The educational exchange grew out of research by Astor and Khoury into the cultural context of school safety — scholarship that has taken them around the world, to Asia, Africa, Europe, the Mideast and the Americas.

The current research project by UCLA, Hebrew University and Amal is powerful, Khoury said. “The principals are doing the hard work. We are highlighting how they got to where they are and where they go in the future, for others to learn from.”

The research is supported by the Rosalinde and Arthur Gilbert Foundation, which also sponsored the UCLA educational research exchange along with Gary Jacobs, trustee of the Rose and James Meltzer Trust, UCLA Luskin, UCLA SEIS and an anonymous donor.

Source: https://newsroom.ucla.edu/stories/building-peace-through-education-research-exchange-jewish-muslim-druze. [Photos in original.]