Latest news with #Mazzola
Business Wire
08-07-2025
- Business
- Business Wire
Schwab Trading Activity Index™: STAX Score Climbs Slightly After Three Months of Decline
WESTLAKE, Texas--(BUSINESS WIRE)--The Schwab Trading Activity Index™ (STAX) increased slightly to 40.66 in June, up from its score of 39.68 in May. The only index of its kind, the STAX is a proprietary, behavior-based index that analyzes retail investor stock positions and trading activity from Schwab's millions of client accounts to illuminate what investors were actually doing and how they were positioned in the markets each month. The reading for the four-week period ending June 27, 2025, ranks 'low' compared to historic averages. 'One theme that carried throughout the June STAX period was the rotation into industrial and discretionary sectors and away from tech,' said Joe Mazzola, Head Trading and Derivatives Strategist at Charles Schwab. 'The industrial sector has been a top performer year-to-date, with all the talk of onshoring leading to increased infrastructure investment.' As the S&P 500 index (SPX) set new record highs in June and climbed more than 5%, Schwab clients gingerly dipped their toes in the water but stayed cautious. The STAX climbed for the first month after three straight declines, but by less than 2.5% and not much above May's two-year lows. The STAX improved the first three weeks of June but declined in the final full week of the month. And while up slightly on a month-to-month basis, the STAX remains well below its 2025 high of 51.94 posted in February and was outpaced by the SPX for the fourth straight month, hinting at prolonged caution by clients. Tech has now seen strong selling by clients since December, excepting a short period of optimism in late January and early February. Meanwhile, the trend toward buying of exchange-traded funds (ETFs) as opposed to individual stocks also remained popular, according to the June STAX data. 'For the fifth month in a row, information technology was the biggest net-sell sector on a dollar basis, and the reason we're seeing big net-outflows in tech is really Nvidia-based,' said Mazzola. 'This was the second month in a row of selling in Nvidia, and the selling came despite Nvidia's shares climbing around 15% during the period amid optimism about U.S. trade with China and rising demand for AI chips overall. Microsoft also saw net-selling as its shares hit new record highs. This could suggest clients getting nervous about the velocity of these moves and trimming into strength." Stock market volatility fell again in June, easing as investors expected positive outcomes on both the tariff and U.S. budget front and despite geopolitical rumblings centered on war in the Middle East. The CBOE Volatility Index ® (VIX) traded well below its historic average of 20 by late June. The May U.S. Nonfarm Payrolls report showed 139,000 jobs created, slightly above expectations but down from a revised 147,000 in April, as unemployment remained low at 4.2%. Participation in the labor market fell to 62.4% from 62.6%, a reversal from April's gain. Inflation reports in June offered fresh signs of price growth retreating, though not approaching the Federal Reserve's 2% target. The May Consumer Price Index (CPI), Producer Price Index (PPI), and Personal Consumption Expenditures (PCE) index generally featured price growth slowing from April, though core PCE that subtracts volatile food and energy prices rose 2.7% year over year, a slightly higher-than-expected reading. The Fed kept rates unchanged at its June meeting at a target range of 4.25% to 4.5%, where it's been since December. Personal income fell a sharp 0.4% in May while spending slipped 0.1%. The reduced spending could reflect demand having been pulled forward into earlier in the year by tariff-based inflation worries. Treasury note yields slipped in June, with the Treasury market gaining despite worries that the Republican budget plan could significantly raise U.S. debt (yields trade inversely to Treasuries). Yields fell below 4.3% for the benchmark 10-year note by late June, down about 30 basis points from a month earlier and not far from two-month lows. Popular names bought by Schwab clients during the period included: Tesla Inc. (TSLA) Palantir Technologies Inc. (PLTR) Inc. (AMZN) Alphabet Inc. (GOOGL) Circle Internet Group Inc. (CRCL) Names net sold by Schwab clients during the period included: NVIDIA Corp. (NVDA) Microsoft Corp. (MSFT) Coinbase Global Inc. (COIN) Meta Platforms Inc. (META) Intel Corp. (INTC) About the STAX The STAX value is calculated based on a complex proprietary formula. Each month, Schwab pulls a sample from its client base of millions of funded accounts, which includes accounts that completed a trade in the past month. The holdings and positions of this statistically significant sample are evaluated to calculate individual scores, and the median of those scores represents the monthly STAX. For more information on the Schwab Trading Activity Index, please visit Additionally, Schwab clients can chart the STAX using the symbol $STAX in either the thinkorswim ® or thinkorswim Mobile platforms. Investing involves risk, including loss of principal. Past performance is no guarantee of future results. Content intended for educational/informational purposes only. Not investment advice, or a recommendation of any security, strategy, or account type. Historical data should not be used alone when making investment decisions. Please consult other sources of information and consider your individual financial position and goals before making an independent investment decision. The STAX is not a tradable index. The STAX should not be used as an indicator or predictor of future client trading volume or financial performance for Schwab. About Charles Schwab At Charles Schwab, we believe in the power of investing to help individuals create a better tomorrow. We have a history of challenging the status quo in our industry, innovating in ways that benefit investors and the advisors and employers who serve them, and championing our clients' goals with passion and integrity. More information is available at Follow us on X, Facebook, YouTube, and LinkedIn. 0725-EH6Y
Euractiv
01-07-2025
- Business
- Euractiv
Europeans would swap planes for trains… if they could
EU citizens believe continental transport links are inadequate and support greater investment in high-speed rail, according to a new survey suggesting most would opt for train travel over flying – if the option existed. Nine out of ten EU citizens are dissatisfied with current transport connections between the bloc's countries, according to a poll of over 5,000 people, commissioned from market research firm Polling Europe by the Community of European Railway and Infrastructure Companies (CER). As cross-border rail travel remains fragmented – due in part to a lack of political will and coordination among member states – the findings highlight a strong public appetite for faster, more accessible train services across the continent. 'These new poll results confirm citizens' climate concerns and show that they are ready to make the necessary changes to their travel habits if they are given the opportunity," CER Executive Director Alberto Mazzola told Euractiv. The survey found that most EU citizens would prefer taking a high-speed train rather than flying for short- to medium-distance journeys, if reliable options were available. A striking 79% of respondents support increased EU investment in high-speed rail. "With a developed network, high-speed rail has the potential to carry over half of all long-distance travellers within Europe by 2070," Mazzola said. EU Transport Commissioner Apostolos Tzitzikostas is expected to unveil a new high-speed rail action plan in the coming months, aimed at connecting all EU capitals and major urban centres. While the current Trans-European Transport Network (TEN-T) regulation calls for long-distance passenger trains to travel at speeds of at least 160 km/h, the upcoming proposal will urge governments to go further – targeting speeds above 250 km/h. The plan is also expected to address key technical barriers and missing links that continue to hinder the development of international high-speed routes. (rh, aw)
Yahoo
30-06-2025
- Health
- Yahoo
Planned Parenthood of MA: Supreme Court Medicaid ruling ‘tied together' with Trump spending bill
Thursday's 6-3 decision issued by the U.S. Supreme Court in Medina v. Planned Parenthood South Atlantic effectively allows states to block Medicaid patients from using their coverage at Planned Parenthood clinics. That means health care services such as cancer screenings, birth control and STI testing would not be covered if they were obtained at Planned Parenthood — in a state that decided to go that direction. On Thursday, Planned Parenthood executives in Massachusetts said care and access will remain the same for the foreseeable future in the Bay State, a staunch protector of reproductive rights. But the Supreme Court ruling sets 'a dangerous precedent' that other states are expected to follow, MaryRose Mazzola, the executive director of the Planned Parenthood Advocacy Fund of Massachusetts, said. And it comes packaged with what's transpiring in the federal budgeting process. 'It's just devastating, especially compounded by what we see going through Congress,' Mazzolla said. 'We see this all as one piece, tied together with the spending bill.' Read more: On Dobbs anniversary, Mass. pols warn of attack on abortion rights in Trump's 'Big Beautiful Bill' In the background of the Supreme Court ruling is President Donald Trump's 'Big Beautiful Bill' that includes language that would ban insurance plans offered under the Affordable Care Act from covering abortion care in certain states, according to an analysis by the National Women's Law Center. The center said the disruption in insurance coverage 'could ultimately lead all insurers to drop abortion coverage for all Americans – even those who get their health insurance through their employers.' Mazzola said MassHealth, the state's Medicaid program, gets about half of its funding from federal Medicaid dollars. If the bill were signed as is, Planned Parenthood in the state would lose approximately $14 million a year. 'Anyone on public health insurance would not be able to visit a Planned Parenthood, period,' Mazzola said. Read more: Mass. lawmaker asks Trump to keep strollers, cribs out of his trade war Medicaid coverage for abortion is already limited by the Hyde Amendment, but some states, like Massachusetts, use their own funding to expand coverage. The 'Big Beautiful Bill' would effectively defund Planned Parenthood by blocking Medicaid reimbursements, according to Dominique Lee, president and CEO of Planned Parenthood League of Massachusetts. Planned Parenthood serves 30,000 patients in the state, and about 40% of them are on Medicaid. During a press conference on Monday in Boston, Lee said if Trump signs the bill in its current form, it would 'wipe out' nearly half of Planned Parenthood's revenue while blocking 'thousands from care.' The bill passed the Republican-controlled U.S. House by a single vote in May and is now before the Republican-controlled U.S. Senate, which is widely expected to amend the bill and return it to the House before it can go to Trump. Read More: MASS.-ive Impact: What Trump's 'Big, Beautiful Bill' means to you | John L. Micek Lawmakers are moving the bill across Capitol Hill under a process known as 'reconciliation,' which requires a simple majority vote. All told, the bill would reduce federal Medicaid spending by $793 billion over 10 years. In Massachusetts, the bill would cost the state's health care system $1.75 billion and strip coverage for about 250,000 people, according to the Healey administration. In a statement Thursday responding to the Supreme Court ruling, Lee said while it doesn't have an immediate impact on Massachusetts, it is 'dangerous' and 'builds on this Court's record of empowering politicians to decide where and what kind of health care people are able to access, when those personal decisions should be made by patients and their doctors.' In South Carolina, the state at the center of the ruling, Republican Gov. Henry McMaster celebrated the outcome, saying they 'took a stand to protect the sanctity of life.' MassLive Politics Editor John L. Micek contributed to this story. Harvard subpoenaed in Ivy League tuition price-fixing investigation Should Harvard enter into a deal with the Trump administration? Baby on board: Mass. lawmaker asks Trump to keep strollers, cribs out of his trade war This big number proves the 'Big Beautiful Bill' is a loser for small biz, Mass. lawmaker says Alliance for Digital Equity pushes for internet access for underserved on namesake day Read the original article on MassLive.
CNBC
20-06-2025
- Health
- CNBC
Taking on Goliath: Brain surgeon's clash with UnitedHealthcare shows insurer's hardball tactics
Dr. Catherine Mazzola, a pediatric neurosurgeon, runs a practice in New Jersey that treats low-income children on Medicaid. Since 2008, she has cared for boys and girls with cerebral palsy, spina bifida and other neurological disorders. But now, her practice is in serious jeopardy, she says, because of recent moves by the insurance and health care giant UnitedHealth Group. The story begins in February 2024, when a unit of UnitedHealth experienced a massive hack. The unit, Change Healthcare, shuttered its systems and halted all reimbursements owed to hospitals and doctors like Mazzola. To help providers stay afloat, Optum, another UnitedHealth subsidiary that includes a bank, began offering "temporary," no-interest loans. Mazzola's practice was among those tapping into the program — it received $535,000, documents show. The practice began repaying the loans, but in January Optum demanded that it repay the money in full and within five business days. "Our practice is doing the BEST we can," Mazzola wrote in an email to Optum on Jan. 20. "Please ask the loan collection people to STOP. We are already in repayment at the maximum possible amount monthly." The situation soon got worse. In mid-February, she stopped receiving reimbursements from UnitedHealthcare. By April, her practice was out $78,000, her accountant's records show, and was struggling to make payroll. Mazzola dug into the UnitedHealthcare claims and was shocked to find the insurer had drawn up reimbursement checks payable to her practice and then deposited those checks into its own bank account, records shared with NBC News show. "They are trying to bankrupt our practice," Mazzola said. "Now, we're going to do brain surgery and instead of paying us, they're going to take the money themselves." Bryan Fisher, a spokesman for UnitedHealth Group, the conglomerate that owns the insurer, declined to comment on its actions related to Mazzola's practice, New Jersey Pediatric Neuroscience Institute. Her case sheds light on something few patients know about: the behind-the-scenes battles doctors say they must wage with insurers over reimbursements and the increasingly aggressive tactics taken by huge payers like UnitedHealthcare. Her experience also gives credence, antitrust experts say, to concerns that UnitedHealth Group's acquisitions of an array of health care operations in recent years have given it too much power over patients and the doctors treating them. "You've got physicians looking out for hundreds and thousands of families, and you've got this big corporate entity exerting as much financial power as it can, just because it can," said Josh Bengal, staff counsel at the Medical Society of New Jersey. "It's upsetting." The hack in February 2024 affected 190 million patients, making it the largest ever involving medical data. UnitedHealth Group ultimately paid a $22 million ransom to the cybercriminals. After the pause in reimbursements, many providers took out loans through Optum — over $9 billion was borrowed, according to company filings. Repayment terms on the loans were vague, with Mazzola's contract noting only that her practice would have to repay the loan within 30 business days of receiving notice from UnitedHealth Group. But Mazzola and other doctors said they were assured by the congressional testimony of Andrew Witty, UnitedHealth Group's former chief executive, who said in May 2024 that the company would seek repayment only when borrowers' businesses were back to normal. Even though Change Healthcare said it restarted claims processing about a month after the breach, doctors who spoke with NBC News said their operations continued to struggle long after, with some saying they are out millions as a result. Others were forced to close after being crippled by the loss of income. When Optum began demanding repayment of loans in January, it gave borrowers five business days, according to letters reviewed by NBC News. Those who didn't meet the demands could have their UnitedHealthcare reimbursements withheld as repayment, the letters say. Mazzola's practice had promised to submit $10,000 a month until her $535,000 loan was repaid. It was all she could afford, she told Optum in emails reviewed by NBC News. Mazzola said an Optum executive told her by phone that her repayments weren't enough. And in mid-February, UnitedHealthcare began intercepting reimbursements owed to Mazzola's practice "to repay amounts owed under your agreement with Change Healthcare Operations LLC," documents show. Upon further investigation, Mazzola learned the puzzling way UnitedHealthcare diverted the money — drawing up checks payable to Mazzola's practice and then depositing them into a UnitedHealthcare bank account, the documents show. "How can United Healthcare claw back money that we are due for surgeries and office visits?" Mazzola wrote to an Optum executive she had been dealing with. She received no response, but in April the company stopped seizing reimbursements from her practice after she complained to the American Medical Association. It waded into the fight on April 11, when Dr. James Madara, the AMA's chief executive, wrote to Roger Connor, the chief executive of Optum Insight, asking that the company stop its payment demands. "Physician practices are still suffering severe financial distress as a result of the cyberattack nearly 14 months after the breach was first discovered," Madara wrote. "We want Optum to honor its commitment to wait to recover repayment for any loans until the physician determines that it is the appropriate time, because the physicians have relied on Optum's statements." In a statement, Optum said it is working with providers "to identify flexible repayment plans based on the individual circumstances of providers and their practices." "We have also worked with UnitedHealthcare to ensure the claims it receives are reviewed in light of the challenges providers experienced, including waiving timely filing requirements for the plans under its control," it added. Multiple lawyers interviewed by NBC News reviewed the loan agreement Mazzola's practice signed and characterized it as a contract of adhesion — in which one party calls the shots and the other has little choice but to agree. The financial ruin Mazzola and other doctors faced because of the hack, an event caused by inadequate security at Change Healthcare, made the loans even more one-sided, some lawyers said. As a result, doctors may have legal recourse after the aggressive actions UnitedHealth Group took to extract loan repayments. The central question surrounding UnitedHealth Group's reimbursement actions is "whether they abused their use of this remedy by insisting on repayment before it was appropriate for them to do so given the damages that they caused," Daniel Schwarcz, a professor at the University of Minnesota law school, said in an email. Amid its clashes with doctors, UnitedHealth Group announced earnings of $9 billion from operations in the first quarter of 2025, a 15% jump from the same period last year. Revenue for the three months was $110 billion. Even after Change Healthcare restarted claims processing, doctors who spoke with NBC News said they were never reimbursed for many claims because the disruption meant they couldn't submit them within insurers' required time periods. The doctors also said their costs increased after the hack because they had to pay staff members to chase reimbursements. Mazzola, who estimates that her practice lost $1 million because of the hack, has asked Optum to reimburse her for costs her practice incurred as a result of the breach. But the terms Optum offered would have barred her from being able to sue it because of the hack. So she declined to accept it. "I really believed that Optum, who was orchestrating these loans, would give physicians and physician groups a reasonable amount of time to repay the loans with the understanding that this financial crisis almost bankrupted us," Mazzola said. "I mean literally, you're talking about $0 in your bank account, and you have 70 employees to pay." Doctors say they weren't the only ones hurt by the hack. Patients, too, were harmed when providers didn't have the reimbursement revenue needed to buy medicine, for example. "There were a lot of delays of patient care as a result of it," said Dr. Pruvi Parikh, an allergist and immunologist in New York City who is medical director of a practice with six locations in New York and 15 in New Jersey. Parikh's group borrowed $400,000 from Optum to survive the hack. By the end of 2024, it had repaid all but $102,000 of it, documents show. On Jan. 7, Optum threatened to withhold reimbursements to Parikh's practice if the rest of the loan wasn't repaid in days, an email shows. "Coming up with that amount of money in five business days is not possible for the majority of private practices," Parikh said in an interview. "Not only did they not give us time to get back on our feet, they were like, 'Pay it now.'" While the practice met Optum's demand, she estimated it is out $2 million because of the hack. In a statement, Change Healthcare said it started clawing back funding it had provided "more than one year post the event and with services restored." The company said it is reaching out to those "that have not been responsive to previous calls or email requests for more information." The main reason doctors like Parikh and Mazzola are in this crucible, antitrust experts and physicians say, is that UnitedHealth Group operates so many cogs in the nation's health care machinery. By acquiring an array of health care operations in recent years—including physician practices and pharmacy benefits management, technology, claims processing and financial services — UnitedHealth Group can exert market muscle over weaker participants like doctors and patients. Federal antitrust lawyers concerned about possible monopolistic activities have sued health care companies in recent years. In 2022, two years before the Change Healthcare hack, the Justice Department and the states of New York and Minnesota sued to stop UnitedHealth Group's acquisition of the claims processor, saying it would reduce competition in health care insurance markets. Because Change Healthcare dominates the claims clearinghouse business, the government argued, its purchase by UnitedHealth Group would give the conglomerate information about how rivals' insurance plans work, a competitive advantage. UnitedHealth disagreed, saying it had strong "firewalls" between units that would prevent sensitive data from being shared throughout the company. Optum, the subsidiary that now houses Change Healthcare, would protect external customers' data from being shared with UnitedHealthcare or its affiliates if the deal went through, the company said. That argument seemed to persuade the federal judge hearing the case in Washington, D.C., a Trump appointee. In his October 2022 decision greenlighting the $13 billion Change acquisition, U.S. District Judge Carl J. Nichols cited the company's data-sharing firewalls as weighing "strongly against the government's position." Now, doctors say UnitedHealthcare's diverting reimbursements to repay Optum loans shows the kind of data-sharing the government was concerned about. Hayden Rooke-Ley is senior fellow for health care at the American Economic Liberties Project, a nonprofit, nonpartisan organization that works to curb monopolies. He said UnitedHealth Group's seizure of doctors' reimbursements is an example of what happens when a company coordinates among its different subsidiaries for its own purposes. "These are the sorts of conflicts of interest we worry about when an insurance company also owns the payment pipes and a bank," Rooke-Ley said in an interview. Asked to respond to the criticism, Fisher of UnitedHealth Group declined. When it added Change Healthcare to its operations in late 2022, Optum said the combined companies would "benefit the entire health system, resulting in lower costs and a better experience for all stakeholders." Parikh, the New York City allergist and immunologist, begs to differ. "It was a complete disaster, and to this day it's not corrected," she said of the hack. "But there hasn't been any accountability to this goliath Optum."
NBC News
20-06-2025
- Business
- NBC News
Taking on Goliath: Brain surgeon's clash with UnitedHealthcare shows insurer's hardball tactics
U.S. news A massive hack of the insurance giant set off a chain of events that has left some doctors' practices on financial life support. June 20, 2025, 6:00 AM EDT By Gretchen Morgenson Dr. Catherine Mazzola, a pediatric neurosurgeon, runs a practice in New Jersey that treats low-income children on Medicaid. Since 2008, she has cared for boys and girls with cerebral palsy, spina bifida and other neurological disorders. But now, her practice is in serious jeopardy, she says, because of recent moves by the insurance and health care giant UnitedHealth Group. The story begins in February 2024, when a unit of UnitedHealth experienced a massive hack. The unit, Change Healthcare, shuttered its systems and halted all reimbursements owed to hospitals and doctors like Mazzola. To help providers stay afloat, Optum, another UnitedHealth subsidiary that includes a bank, began offering " temporary," no-interest loans. Mazzola's practice was among those tapping into the program — it received $535,000, documents show. The practice began repaying the loans, but in January Optum demanded that it repay the money in full and within five business days. 'Our practice is doing the BEST we can,' Mazzola wrote in an email to Optum on Jan. 20. 'Please ask the loan collection people to STOP. We are already in repayment at the maximum possible amount monthly.' The situation soon got worse. In mid-February, she stopped receiving reimbursements from UnitedHealthcare. By April, her practice was out $78,000, her accountant's records show, and was struggling to make payroll. Mazzola dug into the UnitedHealthcare claims and was shocked to find the insurer had drawn up reimbursement checks payable to her practice and then deposited those checks into its own bank account, records shared with NBC News show. 'They are trying to bankrupt our practice,' Mazzola said. 'Now, we're going to do brain surgery and instead of paying us, they're going to take the money themselves.' Bryan Fisher, a spokesman for UnitedHealth Group, the conglomerate that owns the insurer, declined to comment on its actions related to Mazzola's practice, New Jersey Pediatric Neuroscience Institute. Her case sheds light on something few patients know about: the behind-the-scenes battles doctors say they must wage with insurers over reimbursements and the increasingly aggressive tactics taken by huge payers like UnitedHealthcare. Her experience also gives credence, antitrust experts say, to concerns that UnitedHealth Group's acquisitions of an array of health care operations in recent years have given it too much power over patients and the doctors treating them. 'You've got physicians looking out for hundreds and thousands of families, and you've got this big corporate entity exerting as much financial power as it can, just because it can,' said Josh Bengal, staff counsel at the Medical Society of New Jersey. 'It's upsetting.' '$0 in your bank account' The hack in February 2024 affected 190 million patients, making it the largest ever involving medical data. UnitedHealth Group ultimately paid a $22 million ransom to the cybercriminals. After the pause in reimbursements, many providers took out loans through Optum — over $9 billion was borrowed, according to company filings. Repayment terms on the loans were vague, with Mazzola's contract noting only that her practice would have to repay the loan within 30 business days of receiving notice from UnitedHealth Group. But Mazzola and other doctors said they were assured by the congressional testimony of Andrew Witty, UnitedHealth Group's former chief executive, who said in May 2024 that the company would seek repayment only when borrowers' businesses were back to normal. Even though Change Healthcare said it restarted claims processing about a month after the breach, doctors who spoke with NBC News said their operations continued to struggle long after, with some saying they are out millions as a result. Others were forced to close after being crippled by the loss of income. When Optum began demanding repayment of loans in January, it gave borrowers five business days, according to letters reviewed by NBC News. Those who didn't meet the demands could have their UnitedHealthcare reimbursements withheld as repayment, the letters say. Mazzola's practice had promised to submit $10,000 a month until her $535,000 loan was repaid. It was all she could afford, she told Optum in emails reviewed by NBC News. Mazzola said an Optum executive told her by phone that her repayments weren't enough. And in mid-February, UnitedHealthcare began intercepting reimbursements owed to Mazzola's practice 'to repay amounts owed under your agreement with Change Healthcare Operations LLC,' documents show. Upon further investigation, Mazzola learned the puzzling way UnitedHealthcare diverted the money — drawing up checks payable to Mazzola's practice and then depositing them into a UnitedHealthcare bank account, the documents show. 'How can United Healthcare claw back money that we are due for surgeries and office visits?' Mazzola wrote to an Optum executive she had been dealing with. She received no response, but in April the company stopped seizing reimbursements from her practice after she complained to the American Medical Association. It waded into the fight on April 11, when Dr. James Madara, the AMA's chief executive, wrote to Roger Connor, the chief executive of Optum Insight, asking that the company stop its payment demands. 'Physician practices are still suffering severe financial distress as a result of the cyberattack nearly 14 months after the breach was first discovered,' Madara wrote. 'We want Optum to honor its commitment to wait to recover repayment for any loans until the physician determines that it is the appropriate time, because the physicians have relied on Optum's statements.' In a statement, Optum said it is working with providers 'to identify flexible repayment plans based on the individual circumstances of providers and their practices.' 'We have also worked with UnitedHealthcare to ensure the claims it receives are reviewed in light of the challenges providers experienced, including waiving timely filing requirements for the plans under its control,' it added. Multiple lawyers interviewed by NBC News reviewed the loan agreement Mazzola's practice signed and characterized it as a contract of adhesion — in which one party calls the shots and the other has little choice but to agree. The financial ruin Mazzola and other doctors faced because of the hack, an event caused by inadequate security at Change Healthcare, made the loans even more one-sided, some lawyers said. As a result, doctors may have legal recourse after the aggressive actions UnitedHealth Group took to extract loan repayments. The central question surrounding UnitedHealth Group's reimbursement actions is 'whether they abused their use of this remedy by insisting on repayment before it was appropriate for them to do so given the damages that they caused,' Daniel Schwarcz, a professor at the University of Minnesota law school, said in an email. Amid its clashes with doctors, UnitedHealth Group announced earnings of $9 billion from operations in the first quarter of 2025, a 15% jump from the same period last year. Revenue for the three months was $110 billion. Even after Change Healthcare restarted claims processing, doctors who spoke with NBC News said they were never reimbursed for many claims because the disruption meant they couldn't submit them within insurers' required time periods. The doctors also said their costs increased after the hack because they had to pay staff members to chase reimbursements. Mazzola, who estimates that her practice lost $1 million because of the hack, has asked Optum to reimburse her for costs her practice incurred as a result of the breach. But the terms Optum offered would have barred her from being able to sue it because of the hack. So she declined to accept it. 'I really believed that Optum, who was orchestrating these loans, would give physicians and physician groups a reasonable amount of time to repay the loans with the understanding that this financial crisis almost bankrupted us,' Mazzola said. 'I mean literally, you're talking about $0 in your bank account, and you have 70 employees to pay.' Delays of patient care Doctors say they weren't the only ones hurt by the hack. Patients, too, were harmed when providers didn't have the reimbursement revenue needed to buy medicine, for example. 'There were a lot of delays of patient care as a result of it,' said Dr. Pruvi Parikh, an allergist and immunologist in New York City who is medical director of a practice with six locations in New York and 15 in New Jersey. Parikh's group borrowed $400,000 from Optum to survive the hack. By the end of 2024, it had repaid all but $102,000 of it, documents show. On Jan. 7, Optum threatened to withhold reimbursements to Parikh's practice if the rest of the loan wasn't repaid in days, an email shows. 'Coming up with that amount of money in five business days is not possible for the majority of private practices,' Parikh said in an interview. 'Not only did they not give us time to get back on our feet, they were like, 'Pay it now.'' While the practice met Optum's demand, she estimated it is out $2 million because of the hack. In a statement, Change Healthcare said it started clawing back funding it had provided 'more than one year post the event and with services restored.' The company said it is reaching out to those 'that have not been responsive to previous calls or email requests for more information.' The main reason doctors like Parikh and Mazzola are in this crucible, antitrust experts and physicians say, is that UnitedHealth Group operates so many cogs in the nation's health care machinery. By acquiring an array of health care operations in recent years—including physician practices and pharmacy benefits management, technology, claims processing and financial services — UnitedHealth Group can exert market muscle over weaker participants like doctors and patients. Federal antitrust lawyers concerned about possible monopolistic activities have sued health care companies in recent years. In 2022, two years before the Change Healthcare hack, the Justice Department and the states of New York and Minnesota sued to stop UnitedHealth Group's acquisition of the claims processor, saying it would reduce competition in health care insurance markets. Because Change Healthcare dominates the claims clearinghouse business, the government argued, its purchase by UnitedHealth Group would give the conglomerate information about how rivals' insurance plans work, a competitive advantage. UnitedHealth disagreed, saying it had strong 'firewalls' between units that would prevent sensitive data from being shared throughout the company. Optum, the subsidiary that now houses Change Healthcare, would protect external customers' data from being shared with UnitedHealthcare or its affiliates if the deal went through, the company said. That argument seemed to persuade the federal judge hearing the case in Washington, D.C., a Trump appointee. In his October 2022 decision greenlighting the $13 billion Change acquisition, U.S. District Judge Carl J. Nichols cited the company's data-sharing firewalls as weighing 'strongly against the government's position.' Now, doctors say UnitedHealthcare's diverting reimbursements to repay Optum loans shows the kind of data-sharing the government was concerned about. Hayden Rooke-Ley is senior fellow for health care at the American Economic Liberties Project, a nonprofit, nonpartisan organization that works to curb monopolies. He said UnitedHealth Group's seizure of doctors' reimbursements is an example of what happens when a company coordinates among its different subsidiaries for its own purposes. 'These are the sorts of conflicts of interest we worry about when an insurance company also owns the payment pipes and a bank,' Rooke-Ley said in an interview. Asked to respond to the criticism, Fisher of UnitedHealth Group declined. When it added Change Healthcare to its operations in late 2022, Optum said the combined companies would 'benefit the entire health system, resulting in lower costs and a better experience for all stakeholders.' Parikh, the New York City allergist and immunologist, begs to differ. 'It was a complete disaster, and to this day it's not corrected,' she said of the hack. 'But there hasn't been any accountability to this goliath Optum.' Gretchen Morgenson Gretchen Morgenson is the senior financial reporter for the NBC News Investigative Unit. A former stockbroker, she won the Pulitzer Prize in 2002 for her "trenchant and incisive" reporting on Wall Street.
