10.06.09
Posted in Uncategorized at 5:33 am by ceo
Excerpt: "This district court opinion holds interest for health care providers and benefit fiduciaries alike. As against a motion to dismiss, the district court holds that the plaintiffs have stated a cause of action against the health care provider for balance billing, i.e., billing the balance 'owed' after their health plan paid the PPO discounted rate." (Attorney Roy F Harmon III in the Health Plan Law blog)
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Posted in Uncategorized at 5:33 am by ceo
13 pages. Excerpt: "Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. . . . Despite [the] challenges, researchers have used the data available to study competition in health insurance markets, typically using one of two measures of competition: (1) HMO market concentration or (2) the number of HMOs in a market." (U.S. Government Accountability Office)
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Posted in Uncategorized at 5:33 am by ceo
3 pages. Excerpt: "On July 29, 2009, New York Governor David Paterson (D) signed into law three health reform bills -- one extending the period for state health coverage continuation rights from 18 to 36 months, one requiring insurers to offer continued coverage for unmarried adults through age 29 under their parent's individual or group health insurance policies, and one instituting a series of managed care reforms." (Buck Consultants)
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Posted in Uncategorized at 5:33 am by ceo
Excerpt: "Consumer Driven Health Plans (CDHPs) in the U.S. have surpassed HMO plans in covered employees, according to preliminary results released by United Benefit Advisors (UBA) from its 2009 UBA Health Plan Survey, a plan benchmarking poll with 17,655 plans from 12,316 employers reporting. According to a press release, CDHPs grew at a rate of 33.9% this past year and now cover more employees (15.4%) than HMO plans (13.6%)." (PLANSPONSOR.com; free registration required)
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10.04.09
Posted in Uncategorized at 1:00 am by ceo
WASHINGTON (AP) -- Medicare recipients could see higher premiums for prescription drug coverage as a result of changes to complex provisions in a Senate health care bill, a senior Republican said Friday.
At issue are marching orders for a powerful new commission that would recommend annual Medicare savings to Congress. Those recommendations would go into effect unless overruled by lawmakers.
Sen. Chuck Grassley, R-Iowa, said an amendment approved by the Finance Committee in the pre-dawn hours Friday would allow the commission to recommend changes leading to higher Medicare prescription drug premiums. The Democratic amendment was approved on a 13-10 party line vote.
"Americans considering what this health care proposal means for them deserve to know that Medicare prescription drug premiums would probably go up," Grassley said in a statement.
As the prescription benefit is designed now, taxpayers cover three-fourths of the cost of the benefit, while Medicare recipients pay the remaining 25 percent.
The amendment would allow the new Medicare commission to recommend "reductions in federal premium subsidies" to the private insurance plans that deliver the prescription drug benefit. Grassley's office said the "premium subsidies" are taxpayers' share of the cost of the prescription plan. If those are reduced, the plans will make up the difference by raising premiums for seniors.
As originally envisioned by Finance Committee Chairman Max Baucus, D-Mont., the Medicare commission would have been barred from recommending any changes to Medicare benefits or cost-sharing.
A Baucus spokesman said the bill would protect seniors and strengthen Medicare. "The Medicare commission will look broadly at Medicare to find savings and efficiencies in the Medicare program, which will only help seniors," said the spokesman, Scott Mulhauser.
Grassley said the Democratic amendment was geared to compensate for a deal that would exempt hospitals from the commission's cost cutting scalpel.
The hospitals have already agreed to forego $155 billion in Medicare and Medicaid payments over the next ten years to help pay for the health care overhaul.
© 2009 The Associated Press.
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