Adam V. Russo | March 31, 2010
DESPITE THE HISTORIC nature of the new health care reform law, it’s difficult not to be ambivalent about the measure.
Certainly, the law’s crowning achievement is its provisions that will make a huge dent in the number of people in the United States without health insurance by expanding Medicaid and establishing federal health insurance premium subsidies. In all, congressional budget analysts estimate, 32 million people will gain coverage. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 31, 2010
Roberto Ceniceros
Most self-insured employers have their third-party administrator manage their Medicare reporting and compliance requirements, but others have turned to independents, several sources say.
The independent companies specialize in Medicare Secondary Payer compliance and reporting requirements under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007. (more…)
Category: Health Care Legislation, Medicaid, Medicare, Third Party Administrators |
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Adam V. Russo | March 31, 2010
Cost trend ranges widely depending on employers’ exposure — Louise Kertesz
The medical stop-loss market for self-insured employers has ample capacity, but prices range from slight reductions to 60% increases for those with high exposures and a poor claims history, experts say.
“The (medical stop-loss) market is very similar to a couple of years ago,” said John Snyder, CEO of Medical Excess L.L.C., in Costa Mesa, Calif., a unit of Chartis Inc. “Rate (increases) are all across the board, same as last year. Rates can run as high as 50% to 60% in accounts with ongoing exposures,” he said. (more…)
Category: Health Care Legislation, Stop Loss |
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Adam V. Russo | March 31, 2010
Joanne Wojcik
WASHINGTON—Benefit managers are becoming increasingly concerned as they learn more about the components of the newly passed federal health reform legislation that will affect group plans.
Among provisions generating the greatest concern are extending coverage to employees’ adult children until age 26 and to part-time employees who work at least 30 hours per week; eliminating annual or lifetime benefit limits and providing 100% coverage for certain wellness and preventive health care services; a cap on contributions to flexible spending accounts and a ban on the use of those funds to pay for over-the-counter drugs; reducing the value of federal subsidies paid to employers that provide prescription drug coverage to Medicare-eligible retirees; and the fact that neither H.R. 3590, the Patient Protection and Affordable Care Act, nor H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, go far enough to reduce the cost of the health care delivery system. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 30, 2010
Michael Bradford
To say most Europeans are not well-informed about the health care debate in the United States would be putting it mildly.
I can’t count the number of times someone in my town near Zurich has asked how I feel about President Barack Obama’s zeal for passing European-style health reforms. But I can say that every time I give them my reply, they look shocked and a little indignant. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 30, 2010
Jerry Geisel
WASHINGTON—Nearly all employers will have to move quickly to redesign their health care plans to comply with requirements in the landmark health care reform legislation that Congress approved last week.
The votes ended nearly a year of debate in Congress on the legislation, which seeks far-reaching changes to the nation’s health care delivery and financing system. The most significant change will be the extension of coverage to more than 30 million uninsured U.S. residents through a huge expansion of Medicaid and establishing new federal health insurance premium subsidies. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 30, 2010
On March 15, 2010, the federal agency responsible for enforcing the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules made an important announcement about its plans for enforcement of some of the new privacy and security requirements added by the Health Information Technology for Economic and Clinical Health (HITECH) Act.1 That agency, the Office for Civil Rights (OCR) within the Department of Health and Human Services, posted a notice on its Web site that appears to indicate that enforcement and compliance regarding certain provisions of HITECH will occur when OCR completes its rulemaking process for those requirements.2 (more…)
Category: Health Care Legislation, HIPAA |
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Adam V. Russo | March 30, 2010
The sweeping health reform law enacted March 23 contains elements that will introduce new coverage requirements on group health plans. Employer groups say this could contribute to the erosion of self-funded plans’ membership.
The reform law expands coverage to 35 million previously uninsured Americans by providing tax credits and discounts and expanding Medicaid coverage. It includes employer mandates to insure workers or pay into a government-run insurance fund to do so. It imposes standards of coverage that plans and policies must follow or be taxed. It eliminates practices insurance companies have used to limit coverage. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 26, 2010
This afternoon the Senate passed the healthcare Reconciliation bill. The Reconciliation bill is a package of amendments to the healthcare reform bill signed into law on Tuesday.
Included in the bill is a provision that applies certain market reforms to grandfathered plans (plans in effect prior to the Patient Protection and Affordable Care Act being signed into law on 3/23/10). SIIA’s Government Relations Staff was able to have an amendment proposed to take out this provision, but unfortunately, this attempt was unsuccessful. The following reforms now apply to grandfathered plans (including self-insured): (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 25, 2010
SIIA, www.siia.org
Healthcare Reconciliation Bill Passes Senate – Grandfathered Plans Now Subject to Additional Reforms
This afternoon the Senate passed the healthcare Reconciliation bill. The Reconciliation bill is a package of amendments to the healthcare reform bill signed into law on Tuesday. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 25, 2010
The sweeping health reform law enacted March 23 will impose onerous new coverage requirements on group health plans. Employer groups say this could contribute to the erosion of self-funded plans’ membership.
The reform law expands coverage to 35 million previously uninsured Americans by providing tax credits and discounts and expanding Medicaid coverage. It includes employer mandates to insure workers or pay into a government-run insurance fund to do so. It imposes standards of coverage that plans and policies must follow or be taxed. It eliminates practices insurance companies have used to limit coverage. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 24, 2010
Healthcare Reform Signed Into Law
This afternoon, President Obama signed into law the healthcare reform package that passed the House over the weekend. SIIA’s Government Relations Office will be sending out detailed information on the new law’s provisions as well as implementation timelines shortly. (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 23, 2010
By David Hogberg
With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose.
Of course, the overhaul is supposed to provide us with security. But it will result in skyrocketing insurance costs and physicians leaving the field in droves, making it harder to afford and find medical care. We may be about to live Benjamin Franklin’s adage, “People willing to trade their freedom for temporary security deserve neither and will lose both.” (more…)
Category: Health Care Legislation |
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Adam V. Russo | March 23, 2010
From The Bench By John H. Eggertsen, Esq. and Michael Friedman, Esq.
As health care costs continue to rise, and employers become more vigilant about policing benefit costs, it is perhaps inevitable that lawsuits by employers against their plan’s TPA are likely to increase. A recent such case, W.E. Aubuchon Company, inc. v. BeneFirst, LLC, 2009 WL 3272491 (D. Mass.), illustrates this trend. (more…)
Category: ERISA, Summary Plan Description, Third Party Administrators |
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Adam V. Russo | March 22, 2010
The $938 billion health care bill is to be paid by a combination of tax hikes on the wealthy and cuts in Medicare. The bill will expand coverage to 23 million Americans, but many of the provisions — with the exception of prescription drug coverage for older americans and children who have been denied insurance because of pre-existing conditions — are not expected to go into effect until 2014. (more…)
Category: Health Care Legislation |
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