cmonfils | August 15, 2011
www.modernhealthcare.com By Rich Daly August 8, 2011
The newly enacted debt-ceiling deal may have saved the nation from a financial crisis, but it also managed to paint a target on the backs of healthcare providers. And the potential size and scope of the cuts they could face has providers scrambling for a response. (more…)
cmonfils | August 8, 2011
MyHealthGuide Source:
• Employee Benefit Management Services, Inc. (EBMS) 2011 Health & Business Symposium, 7/28/2011, www.EBMS.com
• Adam Russo, Esq., The Phia Group, LLC, 7/28/2011, www.phiagroup.com
• RAND Corporation, Study sponsored by the U.S. Department of Labor, RAND Study: Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA)
“Health care reform is making self-funding an increasingly attractive way to insure employee health,” says Adam V. Russo, Esq., Co-Founder & CEO, The Phia Group, LLC, “…and the government sponsored the study that proves it!” (more…)
cmonfils | August 7, 2011
www.modernhealthcare.com By Dr. Leonard Morse July 25, 2011
Who will lead the way? All parties—especially physicians—must work to solve cost, quality issues
The cost of healthcare is stifling. It is crippling the budgets of individuals, families, businesses, communities and state and federal governments. It is, and should be, the concern of every person in our society. The attitude, ‘I’ve got health insurance, let somebody else pay for it’, is careless and undermining.” (more…)
cmonfils | August 4, 2011
Claims Appeal and Review Obligations Lessened to Relief of Plans, Insurers
July, 2011
Thompson Publishing Group
Plans and insurers will have an easier time complying with health reform’s internal appeals and external review rules, under rules the U.S. Departments of Labor, Treasury and Health and Human Services issued June 24.
The changes, such as dropping the requirement for plans to display diagnosis and treatment codes on initial and final notifications of adverse determinations, should ease burdens for employer-sponsored plans. Another change lengthened the time allowed to review urgent care claims from “no more than 24 hours” to “as soon as possible but no more than 72 hours.” (more…)
cmonfils | August 2, 2011
www.myhealthguide.com
MyHealthGuide Source: Health Affairs, 7/28/2011, HA Abstract and HA Full Text
National health spending is expected to grow 5.8% per year for the period 2010 through 2020, 1.1 percentage points faster than the expected average annual rise in gross domestic product.
As a result, the health share of the gross domestic product is projected to increase from 17.6% in 2009 to 19.8% by 2020. (more…)
cmonfils | July 28, 2011
www.thehill.com By Julian Pecquet – 07/21/11
A major provision of the healthcare reform law designed to prevent businesses from dropping coverage for their workers could inadvertently leave families without access to subsidized health insurance.
The problem is a huge headache for the Obama administration and congressional Democrats, because it could leave families unable to buy affordable health insurance when the healthcare law requires that everyone be insured starting in 2014. (more…)
cmonfils | July 21, 2011
www.cfo.com Jeff Mamorsky July 19, 2011
Court challenges to the health-care reform law, especially its provision requiring everyone to buy health insurance, make for an uncertain future.
The Patient Protection and Affordable Care Act (the “Act”) — known as health-care reform or ObamaCare by many proponents and opponents, respectively — is being challenged in the courts. A major issue concerns the constitutionality of the federal mandate that all individuals maintain adequate health-insurance coverage or pay a penalty to the Internal Revenue Service. (more…)
cmonfils | July 21, 2011
www.healthcare-legislation.blogspot.com July 15, 2011
Two new regulations proposed by the Department of Health and Human Services (HHS) set basic standards for health benefits exchanges established under the Patient Protection and Affordable Care Act. Basically, these rules do the following: (more…)
cmonfils | July 21, 2011
www.dwt.com By Dipa N. Sudra and Jeff Belfiglio 07.14.11
Health care reform requires nongrandfathered group health plans, both insured and self-insured, to change their internal claims procedures and external review procedures. Even as plans work to implement these rules, the Internal Revenue Service, the Department of Labor, and the Department of Health and Human Services have jointly released amended interim final regulations in response to comments on the interim final regulations issued last July (discussed in a previous advisory). The agencies also issued technical guidance1 and revised model notices.2 (more…)
cmonfils | July 20, 2011
www.businessinsurance.com Jerry Geisel July 18, 2011
WASHINGTON—States have the authority to decide whether large employers can purchase coverage through new state health insurance exchanges starting in 2017, according to health care reform regulations issued last week. (more…)
cmonfils | July 15, 2011
www.nytimes.com July 11, 2011 Robert Pear
WASHINGTON — In a big step to carry out the new health care law, the Obama administration unveiled standards on Monday for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage. (more…)
cmonfils | July 15, 2011
www.kaiserhealthnews.com Jul 11, 2011
Health and Human Services Secretary Kathleen Sebelius today announced the release of proposed regulations that will govern how states are to set up and run new marketplaces where individuals and small businesses can shop for health insurance. (more…)
cmonfils | July 11, 2011
www.businessinsurance.com July 4 & 11, 2011
IS THE HEALTH CARE reform law constitutional?
That’s the question courts have faced since Congress passed the Patient Protection and Affordable Care Act and President Barack Obama signed it into law last year.
In the highest-level court decision so far, the 6th U.S. Circuit Court of Appeals ruled last week that a key provision in the law is constitutional. The provision requires U.S. residents to enroll in a qualified health plan starting in 2014 or pay a fine. (more…)
