cmonfils | May 10, 2012
NEW YORK — U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients. The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking. Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960.
cmonfils | May 10, 2012
Objective: The study developed information on behavioral health spending and utilization that can be used to anticipate, evaluate, and interpret changes in health care spending following implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA).
cmonfils | May 9, 2012
Health Care for All-Oregon plans statewide campaign to put pressure on Legislature
Taking a page from Vermont’s playbook, Oregon reform advocates plan to launch a major campaign to have health care declared a human right.
“It means you get the care you need when you need it,” said Dr. Mike Huntington of Corvallis, the newly elected president of Health Care for All-Oregon.
http://www.gazettetimes.com/news/local/group-backs-human-rights-status-for-health-care/article_0cbcc358-8d91-11e1-adf8-0019bb2963f4.html#ixzz1tLjzfEWj
cmonfils | May 9, 2012
Under the Affordable Care Act (ACA), four tiers of health insurance will be offered in the health insurance exchanges and throughout the individual and small group markets beginning in 2014. Under the minimum coverage plan, the “Bronze” plan, the insurance plan will pay for 60 percent of the costs of covered benefits on average while the individual enrolled will pay the remaining 40 percent in deductibles, copays and coinsurance. Individuals will have the option to purchase plans with more comprehensive coverage at higher premiums.
cmonfils | May 9, 2012
H. Con. Res. 112, the Concurrent Budget Resolution for fiscal year 2013, as passed by the House of Representatives on March 29, 2012, instructed several committees of the House to recommend legislative changes that would reduce deficits over the 2012-2022 period. As part of that reconciliation process, the House Committee on the Judiciary has approved legislation that would impose limits on medical malpractice litigation in state and federal courts by capping awards and attorney fees, modifying the statute of limitations, and eliminating joint and several liability.
cmonfils | May 8, 2012
Beginning in 2014, employers that sponsor health plans will have to watch closely if any employees qualify for a premium tax credit, triggered whenever the employer-sponsored coverage is unaffordable, or does not provide minimum value.
cmonfils | May 8, 2012
About a year from now, employers and plan administrators will be preparing to pay a fee to fund the Patient Centered Outcomes Research Institute (PCORI). The IRS on April 17 (77 Fed. Reg. 22691) issued proposed regulations on the fee.
cmonfils | May 3, 2012
By Kathryn Mayer May 3, 2012
Though America spends more on health care than 12 other industrialized countries, the quality isn’t better, a new study from The Commonwealth Fund finds.
The U.S. spent nearly $8,000 per person for health care services in 2009 while Norway and Switzerland were a distant second and third on medical spending, respectively, at a little more than $5,000 per person. (more…)
cmonfils | May 3, 2012
When Sharon Smith chose an out-of-network specialist to perform a complicated jaw surgery on her teenage son last May, she knew it would cost her more. But she was not expecting $15,000.
Consumers have long complained about the cost of going outside their health plan’s network, but Smith encountered a new twist: A growing number of insurers have changed the way they calculate reimbursements to shift more of the expense to patients.
cmonfils | April 25, 2012
Not only is it painful for an employee to hear the news that their loved one has suffered a heart attack, but the unforeseen costs of health care will soon take a physical, emotional and financial toll if they are not prepared.
cmonfils | April 25, 2012
On April 17, the Internal Revenue Service published in the Federal Register proposed Regulations setting forth the details for the new fees imposed upon self-insured plans and health insurance policy issuers. These fees were mandated in the Patient Protection and Affordable Care Act (PPACA) and are effective for current plan years and for the six years thereafter.
cmonfils | April 25, 2012
Employer’s Guide to Self-Insuring Health Benefits April 2012 | Vol.19, No.7
ERISA allegations against a claims administrator advanced partly because plan terms had not defined the difference between a medical emergency and nonemergency services. A hospital had alleged that the claims administrator improperly classified emergency room (ER) visits in order to pay claims at lower out-of-network rates. (more…)
cmonfils | April 25, 2012
Employer’s Guide to Self-Insuring Health Benefits April 2012 | Vol.19, No.7
The Obama administration’s attempt to compromise on contraceptive coverage fails to shift costs away from self-funded plans, a chief executive at the Self-Insurance Institute of America (SIIA) says. (more…)
cmonfils | April 25, 2012
Employer’s Guide to Self-Insuring Health Benefits April 2012 | Vol.19, No.7
State insurance exchanges will play a pivotal role deciding which large employers pay “shared responsibility” (pay-or-play) assessments based on their determination that health plans’ premium burdens on workers are unaffordable or insufficient. For small employers, on the other hand, they will present a streamlined way of shopping for affordable small-group coverage for workers. The insurance exchanges will certify health plans, set up websites comparing plans, determine eligibility for enrollment and provide consumer assistance. They will calculate and collect premiums from employers, according to a newly issued final HHS rule. (more…)
