Archive for the ‘Medicaid’ Category

For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer’s Benefits Reports provides regular updates about state health care reform.

Wisconsin. The state is anticipating cutting more than $600 million from its Medicaid program. The areas targeted for cuts include delaying payments into the budget next year, increasing generic drug usage, reducing rural hospital reimbursement payments, and rebidding contracts for state health care programs. Even with those reductions, high demand from the poor for health insurance benefits could result in up to a $150 million shortfall. For more information, visit http://dhs.wisconsin.gov/MEDICAID/.

The Office of the Actuary of the Centers for Medicare & Medicaid Services (CMS) recently released two new memoranda on the “Patient Protection and Affordable Care Act,” as approved by the Senate on December 24.

In one memorandum, CMS Chief Actuary Richard Foster discusses the impact the bill would have on costs, savings, and coverage. The analysis estimates that the Senate-passed bill would increase national health expenditures, from 2010 through 2019, by a total of $222 billion, or 0.6 percent, over the updated baseline projection that CMS released in June 2009. It further projects that the bill’s coverage provisions would cost an estimated $882 billion over the first ten years. Also, an estimated 34 million currently uninsured people would gain comprehensive coverage by 2019 through the health insurance exchanges, their employers, or Medicaid. Read more

Reid Still Looking For 60 Votes

Majority Leader Harry Reid (D-NV) is still seeking support from a number of Senate Democrats who have yet committed to support his healthcare reform package. As reported, a compromise package was negotiated between a select group of liberal and moderate Senate Democrats, which Reid has sent to the Congressional Budget Office (CBO) for an official cost and coverage estimate. Those results are expected within the next few days. It is likely that the cost estimate of the compromise will come in at an increased cost to the overall healthcare reform package. The provision that will most significantly lead to the increase will be the proposed lower of Medicare eligibility to 55 years of age. Medicare premiums are significantly higher that those expected in the proposed exchanges, so any subsidies for eligible low-income workers or early retirees will be more expensive for taxpayers. The expected increase in cost as well as the expansion of a public entitlement program raises the most concern among non-committed Senate moderates. Read more

This issue brief examines health reform and access to coverage for abortion services, a much-discussed subject in the reform debate. The paper discusses current law regarding federal and state policies that address abortion coverage, lays out key issues being debated regarding abortion coverage under health reform, and raises questions about the possible impact of the House and Senate legislation on women’s coverage for abortion services. The House and Senate bills handle the issue in different ways, which can be seen in the paper’s side-by-side comparison of abortion provisions in the two leading bills. Read more

This brief compares the Medicaid and Children’s Health Insurance Program provisions in the House health reform legislation, Affordable Health Care for America Act, as passed by the full House on Nov. 7, 2009, with the Senate Leadership bill, The Patient Protection and Affordable Care Act, as released on Nov. 18, 2009. It includes details about Medicaid coverage, maintenance of eligibility, Medicaid financing, benefits and access.

Issue Brief

John Cattie of the Garretson Firm, recently informed us about his firm’s “Learning and Resource Center” webpage which provides current material related to MMSEA and MSAs. To learn more about MMSEA and MSAs go to http://www.garretsonfirm.com/garretson/resources/

by Janet Adamy and Elizabeth Williamson, The Wall Street Journal, www.wsj.com

Medical-device makers are adamant that U.S. health care needs fixing. They’re equally adamant that they shouldn’t have to pay for it.

“If you’re looking for savings, don’t come at us,” says Tim Trysla, a top industry representative. He has marched into the offices of 120 lawmakers, sometimes with General Electric Co. officials in tow, to argue that the government already provides so little reimbursement for high-tech medical scans that it shouldn’t chop payments further. Read more

by Tron Emptage of SIIA, www.siia.org

Self-insurers will soon face stiff consequences for failing to report Medicare eligible claims in a timely manner. This is due to changes to the Medicare, Medicaid and State Children’s Health Insurance Program (SCHIP) Extension act, which was signed into law in 2007. Read more

Under a new MSP reporting requirement, plans working through an insurer, third party administrator (TPA) or plan administrator will have to disclose information on situations in which the group health plan was primary in relation to Medicare.

The requirement is at Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007, passed by both chambers of Congress and signed into law on Dec.29. (P. Law No. 110-173) Its effective date will be Jan. 1, 2009. Read more