Adam V. Russo | October 9, 2009

by Ron E. Peck, Esq. of The Phia Group, LLC

Three days have passed since I was soaking up the Arizona sun in lovely Tucson. The only thing more interesting than the blue skies, mountainous terrain, and dry heat was the discussion taking place in the Hilton “El Conquistador” resort’s “Coronado” conference room. In that room, an esteemed panel took it upon themselves to expose the conflict that has festered in darkness, existing between medical service providers, health insurance carriers, third party administrators, benefit plans, and PPO networks. (more…)

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Adam V. Russo | October 5, 2009

AHIP, www.ahip.org

1) SFC Markup: Amending Process Completed, Final Committee Vote Expected Next Week

(2) House Floor Debate At Least Two Weeks Away

(3) Senate Hearing Focuses on Cost Issues and Lessons From Abroad

(4) Joint Economic Committee Republicans Release Paper on Health Reform Tax Proposals (more…)

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Adam V. Russo | October 2, 2009

by Roy Harmon, III of Health Plan Law, www.healthplanlaw.com

Horning v. Lab. Corp. of Am., 2009 U.S. Dist. LEXIS 80866 (N.D. Ill. Sept. 3, 2009)

The Hornings contend that their contract with the PPO provides that in return for the premiums they pay, the PPO makes payments to the providers on their behalf in accordance with the PPO’s contract with the provider. Moreover, the contract the PPO has with the provider ensures that the provider accepts payment at a discounted rate in consideration of the PPO’s referral of patients to the provider. (more…)

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Adam V. Russo | October 1, 2009

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Adam V. Russo | August 12, 2009

by Phillip Elliot, Associated Press Writer

WASHINGTON – President Barack Obama is turning his eyes West and hitting the Web as he steps up his counteroffensive against critics of a proposed health care overhaul. (more…)

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Adam V. Russo | August 11, 2009

by Parija B. Kavilanz, www.cnnmoney.com

More than $1.2 trillion spent on health care each year is a waste of money. Members of the medical community identify the leading causes.

Down the drain: $1.2 trillion.
That’s half of the $2.2 trillion the United States spends on health care each year, according to the most recent data from accounting firm PricewaterhouseCoopers’ Health Research Institute. (more…)

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Adam V. Russo | August 5, 2009

Reaction from AMA, TMA, GMA, Self-Funded Employer• Getahn Ward, The Tennessean, 5/16/09, Tennessee HRI Article

• Emily Berry, American Medical News, 4/13/09, AMedNews Article

• Tennessee Medical Association (TMA) Legal Department 5/5/09, TMA Alert on HRI Recoupment Letters
Franklin (TN)-based Health Research Insights, has temporarily halted efforts to collect on potential overpayments of medical claims by two Nashville-area self-insured employers to doctors and other health-care providers.

Under pressure from doctors, Metro Nashville Public Schools and Cookeville (TN)-based trucking company, Averitt Express Inc. asked Health Research Insights to stop sending letters that physicians say assume wrongdoing on their part without a review of related medical records. (more…)

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Adam V. Russo | July 24, 2009

SIIA, www.siia.org

Senate Health Bill Delayed Until Fall
Although a priority for President Obama, Senate Majority Leader Harry Reid (D-NV), this afternoon officially announced that the Senate would not take up healthcare reform in the full Senate body until after the August Summer Recess. The delay is caused in part to Democrat Leadership’s inability thus far to garner the 60 votes needed to pass their reform that includes government-run healthcare. They have also been waiting for Senate Finance Committee Chairman Max Baucus (D-MT), who has admirably been working on a bi-partisan deal that would keep the employer-system and would limit government involvement, to release his Committee’s formal proposal. (more…)

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Adam V. Russo | July 24, 2009

by Chris Rauber, Boston Business Journal, www.boston.bizjournals.com

Robert Reich, a prominent faculty member at Brandeis University in Waltham as well as the U.S. secretary of labor in the Clinton administration, told a conclave of health care executives in San Francisco Thursday afternoon that President Barack Obama needs to “start knocking heads” on health reform if he intends to get a major bill through Congress this fall. (more…)

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Adam V. Russo | July 23, 2009

Employee Benefit News, www.benefitnews.comThe majority of Americans (56%) continue to believe that taking action on health reform is “more important than ever,” according to the July Kaiser Health Tracking Poll. However, than number is down 5% from June’s 61% support.

“The public wants help with their health care bills and supports health reform, but the hotter the debate and the longer it lasts, the more anxious the public will become,” says Drew Altman, president and CEO of Kaiser. (more…)

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Adam V. Russo | July 23, 2009

by Elizabeth Galantine, Employee Benefit News, www.benefitnews.com

While the details of legislation from three committees in the House of Representatives and one in the Senate have been released and we await more from the Senate Finance Committee, EBA asked our health reform panelists one question: “What’s the biggest misconception about the legislation that’s flying around D.C. right now?”
Tom Schuetz, co-president of Iowa’s Group Services, sums up the overall sentiment. “That it is going to reduce the cost of health insurance,” he says. (more…)

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Adam V. Russo | July 23, 2009

by Louis Porter, Vermont Press Bureau, www.timesargus.com

MONTPELIER – Former Vermont Gov. Howard Dean said Thursday that without a public health insurance option – a federally-run program that would be offered in addition to private plans – the health care reform effort now being debated in Washington would not be worth supporting. (more…)

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Adam V. Russo | July 23, 2009

by David Espo and Erica Werner, www.news.yahoo.com

WASHINGTON – A plan to raise taxes on the wealthy is emerging as the leading option among House Democrats looking to finance health care legislation that President Barack Obama wants.

Numerous officials say that under the proposal, an income tax surcharge would be imposed on individuals earning more than $200,000, with a higher threshold for couples. (more…)

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Adam V. Russo | July 23, 2009

by Bijoy Anandoth Koyitty, www.reuters.com

BANGALORE (Reuters) – Outsourcing of healthcare services is expected to gain momentum as the prolonged slowdown forces U.S.-based government agencies and healthcare firms to cut spiraling costs and deal with a shortage in qualified personnel.

Companies such as Affiliated Computer Services (ACS.N: Quote, Profile, Research, Stock Buzz), Cognizant Technology Solutions (CTSH.O: Quote, Profile, Research, Stock Buzz), Convergys (CVG.N: Quote, Profile, Research, Stock Buzz) and Genpact (G.N: Quote, Profile, Research, Stock Buzz), whose customers include hospitals, insurers and the Federal government, are expected to gain from the trend. (more…)

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Adam V. Russo | July 20, 2009

SIIA, www.siia.org

House Reform Bill Proposes Provisions Harmful to Self-Insurance

As reported by SIIA, yesterday the House Democrat Leadership formally released their healthcare reform proposal. There are many provisions included that would be harmful for the Employer-Based Healthcare System and the private marketplace as a whole. Listed below are descriptions of the provision that would negatively affect self-insurance specifically. (more…)

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