Archive for the ‘Massachusetts’ Category

I received this from Dana Driscoll at National Underwriting Services, Inc.

By Bob Unruh

A community hospital in Batesville, Miss., has gone to the unusual lengths of posting a building-size banner on the side of its structure to thank Massachusetts voters for their choice in the recent election to replace the late Sen. Ted Kennedy. Read more

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.

Massachusetts. Lawmakers are considering a bill that would require every full- and part-time college student in the state to have at least the basic level of health insurance required under the state’s 2006 health care reform law. Under the proposal, any public or private institution of higher learning that fails to insure its students would face fines of $1 per student for every day the student remains uninsured. For more information, visit http://www.mass.gov/dph/.

Massachusetts has a big election Tuesday. Please see the link to Scott Brown’s campaign if you wish to donate. We here in my home state have a great chance to make history and show the country that we are about REAL change. If we can elect a republican then anyone can!

Click here to donate

W.E. Aubuchon Co. v. BeneFirst, LLC, 2009 WL 3272491 (D. Mass. 2009

The employer in this case sued the former TPA of its two self-insured medical plans for claims processing errors that allegedly created millions of dollars in additional costs for the plans. Asking the court to enter judgment in its favor, the TPA argued that the employer’s ERISA fiduciary breach claims failed because the TPA was not a fiduciary and that the employer’s state-law claims for breach of contract failed because they were preempted by ERISA. In this pre-trial decision, the court rejected the TPA’s position that the employer had no claims, saying that it would effectively render TPA contracts unenforceable. Instead, the court entered two alternative rulings: (1) that although the TPA was not an ERISA “functional” fiduciary, it might be a “named” fiduciary under the TPA contract, allowing the fiduciary breach claims to proceed, and (2) that, if the TPA was not a fiduciary, then the state-law claims should be allowed to proceed because they would not be preempted. Read more

By Stanley D. Baum – Erisalawyerblog.com

In Hitachi High Technologies America, Inc. v. Bowler, SJC-10386 (Supreme Judicial Court of Massachusetts 2009), the Court faced the question of whether ERISA preempts a State law action brought by a retirement plan fiduciary to recover money mistakenly paid to a plan participant. In this case, the plaintiff, Hitachi High Technologies America, Inc. (Hitachi), filed an action for unjust enrichment in the Mass. Superior Court against its former employee, the defendant Kevin Bowler, for his alleged failure to reimburse $29,315.75, with interest, in retirement benefits that Hitachi had overpaid to Bowler due to an accounting error. The lower court dismissed the case on the grounds that it lacked subject matter jurisdiction. Read more

Commonhealth, www.commonhealth.wbur.org

Jon Hurst, President of the Retailers Association of Massachusetts, says lawmakers currently negotiating a national health care overhaul should learn from the Bay State and not penalize employers in the rush toward reform: Read more

Health-care reform advocates say Massachusetts proves it can be done. But the results are mixed.

The Week Aug. 25- Sept.4, 2009
Briefing•Thursday, August 20, 2009

How does the state’s health plan work?
In an effort to achieve universal coverage, Massachusetts essentially requires every resident to obtain health insurance-either through their employer, a private plan, or, for low-income residents, a subsidized state program. Those who don’t get insurance are fined about $1,000 a year, largely levied through the state income tax. Businesses with more than 11 employees must offer health insurance to their workers or pay annual fines of $295 per employee. This strategy, known as employer and individual mandates, also forms the backbone of reform bills making their way through Congress. The state, which enacted the reform in 2006, also created a fund to subsidize insurance for those who can’t afford it. Unlike the “public option” that has been pushed by President Obama and many congressional Democrats, this is not a separate government insurance plan, but a fund that pays for private insurance. Read more

by Robert Weisman, The Boston Globe, www.boston.com

If you want to know how the proposed overhaul of the US healthcare system may play out nationally, talk to top executives at the biggest medical and life sciences companies in Massachusetts. Read more

by Ken Terry of BNET Healthcare, www.industry.bnet.com

Once again, Massachusetts is pointing the way toward a possible model for national healthcare reform-but one that most healthcare providers would have a hard time swallowing. To reduce costs that are rising at 8 percent annually, a state commission will soon recommend that insurance companies pay hospitals and physicians a lump sum to treat each patient for a year. And if that’s not shocking enough, Massachusetts Governor Deval Patrick supports this radical change. Read more

by Kevin Sack of Benefits Link, www.benefitslink.com

In any effort to restructure American health care, two interconnected goals inevitably compete for primacy. One is providing health coverage to the uninsured, counted in 2007 at 46 million, or 15 percent of the population, and almost certainly more now. The other is slowing the relentless and unsustainable growth of health costs, which threaten virtually every family, in imagination if not in fact. Read more

In April 2006, Massachusetts became the first state to require that all of its residents purchase health insurance. The plan had support from organizations and individuals across the political spectrum.  The Massachusetts plan was a response to today’s health care costs, which are rising twice as fast as inflation, making insurance increasingly unaffordable for many employers and individuals.    Read more

Motor vehicle insurance policies usually include personal injury protection (PIP) coverage that will reimburse the insured and/or a family member for a limited amount of medical expenses regardless of who was at fault. Many current motor vehicle policies limit the PIP coverage to relatively small amounts if the injured person has other health coverage. The general idea of that approach is to provide greater PIP coverage, but to permit the auto insurer to have secondary liability if the injured person has other coverage. Read more

Under the Massachusetts health care reform initiative, which became law in April 2006, 439,000 residents of the Commonwealth have become newly insured. Slated to become effective in 2009 are provisions which will impose new minimum standards on the health insurance that Massachusetts residents are required to carry under financial penalty. The Commonwealth seeks to further expand the reform by widening the group of employers potentially subject to a “fair share contribution” to the state fund. Read more

Business groups won a partial victory when Gov. Deval Patrick’s administration decided to exempt companies with 50 or fewer full-time employees from a new health care coverage requirement.  The Patrick administration unveiled the change, which would collectively cost businesses in the state about $30 million a year under the state’s “Employer Fair Share” rules. Read more

In the Commonwealth of Massachusetts, according to G.L. c. 90, §34A, auto insurers must provide their insureds with $8K personal injury protection (PIP).  In addition, insureds may purchase optional medical payments coverage (MPC) on top of the PIP.

The law also states that the auto insurer is only responsible to pay $2K of the $8K PIP towards medical expenses arising from an automobile accident when and if the insured has health insurance.  This rule was later clarified to mean only fully funded health insurers (coming within the purview of state law) are saddled with bills beyond the first $2K.  Self-funded plans coming within the purview of ERISA will only be responsible for medical expenses after the entire $8K mandatory PIP is exhausted. Read more