cmonfils | January 3, 2012
Employer’s Guide to Self-Insuring Health Benefits December 2011 | Vol. 19, No.3
The lack of cost transparency stands in the way of health cost control because it makes plan members unable to see prices before services are actually rendered, and harms their ability to budget health spending. Problems include: (1) multiple providers; (2) multiple network-provider contracts; (3) providers that often don’t know how extensive a patient’s treatment needs are until they start treatment; (4) insurers say contractual obligations with providers prohibit the sharing of negotiated rates; and (5) providers afraid of sharing negotiated rates due to their proprietary nature. Leah Binder, CEO of the Leapfrog Group, suggested that most employers can bring more efficient purchasing to their health plan in two ways: (1) change plan documents to reward members for using high-performance providers (for example, by waiving deductibles); and (2) computerize drug ordering and management systems, which would have quality as well as cost and efficiency advantages. (more…)
Category: California, CMS, Florida, Massachusetts, Medicaid, Medicare, New Hampshire, Transparency, Wisconsin |
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cmonfils | July 11, 2011
The Subrogator Spring/Summer 2011
By Kammy Poff, Allstate Insurance Company, Roanoake, VA and Daran Kiefer, Kreiner and Peters Co., LPA, Cleveland, OH
Bills/Legislation
In February of this year, the National Association of Subrogation Professionals (NASP) embarked on a trip to Pierre, South Dakota. House Bill 1184 had just passed in the South Dakota House of Representatives and was on its way to the Senate. NASP was slated to testify before the Senate Judiciary Committee. House Bill 1184 needed to be stopped in the Senate. (more…)
Category: Made Whole Rule, New Hampshire, New Jersey, Oregon, Pennsylvania, South Dakota, Workers' Compensation |
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cmonfils | March 10, 2011
www.subrogation.org
South Dakota House Bill 1184
If you have been following the progress of House Bill 1184, we would like to report that the bill has finally been defeated in the South Dakota Senate. The full Senate voted 11-24 not to bring the bill to the floor for a debate. This is the second consecutive year that the proposed codification of the Made Whole Doctrine has been stopped. (more…)
Category: Nevada, New Hampshire, South Dakota |
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Adam V. Russo | March 3, 2010
The New Hampshire House Judiciary Committee reviewed and recommended a bill recently pertaining to contract, Medicaid or statutory subrogation rights of subrogation for “”reimbursement of medical expenses” against plaintiff’s recovery. The proposed bill requires these subrogated entities to pay costs and attorney fees to the injured party “as justice requires”. The bill does not give any direction on how the court should divide the proceeds other than “as justice requires”. However, the bill does provide a cap and states the insurance carrier, medical provider, or the state shall not be awarded more than two thirds (2/3) of the amount claimed. The bill would apply to health, auto medical payments and worker’s compensation lines of coverage. The effective date of the bill if passed would be January 1st, 2011.
Category: Attorneys' Fees, New Hampshire, Subrogation |
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Adam V. Russo | October 29, 2008
As of October, 2008, health plans will have to re-evaluate how they cover full time student dependants. Proposed legislation (H.R.2851) recently signed into law by President Bush, will make it mandatory that health plans which cover full time student dependants allow those dependants to remain covered for up to a year out of school, if they are on sick leave with a physician certified illness. This, after numerous youths have had to choose between coverage, and taking time off to care for their serious ailments. (more…)
Category: New Hampshire |
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