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MN State Health Care Reform Update

February 23, 2010 | Health Care Legislation, Minnesota | No Comments

Minnesota. Starting March 1, the state is going to charge counties extra to cover the cost of health care for their neediest residents. Previously, a $400 million General Assistance Medical Care program was available to help provide coverage for the poorest in the state, but the program is ending in an attempt to balance the budget. State legislators have proposed funding the program through surcharges on hospitals and health groups to draw down federal dollars and would levy a 10% match by counties to share the program’s cost. For more information, visit http://www.health.state.mn.us/.

MD State Health Care Reform Update

February 23, 2010 | Health Care Legislation, Maryland | No Comments

Maryland. A bill pending in the state would allow young adults to continue enrollment in their parents’ health care plan until age 30. Current law allows dependent individuals to remain on a parent’s plan until they attain age 25. By expanding this to age 30, graduate students, veterans returning to school, and young adults who have been laid off and are seeking employment would be helped. Similar laws exist in New Jersey, New York, and Pennsylvania. For more information, visit http://www.mdinsurance.state.md.us/sa/jsp/Mia.jsp.

IL State Health Care Reform Update

February 23, 2010 | Health Care Legislation, Illinois | No Comments

Illinois. The Illinois Supreme Court has struck down a medical malpractice law enacted in 2005 that limited monetary damages for pain and suffering to $1 million from hospitals and $500,000 from doctors. The court said the law violates the state’s separation-of-powers clause between the branches of government by allowing lawmakers to interfere with a jury’s right to determine damages. According to the American Medical Association, courts in 16 states have upheld these types of laws, while those in 11 states have overturned them. For more information, visit http://www.state.il.us/court/.

GA State Health Care Reform Update

February 23, 2010 | Georgia, Health Care Legislation | No Comments

Georgia. Georgia Health Commissioner Rhonda Medows has urged state lawmakers to adopt a tax hike on hospitals and health care plans to help with the state’s Medicaid deficit problem. Beginning on July 1, the state will face a $506 million shortfall in Medicaid funds. The recession has caused enrollment in Medicaid to soar:from Une 2009 to 2010 enrollment has increased 7.7% to more than 1 million people. For more information, visit http://health.state.ga.us/.

FL State Health Care Reform Update

February 23, 2010 | Florida, Health Care Legislation | No Comments

Florida. To avoid a legislative mandate on the issue, major health insurers in the state have agreed to pay for care for members diagnosed with cancer who participate in clinical trials. The “Clinical Trials Compact” ensures that cancer patients will receive continued benefits while being treated with experimental drugs and other therapies. Participating insurers are: Blue Cross and Blue Shield of Florida, Humana, Aetna, Cigna, UnitedHealthcare, Vista Healthplans, and AvMed Health Plans. In recent months, there had been a move toward legislation to eventually cover all phases of cancer clinical trials, but the health insurers wanted to avoid a legislative mandate. Florida is the fifth state to use a compact for cancer trials, after Georgia, Michigan, Nebraska, and New Jersey. For more information, visit http://acscan.org/action/fl/updates/693/.

CT State Health Care Reform Update

February 23, 2010 | Connecticut, Health Care Legislation | No Comments

Connecticut. Insurance regulators in the state have given three of the top five insurers approval to raise rates for 2010 by double-digit percentages. Anthem Blue Cross and Blue Shield, Health Net of Connecticut, and ConnectiCare asked for group health plan rate increases of 15.78%, 19.09%, and 14.5%, respectively, for 2010. According to the health insurers and the Connecticut Insurance Department, the increased premiums will keep premiums in line with medical costs. For more information, visit http://www.ct.gov/cid/site/default.asp.

CA State Health Care Reform Update

February 23, 2010 | California, Health Care Legislation | No Comments

California. The state senate has approved the creation of a government-run health care system for the state, ignoring a veto threat from Gov. Arnold Schwarzenegger. The plan would cost an anticipated $200 billion per year. Also, the California Department of Managed Health Care has released rules that limit HMO wait times. The rules require that patients be treated by HMO primary care doctors within ten business days of requesting an appointment and by specialists within 15 days. In addition, patients seeking urgent care that does not require prior authorization must be seen within 48 hours. California is the first state to set time standards for HMOs, which serve approximately 21 million state residents. For more information, visit http://www.healthhelp.ca.gov/.

Bipartisan Hearings on President Obama’s Health Care Proposal to Air on Wednesday, February 24, 2010

February 23, 2010 | Health Care Legislation | No Comments

The President’s Proposal puts American families and small business owners in control of their own health care.

  • It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps over 31 million Americans afford health care who do not get it today – and makes coverage more affordable for many more. Read more

SIIA Legislative Update

February 23, 2010 | Health Care Legislation | No Comments

President Releases Recommendations in Advance of Bipartisan Healthcare Reform Summit

To give the public a more clear picture of the recommendations on healthcare reform that the President will bring to this Thursday’s healthcare reform summit, moments ago the White House released a set of the President’s general policy recommendations. The recommendations build on many of the proposals already in the House and Senate bills, with many of his recommendations simply bridging the gap between the differences of the two. Read more

MedMal RRGs Spared from Anti-Trust Legislation

February 23, 2010 | Health Care Legislation, Medical Malpractice | No Comments

WASHINGTON, D.C., Feb. 22, 2010 – The Self-Insurance Institute of America, Inc. (SIIA) today saluted the exclusion of medical malpractice insurance from a Congressional bill that would eliminate portions of the McCarran-Ferguson Act in governing the insurance industry. Read more

ERISA-Sixth Circuit Rules That Equitable Lien Does Not Attach To Social Security Benefits

February 23, 2010 | 6th, ERISA, Federal Circuits | No Comments

In Hall v. Liberty Life Assurance Company, No.s 08-4738/4739 (6th Cir. 2010), the plaintiff, . Sonya Hall, had received long-term disability benefits (the “LTD Benefits) for nearly five years through the National City Corporation Welfare Benefits Plan (the “Plan”). Liberty Life Assurance Company of Boston (”Liberty Life”), the third-party claims administrator, terminated the LTD Benefits when it determined that Hall was no longer totally disabled. The Plan then sought reimbursement for overpayment of the LTD Benefits, caused by retroactive Social Security benefits being awarded to Hall. Hall responded by filing suit against the Plan. Read more

Medical marijuana laws create dilemma for firms

February 17, 2010 | Litigation | No Comments

Judy Greenwald

Employers are facing the challenge of maintaining a safe workplace while more states legalize the use of medical marijuana, experts say.

While courts generally have ruled that firms do not have to accommodate medical marijuana users, employers in some jurisdictions still are awaiting guidance on the issue. Read more

I Thought We Were Worried About Cost?

February 17, 2010 | Subrogation, Summary Plan Description | No Comments

By Chris Aguiar of The Phia Group, LLC

Can anyone disagree with the notion of affordable healthcare? No matter where you sit on the political spectrum, I would imagine it would be difficult to vote against such an idea. Over the past few months, we have witnessed contentious debate on the most effective means to provide affordable healthcare for all. One of the main points of contention on that debate, as is always the case when dealing with political matters, is cost. Read more

Not All Plan Documents Are Created Equally… Are Yours In Compliance?

February 17, 2010 | Mental Health Parity, Summary Plan Description | No Comments

An Overview of the MHPAEA Regulation Requirements

By Jennifer M. McCormick, Esq. of The Phia Group, LLC

Joint issuance of the interim final mental health parity regulations by the DOL, DHHS, and Treasury offer guidance for employers in ensuring compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Read more

COBRA extension hits speed bump

February 17, 2010 | Health Care Legislation | No Comments

Lawmakers expected to find new route to continue subsidy

Jerry Geisel

WASHINGTON—Senate Majority Leader Harry Reid, D-Nev., last week abruptly removed provisions from a fast-moving jobs bill that would extend the 65% COBRA premium subsidy in duration and to more people, but experts say the COBRA provisions remain very much alive. Read more