Latest Entries

Today marks the 10 year anniversary of Mike and I creating our company.

At the time we had no idea what would happen, but it’s clear that based on the hard work of our staff and dedication of our clients, we are a key resource in the industry’s quest to reduce healthcare costs.

 Thanks to all of you for making this happen.

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

By Mark Hillman

If there’s one thing personal injury lawyers are especially good at, it’s exploiting the misfortunes of their clients while devising new ways to line their own pockets.

Colorado House Bill 1168 is this year’s prime example. While claiming to help injured parties receive full compensation for damages caused by the fault of someone else, what it really does is guarantee that the injured person, in order to be fully compensated, must hire a lawyer. Read more

In the waning days of 2007, with the cost of health care continually escalating and with more and more of the costs being borne by the United States Government, Congress passed and President Bush signed into law the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). With the stroke of his pen, the President created a responsibility for self insured organizations, liability insurers, group health plans and non-group health plans that pay bodily injury claims to insure that the Medicare system is protected from bearing the costs of current and future medical expenses if those expenses are the primary responsibility of an entity other than Medicare. Entities making such payments are known as RREs. Read more

By Peter Grier Staff writer / February 8, 2010

Washington

President Obama has invited Republican and Democratic congressional leaders to meet him on Feb. 25 for a televised discussion of healthcare reform alternatives. Will this be the spark needed to get the administration’s top domestic priority moving again? Read more

Taylor Armerding

Obamacare is off the front burner.

The president still insists it is still going to happen, but he has moved on. Given his recent rhetoric, one of his biggest jobs right now is to erase our memory of what he spent most of his time doing in 2009. He wanted a health care bill on his desk by August. Then he wanted it before Christmas. Then there was no rush. And now his top priority for 2010 is jobs. He wants a jobs bill on his desk soon — probably well before August. Read more

South Dakota Senate seeks to graft “made whole” into each and every subrogation provision which insurers seek to enforce in the state. The legislature in South Dakota is attempting to amend Title 58-11 of the Insurance Code by adding the following new section: Read more

Mental health and substance abuse care can’t be handled differently from medical and surgical treatment, according to the new rules. Also, employee assistance programs cannot serve as mental health care gatekeepers, benefit experts say.

Employers would no longer be permitted to require separate deductibles for mental health and medical treatment under new proposed parity rules issued last week by the departments of Health and Human Services, Labor and the Treasury. Read more

By ROBERT PEAR – The New York Times

WASHINGTON — The Obama administration issued new rules on Friday that promise to improve insurance coverage of mental health care for more than 140 million people insured through their jobs.

In general, under the rules, employers and group health plans cannot provide less coverage for mental health care than for the treatment of physical conditions like cancer and heart disease. Read more

The U.S. Departments of Labor, Health and Human Services (HHS), and the Treasury have jointly issued new rules providing parity for consumers enrolled in group health plans who need treatment for mental health or substance use disorders.

The new rules prohibit group health insurance plans — typically offered by employers — from restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits. The rules implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Read more

House Set to Formally Consider Partial Repeal of McCarran-Ferguson

SIIA’s Government Relations Staff has learned that the House will most likely vote on legislation next week that would partially repeal McCarran-Ferguson. The bill, HR-3596, the Health Industry Anti-Trust Enforcement Act, seeks to prohibit issuers of health and/or medical malpractice insurance from engaging in any form of price fixing, bid rigging, or market allocations in connection with providing health insurance coverage or coverage for medical malpractice claims or actions. The bill also authorizes the Federal government the ability to prosecute any prohibited actions under anti-trust law. Read more

Subrogation rights are again in danger in Colorado with the introduction of H.B. 10-1168. This bill essentially undoes healthcare subrogation while codifying the “made whole” and “common fund” doctrines into law. The proposed bill will certainly have a devastating effect on healthcare, workers compensation and UM insurance subrogation, but other auto and property subrogation rights will also be greatly impacted whenever there is a personal injury suffered in the same loss. The most dramatic aspect of the proposed bill is that carriers cannot bring direct subrogation actions in such instances. Read more

February 1, 2010

(1) Discussions Continue on Comprehensive Health Reform as House Prepares to Act on Narrowly Focused Bills

Congressional leaders are considering options for moving forward with health reform legislation following President Obama’s State of the Union address last week in which he urged lawmakers to “come together and finish the job.” Read more

MyHealthGuide Source: Meredith Z. Maresca, BNA’s Pension & Benefits Daily, 1/27/2010, www.bna.com

In a decision addressing identification of the proper defendant in a benefit claim action brought pursuant to the ERISA’s civil enforcement provision, the U.S. District Court for the Southern District of Ohio held that the health plan’s TPA potentially could be liable for the alleged wrongful denial of benefits to cover a beneficiary’s bone cancer treatment. Read more

The Boeing Company v. Thurmon, No. 4:09-cv-1456, in the United States District Court for the Eastern District of Missouri, December 7, 2009. This is a subrogation case, significant for its fresh and express reiteration of the bedrock proposition that purchase of stop loss insurance by the sponsor of a self-insured employee benefit plan does not affect pre-emption analysis. In other words, a self-insured plan is still a self-insured plan, despite the existence of excess loss coverage. Read more