The Health Insurance Blog of Attorney Adam V. Russo
Welcome to Passion for Subro! The purpose of this site is to share my passion for the health insurance industry with the rest of you fanatics. I hope this site will be your destination for the latest in health care as well as self insured news across the country. While I envision that this site will serve as a great educational resource, it will also keep you entertained with the funny, difficult, confusing and just plain weird world of self insurance.
Thanks for visiting!
Posted By cmonfils on January 13, 2012
A mandatory uniform standard for health plans to pay claims electronically was adopted in rules issued Jan. 5 by the U.S. Department of Health and Human Services (HHS). The rules are designed to help health care providers match payments received with the “remittance advice” transactions that plans are already sending them under an existing HHS standard.
Posted By cmonfils on January 13, 2012
To view a PDF version of this article, please click here.
The Centers for Medicare and Medicaid Services (“CMS”) posted Version 3.3 of the User Guide, dated December 16, 2011 (the “Version 3.3”) on its website.
Version 3.3 includes the guidance that CMS has provided in various alerts since the previous User Guide was published as of August 17, 2011. A link to the User Guide is included in footnote 1, below. A summary of all of the changes to Version 3.3 are available on pages 6 and 7 of the User Guide; however, the following summarizes the most significant changes:
Posted By cmonfils on January 13, 2012
Streamlining electronic funds transfers in health care will bring total savings to
more than $16 billion over 10 years
New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published today by the U.S. Department of Health and Human Services (HHS). The standards build upon regulations published earlier this year that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.
Posted By cmonfils on January 12, 2012
Reporting from Sacramento— Fewer California companies offered their workers health insurance last year, and the ones that did charged employees more for their coverage.
That’s among the findings of an annual California Employer Health Benefits Survey released Wednesday by the California HealthCare Foundation, a research and grant-making nonprofit organization.
http://www.latimes.com/health/healthcare/la-fi-california-health-care-costs-20120105,0,3760812.story
Posted By cmonfils on January 12, 2012
While the vast majority of companies in the United States are now offering wellness programs, most would admit their program is far from perfect. Figuring out how to squeeze the highest impact out of what seems like an ever-shrinking budget is one of the biggest struggles a benefit administrator will run into when putting together a wellness program. While most behavior change or “intervention” programs available in the wellness world are focused on a single issue, we may have found the one focus that can impact multiple health risks and make your dollar go the furthest.
Posted By cmonfils on January 12, 2012
An Oregon labor relations board has sided with the state regarding a controversial state workers wellness program, ruling that the measure is not subject to union negotiations.
The Employment Relations Board decided on a 2 to 1 vote that the state did not have to negotiate with the Association of Oregon Corrections Employees over the implementation of the Health Engagement Model as part of this year’s health plan for state workers.
Posted By cmonfils on January 12, 2012
Health reform had a big year in 2010, when it passed Congress and a slew of consumer-friendly provisions came online. And it’ll have another big year in 2014. That’s when the individual mandate kicks in, pre-existing conditions end and Medicaid expands to cover 16 million more Americans. But 2012 won’t be all quiet on the health-care front: The Obama administration is laying a policy foundation for 2014, while health reform opponents try to stop the law altogether. Here are five key dates to mark on your health reform calendar (you do have one of those, don’t you?):
Posted By cmonfils on January 12, 2012
WASHINGTON—Internal Revenue Service guidance released last week resolves additional questions employers have raised about a health care reform law requirement that they report the cost of health care coverage on employees’ W-2 wage and income statements.
Under the requirement, health care cost information must be reported on 2012 W-2s, which will be issued in 2013. Under previous IRS guidance, smaller employers—those that distribute fewer than 250 W-2s in 2011—are exempt from this requirement until at least 2014 and possibly longer.
http://www.businessinsurance.com/article/20120108/NEWS03/301089986#crit=Health
Posted By cmonfils on January 12, 2012
Healthcare Transparency Through HealtheReports Reveals Significant Savings Opportunities, Reducing Costs for Insurers, Preferred Provider Organizations, Self-Insured Employers and Their Members
(Lexington, KY)—Jan. 11, 2012—According to internal analytics for the year 2011, IF Technologies has determined that a consistent 400% or more price variance is typical amongst network providers for top routine surgical procedures across the US.
Posted By cmonfils on January 12, 2012
Published by the Self-Insurance Educational Foundation, Inc. in cooperation with the Self-Insurance Institute of America, Inc.
Manage your Health Plan as you would manage your business. An introduction to self-funding.
“Become part of the Health Care solution!”
If there were a proven method to managing your health plan costs that over 57% of employees in the U.S. were utilizing today, would you be interested? Well there is a proven method, and it is called self-funding. (more…)
Posted By cmonfils on January 11, 2012
Though it was not unexpected, state officials don’t yet have a complete plan to deal with a high court ruling that roughly 30,000 legal immigrants were unfairly excluded from a state health care program.
“Over the time of this deliberation we’ve understood that there might be a need to adjust the way that things go,” Health and Human Services Secretary JudyAnn Bigby said Friday.
Posted By cmonfils on January 11, 2012
A major medical group issued ethical guidelines on Monday that take the provocative position of urging doctors to consider cost-effectiveness when deciding how to treat their patients.
The American College of Physicians, the second-largest U.S. doctors’ group after the American Medical Association, included the recommendation in the latest version of its ethics manual, which provides guidance for some 132,000 internists nationwide.
Posted By cmonfils on January 11, 2012
No, it’s not quite going down. But health care spending in 2010 rose at the second-slowest rate in the last half-century.
The Centers for Medicare and Medicaid Services reports that total health spending in the U.S. increased by 3.9 percent in 2010, just a notch above the slowest rate since the government started keeping track — 3.8 percent in 2009.
Posted By cmonfils on January 11, 2012
| January 10, 2012 – The United States Government Accountability Office (GAO) today released a new report on risk retention groups (RRGs) entitled Clarifications Could Facilitate States’ Implementation of the Liability Risk Retention Act.
Congress requested that this report be prepared in order to better determine whether the Liability Risk Retention Act (LRRA) should be amended. SIIA along with other industry groups currently support the passage of the Risk Retention Modernization Act (HR 2126). (more…) |
Posted By cmonfils on January 10, 2012
The FMLA was created to allow employees time off to deal with their own serious health conditions or those of family members who need medical care. But the law carefully balances the rights of employees to keep their jobs while facing temporary hardships with the rights of employers to run their businesses.
That’s one reason the statute and the U.S. Department of Labor’s (DOL) FMLA regulations give employers several options for calculating how much leave employees are entitled to at any given time. Most employers choose one of these two:
