Health insurance quotes care reform weekly

States with Republican governors kept up the pressure last week on Washington to give the states greater control over wellness care under the Patient Protection and Inexpensive Care Act (PPACA). Twenty-1 Republican governors sent a letter to Wellness and Human Services (HHS) Secretary Kathleen Sebelius asking for greater authority over some provisions of well being reform, which includes the capacity to define “essential” health rewards and set minimum criteria for participating in insurance exchanges. They threatened not to run their own state-based exchanges if HHS does not act on their requests. Sebelius speedily responded with her own letter in which she reviewed the numerous choices states have to decrease costs in their Medicaid programs, and she indicated she is continuing to review what authority she may have to “waive the maintenance of effort under current law.” Senate bills have already been introduced to address the role of the states in health care reform, which is positive to maintain the issue on the front burner. Pay a visit to Easy To Insure ME for a lot more information

Federal

The House Committee on Techniques &amp Means held a hearing last week on “The Health Care Law’s Impact on Medicare and Its Beneficiaries,” featuring testimony from CMS Administrator Donald Berwick, M.D., and CMS Chief Actuary Richard Foster. Berwick testified that the PPACA has had a positive impact on Medicare beneficiaries, noting that beneficiaries now have initial-dollar coverage of key preventive advantages, additional help with prescription drug costs, and an annual wellness check out with the physician of their option. In response to concerns noted by a number of committee members about the impact of funding cuts on Medicare Advantage, Berwick indicated that Medicare Benefit enrollment increased by 6 percent from 2010 to 2011. He suggested that the program is healthy and offers robust choices. Foster’s testimony reiterated his prior projection that the PPACA will trigger Medicare Advantage enrollment to decline by about 50 percent by 2017 — from a projected 14.five million under the pre-PPACA law to 7.three million under the new law.  His testimony further explained that Medicare Benefit enrollees will expertise “a huge boost in out-of-pocket expenses” and “much less generous benefit packages” simply because PPACA will decrease rebates to Medicare Advantage plans, with the reduction in rebates reaching ,500 per beneficiary by 2019.

The Administration last week issued favorable guidance with respect to student wellness coverage that will result in small disruption, if any, to this enterprise until at least the 2012-2013 academic year. This guidance was announced in a Notice of Proposed Rule Making (rather than as an interim final regulation), which fortunately means that the rule is not effective quickly as has been the case with most regulations relating to PPACA reforms. The proposed student well being rule would develop a unique class of individual coverage for student well being pursuant to a set of aspects, e.g., written contract between school and insurer, coverage only for students and dependents, wellness status could not be utilized as a condition of eligibility.  As Aetna has advocated, the impact would be delayed, as the rule (whenever finalized) would not be powerful until policy years beginning on or soon after January 2012. Until then, student health is not subject to PPACA reforms.  And, when efficient, student health would be excepted from the current guaranteed issue and renewability provisions of PPACA.  Although it will be unclear for a while regardless of whether and how student health will be subject to the medical loss ratio (MLR) provisions of PPACA, we are encouraged by the reality that the proposed rule invites comments on regardless of whether student wellness need to receive some sort of unique accommodation (akin to the special rule for limited benefit plans) with respect to MLR, owing to the special characteristics of the student well being marketplace.

States

ARIZONA:  The industry-supported exchange bill was introduced last week under the sponsorship of the Home Well being Committee Chairman and the respective chairmen of the Home and Senate Banking and Insurance Committees. The bill offers for a market-based mechanism governance by a board with insurer representation no dual regulation and a conditional repeal provision. The 1st hearing will be held this week. In other news, Governor Jan Brewer appointed Don Hughes, former AHIP retained counsel, as Unique Advisor for Well being Care Innovation. Hughes will support direct state efforts to boost the price-effectiveness and accessibility of health care. He will engage in strategic planning with a focus encompassing both public wellness care and Arizona’s big private well being insurance business.

CONNECTICUT:  A jointly held public hearing of the Public Health and Insurance and Real Estate Committees was scheduled for this week on two new wellness care bills. The initial bill would establish the SustiNet Program Authority, a quasi-public agency empowered to implement a public well being care alternative. The SustiNet Strategy is a health insurance program that consists of coordinated individual well being insurance plans that offer wellness insurance items to state employees, Medicaid enrollees, HUSKY Program, Component A and Part B enrollees, HUSKY Plus enrollees, municipalities, municipal-related employers, nonprofit employers, modest employers, other employers, and individuals in Connecticut. The Authority is authorized, but not required, to begin offering SustiNet coverage to employees and retirees of non-state public employers, municipal-related employers, little employers, and nonprofit employers after January 1, 2012.  Beginning on January 1, 2014, SustiNet will give coverage to individuals and employers.  Amongst other issues, the bill directs the Authority to implement primary care case management and patient-centered medical houses for all SustiNet Program members, establish a pay-for-performance method, and establish procedures to avoid adverse selection.

The Committees also will hear testimony on a bill to establish the Connecticut Wellness Insurance Exchange pursuant to PPACA.  The exchange would be a quasi-public agency offering qualified well being plans to individuals and qualified employers by January 1, 2014.  The bill would establish a 13-member board of directors to manage the exchange. The exchange would have the authority to review the rate of premium growth within and outside the exchange in order to develop recommendations on regardless of whether to continue limiting qualified employer status to little employers. It also would have the authority to charge assessments or user fees to health carriers to generate funding necessary to support the operations of the exchange. The bill directs the exchange board to report to the legislature by January 1, 2012 on regardless of whether to establish two separate exchanges, 1 for the individual market and one for the small employer market, or to establish a single exchange regardless of whether to merge the individual and small employer wellness insurance markets regardless of whether to revise the definition of “small employer” from not much more than 50 workers to not more than 100 and no matter whether to enable huge employers to participate in the exchange beginning in 2017.

Aetna will submit comments on both bills via the Connecticut Association of Health Plans.

IDAHO: Draft legislation is circulating that would prohibit insurance businesses and managed care organizations from refusing to contract with qualified providers solely simply because the provider: is not a member of a group, network or any other organization of providers contracting with the insurance business or does not supply all of the services obtained by means of the group, network or organization of providers contracting with the insurance company. Even so, the provider could be needed to comply with the practice standards and quality requirements of the contract certain to the services contracted. The bill usually is intended to impact insurers and managed care organizations. It does not contain an exclusion or exception for HIPAA-excepted positive aspects. As but, the bill has not discovered a sponsor and has not been “introduced.”  While there remains a possibility that the bill could be introduced prior to the deadline for committee bill introductions, it is regarded as unlikely.

MINNESOTA: When the legislature convened the very first half of its 2011-2012 biennium last month, Republicans controlled both legislative chambers for the first time since 1972. And, Republican lawmakers wasted little time introducing bills to repeal measures passed by the 2010 legislature to fund state medical help, general help medical care, and MinnesotaCare. In his very first official act as Governor, Mark Dayton signed an executive order implementing early Medicaid expansion (to 133 percent of the federal poverty level) for Minnesota, which is expected to make 95,000 a lot more state residents eligible. Minnesota’s 8 million investment is expected to bring about .2 billion in matching federal funds. Governor Dayton also signed an executive order removing the ban on applications for federal PPACA-related grants. Minnesota is expected to receive an exchange planning grant soon. Whilst Governor Dayton cleared the way for the state to seek grants for implementing federal well being reform, it is unlikely that state legislators will be passing bills to implement the federal well being reform law unless absolutely necessary. Other pending bills of interest incorporate anti-PPACA legislation, a bill requiring guaranteed concern in the individual market, creation of a defined contribution program for childless adults with incomes at or above 133 percent of FPL (reduction from current level of 250 percent), the prohibition of dental plan fee schedules for non-covered services, and an autism coverage mandate. In addition, Governor Dayton named a new Commissioner of the Department of Commerce, Minneapolis attorney Michael Rothman.

NEVADA: The legislature convened on February 7 with a scheduled adjournment date of June 6. Governor Brian Sandoval will sponsor an exchange bill, though he opposes federal health care reform. His reasons incorporate not wanting the federal government to take action in the state and the fact that the legislature will not meet in 2012. The Division of Insurance (DOI) has indicated that it will pursue federal reform measures, such as external review. Other legislation of interest consists of the establishment of a statewide well being info exchange method and amending the requirements for reimbursement of out-of network services to comply with the PPACA.

TEXAS: Governor Rick Perry delivered his State of the State speech last week, which included plans to suspend the State Historical Commission and the Commission on the Arts in addressing the state’s billion spending budget deficit. Speaking to a joint session of the legislature, Perry said the time has lastly come to streamline state government. Perry’s speech focused heavily on how powerful the state’s economy is, in spite of the deficit. According to Perry, Texas added far more jobs in 2010 than any other state in the nation. That state-wide job growth occurred in the sectors of enterprise, health care, manufacturing, hospitality, construction and energy. Perry’s speech was highly crucial of national politics, and he threatened to push back when Washington encroaches on states’ rights. His spending budget proposal calls for cutting a lot more than billion in state spending on public education and an additional billion in greater education, plus much more than billion in wellness and human services programs. Those cuts would come with much bigger reductions in federal dollars, because states draw federal funding for programs such as Medicaid by spending state income.

VERMONT: Newly-elected Governor Peter Shumlin’s focus has been on reducing the state’s projected million budget deficit. Proposals to deal with the deficit incorporate changes to the administration of the state’s Catamount program, changes to Catamount reimbursement, imposing an assessment on managed care organizations, growing the provider tax on hospitals, and imposing an assessment on dentists. The legislature is also taking into consideration a number of bills that would produce a single-payer, government-run well being care strategy and demand rate reviews. The bills contain:

Supported by the governor, H.B. 202 would establish Green Mountain Care and the Vermont Well being Benefit Exchange, by way of which all state residents would be eligible for well being advantages. After implementation of the Green Mountain single-payer method, private insurance firms would be prohibited from selling health insurance policies in that cover services also covered by Green Mountain Care.

H.B. 80 would develop a single-payer well being care program referred to as Ethan Allen Well being. If the secretary of Human Services obtains a waiver from the exchange requirement, private insurance businesses will be prohibited from selling insurance policies in the state for coverage of services covered by Ethan Allen Wellness. But it would not prohibit individuals from buying supplemental health insurance covering services not already covered by Ethan Allen Well being.

S.B. 57 would establish Green Mountain Care as a single-payer well being care program, which will contain coverage supplied under a wellness benefit exchange, Medicaid, and Medicare.

H.B. 146 would establish a public wellness care coverage choice referred to as Green Mountain Care that would demand Vermont residents to have health care coverage at least equivalent to the actuarial value of Green Mountain Care and would assess a monetary penalty against those who fail to maintain such coverage. The bill would institute a candy and soft drink tax as well as a 10 percent payroll tax on all employers with far more than four workers to fund Green Mountain Care.

S.B. 56 and H.B. 165 would amend present rate review procedures to need written approval from the commissioner before a wellness insurance policy can be issued and to need that all rate and form filings be filed electronically.  Rate adjustments would require approval by the commissioner prior to implementation and notice to plan members of rate adjustments and a 30-day comment period.

H.B. 82 would demand health insurers to disclose to the Department of Banking, Insurance, Securities, and Well being Care Administration the fee schedules they negotiate with providers, and directs the department to post the info on its website.

The 1st music video from the LA-based band Wellness, whose self-titled debut album was released on Lovepump United Records. This video was made entirely from footage taken from the Werner Herzog documentary “The Fantastic Ecstasy of the Woodcarver Steiner” (1974).