Politico (9/23, Haberkorn, 25K) reports, “The Obama administration has to decide by Monday whether it wants to directly ask the Supreme Court to review the constitutionality of its signature health reform legislation.” Since a three-judge panel of the 11th Circuit Court of Appeals “ruled against the health law in August, the administration can either ask the full court to take another look at the case or ask the Supreme Court to review it and issue a final decision.” Politico notes that the Justice Department “has until Monday to file paperwork if it wants to go back to the full circuit court,” and if the department does not file or get an extension, it has no other option than to ask the Supreme Court to rule on the 11th Circuit’s decision. http://www.politico.com/news/stories/0911/64140.html
Members of the Healthcare Leadership Council—which includes top executives from Pfizer Inc., Aetna Inc. and the Mayo Clinic-are expected to approve a proposal that would call for raising Medicare’s eligibility age and shifting the program toward private plans for beneficiaries. The group plans to press members of the congressional “supercommittee,” charged with finding $1.2 trillion in budget savings, to include the changes in its broader cost-cutting plan.
The council’s proposal is part of a larger effort inside the health industry to overhaul how lawmakers achieve savings from federal health programs. For years, Congress largely has relied on slicing payments to doctors and hospitals that treat Medicare beneficiaries to shrink spending in the program that insures 48 million elderly and disabled Americans.
Frustrated at being the target, the health industry is pushing back, arguing that some of those savings should come directly from the pockets of Medicare beneficiaries.
“This thinking that we’re protecting beneficiaries because we’re only cutting providers—that’s mythical,” said Mary Grealy, the council’s president. “At some point it does affect beneficiaries,” she said, because such cuts weaken health-care providers’ ability to offer services.
There’s growing pressure in Washington to rein in the major health-care entitlement programs—Medicare and Medicaid—as lawmakers struggle to cut the federal budget deficit.
Industry Seeks Savings from Medicare beneficiaries, The Wall Street Journal – Print and Online September 13, 2011
All healthcare accounts are not created equal. That’s why you need an experienced, trusted advisor to help you when it comes to your healthcare finances. Benefit Solutions by Design is here to help youunderstand the sometimes complex and confusing world of healthcare account acronyms (HSA, HRA, FSA, MSA, Oh my…). Are you a Smart Healthc Care Consumer?
Consumer-driven health plans are the latest response to soaring costs. They teach and empower consumers to take financial control of their health care spending; Health Savings Accounts (HSAs) are the centerpiece of this new approach.
With the HSA/HDHP, consumers have significant power and responsibility for their health care decisions. The consumer (or the employer, or both) sets aside a pool of money to spend on health care before HDHP coverage kicks in. Policymakers hope that, by having such a financial incentive, participants will become better and more prudent health care consumers; healthcare nest egg or smart spender.
The New York Times /Texas Tribune (6/10, A19A, Ramshaw, Subscription Publication) reports that despite Texas Gov. Rick Perry’s (R) “stated opposition to a federally-mandated health insurance exchange and the state’s participation in lawsuits aimed at overturning federal health reform, officials at the Texas Department of Insurance acknowledge that since last fall, with the help of a $1 million grant from the United States Department of Health and Human Services, they have been working quietly to plan for a health insurance exchange.” The article quotes John Greeley, a spokesman for the Texas Department of Insurance, as saying, “We’ve been going full speed ahead on implementation, doing the due diligence so that we can be on time with what the law says.” Meanwhile, “Lucy Nashed, a spokeswoman for Mr. Perry, said the governor is aware of the grant, which she said is exploratory and does not require Texas to set up an exchange.” http://mailview.custombriefings.com/mailview.aspx?m=2011061001nahu&r=4958615-5c23
Some of the foods at the grocery store may be making you sick. This month’s video clip from The Dr. Oz Show provides simple ways to protect yourself as you shop. The video messages are available on UHC.com, myuhc.com, and Source4Women.com for six months.
Each month UnitedHealthcare posts a video clip featuring Dr. Mehmet Oz, a renowned physician, bestselling author and host of The Dr. Oz Show, which airs daily on TV stations across the United States.
The messages focus on achieving or maintaining a healthy weight, heart health, exercise, and healthy eating. These clips can be shared simply by copying and pasting the web link from the sites above into an email or your web browser.
These video clips are a part of UnitedHealthcare’s commitment to work with renowned doctor and nationally recognized author Dr. Mehmet Oz to share health and wellness topics on his talk show, The Dr. Oz Show, and his website, DoctorOz.com. You can find out when and where The Dr. Oz Show airs in your area by going to DoctorOz.com and clicking on “Local Listings.”Shop Safe at the Grocery Store
Confused about what compliance rules apply when an employee terminates employment triggering a loss of their benefits. What are your obligations as an employer to keep in compliance with the state / federal regulations in offering the terminated employee & their covered dependents continuation rights. Rules and regulations, who is responsible, what are the requirements and time lines? Great questions that I can help you resolve. Since groups subject to Texas State Continuation (TSC) are almost 100% fully insured groups, “the employer or the group policyholder” are one and the same! Required to provide the terminated members their right to continuation of group coverage. As an industry professional, your hiring me to provide solutions driven support to meet these compliance needs. Let’s close your compliance gaps.
What’s the BUZZ about Group Medical Bridge -GMB?
Employers are struggling with managing health care costs while still providing a competitive benefits program. Employees are struggling with increasing financial exposure from out-of-pocket costs.
New Group Medical Bridge 1.0 can help employers and employees with these top concerns. And it’s guaranteed issue – no health questions asked – and includes the ability to waive pre-ex on all covered insureds (employee, spouse, dependents) when participation is met. It’s also available situs state, which makes your job even easier!
Find out when you can begin offering this innovative new solution to rising health care costs to your clients. Continue…
The new Group Medical Bridge 1.0 provides a one-page state-specific GMB 1.0 that shows your savings by pairing GMB 1.0 with a high-deductible health plan. What are you waiting for? Let’s talk about your options as a smart minded business owner.
The health care systems were complex as we know them, now the old rules are gone, with new ones here and more to be added as a work in progress. Politics and legislation will continue to shape specific elements and timing, but the trajectory of health reform is unlikely to change and the momentum is not likely to disappear.
An environment of change means more than planning; It calls for agility. The Patient Protection and Affordable Care Act (PPACA) is only part of a larger wave as regulatory mandates change how and with whom you do business. New endeavors and new operating models can create strategic advantages while operational changes may generate streamlining opportunities and drive growth in new areas. Reform has far-reaching effects on employers and organizations of almost every type as they face each of these challenges and more.
Leaders both inside and outside the traditionally defined health care industry have hard choices to make. No matter where your organization is on the emerging landscape, the potential impacts on your business are as real as they are serious. Benefit Solutions by Design can assist in your efforts to navigate these challenges and more.
Repeal the expanded 1099 mandate The House passed the Small Business Paperwork Mandate Elimination Act of 2011 (H.R 4) that would repeal ObamaCare’s onerous 1099 mandate – a law that requires all businesses to file an IRS Form-1099 for any vendor with which they have more than $600 in yearly transactions. H.R. 4 passed with bipartisan support by a vote of 314-112 and will save taxpayers $20 billion over the next 10 years. The Senate passed a similar version of the legislation earlier this year.
The American people want the spending binge and fiscal irresponsibility in Washington to come to an end, and I stand ready to work with the Administration and members on both sides of the aisle in restoring fiscal order.