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Home   Advocacy   Education   Solutions Summit   Membership   Member Login July 22, 2010
Insurers push plans that limit choice of doctor
The New York Times    Share   Share on FacebookTwitterShare on LinkedinE-mail article
As the Obama administration begins to enact the new national health care law, the country’s biggest insurers are promoting affordable plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals. The plans, being tested in places like San Diego, New York and Chicago, are likely to appeal especially to small businesses that already provide insurance to their employees, but are concerned about the ever-spiraling cost of coverage. More

Out-of-network emergency care
The Washington Post    Share    Share on FacebookTwitterShare on LinkedinE-mail article
In the middle of a medical emergency, you don't have time to wonder whether the doctor who is reading your X-rays is in your insurance network. Starting this fall, changes under the health-care overhaul will take some of the worry out of emergency room visits. But the new provisions don't cover all the bases, and in some instances you may still get blindsided by unexpected costs. More

Florida gets OK to 'mine' Medicaid billing data
Battle Creek Enquirer    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The battle against Medicare fraud scored another big win last week with the arrest of 94 people in five states. At the same time that special federal strike forces were rounding up suspects, officials were gathering in Miami for a health care fraud prevention summit that yielded an important announce-ment in the fight to eliminate fraud in the Medicare and Medicaid systems. U.S. Health and Human Services Secretary Kathleen Sebelius announced federal funding to help Florida conduct a demonstration program that will give investigators access to Medicaid Management Information System billing data to help identify cases of potential fraud. More

Senate unlikely to take up gap in Medicaid
Richmond County Daily Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
It appears doubtful the U.S. Senate will decide the fate of enhanced federal Medicaid matching funds for the states this afternoon, despite rumors to the contrary Monday. The Senate probably will consider extending unemployment insurance benefits to the nation’s jobless. A spokesperson from U.S. Sen. Richard Burr’s office said Federal Medical Assistance Percentages (FMAP) funding will not be included in the unemployment bill, while a spokesperson from U.S. Sen. Kay Hagan’s office said it appeared Monday afternoon the funding would not be included in the bill. More

Health overhaul may overshadow strong managed-care 2Q
The Wall Street Journal    Share    Share on FacebookTwitterShare on LinkedinE-mail article
As health insurers release earnings starting this week, the focus will likely be on clues as to how the U.S. health overhaul affects margins and growth. Led by managed-care bellwether UnitedHealth Group Inc. (UNH), the sector is seen posting hardy earnings for the second quarter. However, uncertainty over the specifics and ramifications of forthcoming overhaul regulations likely will leave investors nervous and stocks in flux. Investors worry that margins may be squeezed from new minimums on what companies must spend on medical costs. The changes also may force some players, especially smaller plans, to exit markets. More

Meaningful use provisions challenged at Hill hearing
Health Leaders Media    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Are the new "meaningful use" guidelines enough to improve the standard for quality? Some Republican members of the House Ways and Means Health Subcommittee do not believe so and used Tuesday's hearing to challenge the meaningful use requirements. Much less is expected from the healthcare providers receiving subsidies under the new measures than what the Centers for Medicare & Medicaid Services (CMS) had initially proposed, said Rep. Wally Herger (R-Calif.), the ranking Republican on the panel. Overall, the final regulations "represent a missed opportunity to improve patient care and reduce waste," Herger added. More

Program to reduce preventable hospital readmissions launches in California
Medical News Today    Share    Share on FacebookTwitterShare on LinkedinE-mail article
With more than one-third of hospitalized patients in California readmitted within a year, a new statewide initiative will focus on reducing preventable readmissions. Project BOOST (Better Outcomes for Older Adults through Safer Transitions) is designed to reduce 30-day readmissions rates, improve patient satisfaction, and enhance the flow of information between hospitals and outpatient physicians. The program also ensures that high-risk patients are identified and patient and family education processes are improved. More

AARP warns Congress against inaction on Medicaid funding
McKnight's    Share    Share on FacebookTwitterShare on LinkedinE-mail article
The powerful seniors' lobbying group AARP has entered the debate over extended Medicaid funding for states. It sent a letter to every member of Congress pushing for approval of the funds. AARP told Congress that failure to act on extending increased Medicaid funding to states through the first six months of 2011 would harm millions of Americans, particularly low-income seniors, The Hill newspaper reported. The temporary 6.2 percent increase in the federal medical assistance percentage is set to expire at the end of 2010. AARP argued in its letter that many states desperately need the funds because they cannot afford the additional Medicaid enrollees that resulted from the economic downturn, and will result from the healthcare reform law. More

Oklahoma insurance chief challenges Medicaid tax
CNBC    Share    Share on FacebookTwitterShare on LinkedinE-mail article
Insurance Commissioner Kim Holland on Tuesday asked the Oklahoma Supreme Court to strike down a new law that supporters say would raise up to $240 million in revenue for the state's Medicaid program. The law creates a 1 percent fee on claims paid by private health insurers and companies with self-insured health care plans to support the Medicaid program, which provides health care to low-income and elderly residents. State lawmakers passed the measure in May. More

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