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February 25, 2003 - 8,036 subscribers
Today's sponsor: EBIA's HIPAA Portability & Privacy
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HIPAA Security Standards Checklist (PDF)
8 pages. Excerpt: "On February 20, 2003, the U. S. Department of Health and Human Services ... released final security regulations, under [HIPAA]. Most covered entities (health plans, health care clearinghouses, and health care providers that transmit health information electronically) must comply with the new security standards by April 21, 2005 (2006 for health plans with annual receipts of $5 million or less)." (Davis & Kuelthau, s.c.)
DOL Says 'Reinsurance' Company Can't Ignore State Insurance Company's Cease-and-Desist Order
Advisory Opinion number 2003-03A, dated February 13, 2003. Excerpt: "[I]t would be imprudent in the Department's view for a fiduciary to use plan assets to tender premiums to an unlicensed insurer that is subject to a cease and desist order, issued under applicable state insurance law, which prohibits the insurer's receipt of those premiums." (U.S. Department of Labor, Employee Benefits Security Administration)
Fewer Premium Dollars Going To Medical Care
Excerpt: "A study released last week by the Blue Cross and Blue Shield Association, Chicago, reveals a decline in the percentage of health insurance premium revenue going toward payment of medical claims." (Modern Healthcare)
Study Says Premium Growth Outpaces Health Plan Expenses
Excerpt: "The study suggests provider contracting; sales and marketing; claims processing and other expenses associated with operating a health plan are not the major force behind escalating health insurance premiums." (Reuters Health via Medscape; one-time registration required)
States Investigating Sales Practices of Health Plans Sold Through Associations
Excerpt: "Insurance regulators in at least eight states have launched investigations into alleged 'sales abuses and deceptive practices' by associations that sell health insurance to members, the Wall Street Journal reports." (KaiserNetwork.org)
Genomics in Medicine: Hype or Real Promise?
Excerpt: "I think in the long term the real potential here is to reduce health care costs, and perhaps substantially so, because a lot of the impact is going to be on prevention. If you can identify in healthy people what their future risks of illness are and then design an individualized plan of preventive medicine that focuses on keeping people healthy by lifestyle or diet or medical surveillance, the outcome of that should be ... the reduction in health care costs." (Healthplan via Medscape; one-time registration required)
Web Doctor Visits Haven't Spread at Speed of Light, But a Few Insurers Embrace Them
Excerpt: "[O]ne insurer is expanding coverage of Web visits after demonstrating cost savings in a pilot.... The insurer targeted relatively low-intensity medical issues that would be appropriate for online consults." (Managed Care Week via AISHealth.com)
Striking Union Workers in Kentucky Told Health Benefits Will End
Excerpt: "USEC Inc. has told striking union workers their company-sponsored health insurance will expire March 1, but they may opt for a federal plan costing tenfold what they pay now." (The Paducah [Ky.] Sun via NewsAlert.com)
A Survey of Class Action Lawsuits Against Drug Manufacturers (Second Edition) (PDF)
36 pages; January 2003. (Families USA)
Proposed CIGNA Settlement Transferred to Miami Judge
Excerpt: "In a setback for CIGNA, the health insurer, a federal judiciary panel has ordered that a proposed settlement of a class-action suit in Illinois be transferred to a federal judge in Miami who has sharply criticized the company's tactics." (New York Times; one-time registration required)
Hospitals' Negotiating Leverage with Health Plans: How and Why it Changed?
February 2003 issue. Excerpt: "Hospitals' increased negotiating leverage contributed to higher payment rates, which in turn are likely to increase managed care plan premiums. This trend raises challenging issues for policymakers, purchasers, plans, and consumers." (Health Services Research, published by the Center for Studying Health System Change)
Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets
February 2003 issue. Excerpt: "[W]ithin and across our study sites, employer decisions in [the] aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results." (Health Services Research, published by the Center for Studying Health System Change)
Changes in Health Plans' Approaches for Managing Costs and Care
February 2003 issue. Excerpt: "Health plans have begun to scale back or abandon their us of selected managed care tools in most communities, with selective contracting and risk contracting practices fading most rapidly and completely. In turn, plans increasingly have sought cost savings by shifting costs to consumers." (Health Services Research, published by the Center for Studying Health System Change)
What Became of the "Managed Care Revolution" in 2001?
Three key developments shaped health care markets between 1999 and 2001: (1) unprecedented, sustained economic growth that resulted in extremely tight labor markets and made employers highly responsive to employee demands for even fewer restrictions on access to care; (2) health plans increasingly moved away from core strategies in the 'managed care toolbox'; and (3) providers gained leverage relative to managed care plans ..." (Health Services Research, published by the Center for Studying Health System Change)
Maine Governor Endorses Mental Health Parity Bill That Would Expand Insurance Coverage
Excerpt: "Maine Gov. John Baldacci (D) on Feb. 18 pledged his support for a mental health parity bill (LD 566) that would require health insurers to cover 11 categories of treatment for mental illness at the same level they cover other medical conditions, the AP/Bangor Daily News reports ..." (KaiserNetwork.org)
White Paper: State Formularies and Cost Controls Restrict Access to Prescription Drugs
Excerpt: "Masquerading as preferred drug lists, formularies, brand name drug restrictions, and 'therapeutic consultation services,' prescription drug price and quantity controls are the latest fad in the continuing struggle to control Medicaid expenditures.... [C]entralized control of prescription drug purchases replaces the decisions made by people intimately familiar with the problem at hand with the ill informed dictates of bureaucrats." (Washington Policy Center)
Next Step In Managed Care: Employers Providing On-Site Doctors
Excerpt: "Jerry Slaughter, executive director of the Kansas Medical Society in Topeka, said he finds the concept intriguing. However, he said he thinks there are several obstacles." (The Business Journal of Kansas City via bizjournals.com; one-time registration required)
Patients Fear Rising Costs
Excerpt: "Half of Californians worry that they won't be able to afford health care in the future, and some already are trying ways to trim costs." (The [San Jose, Calif.] Mercury News)
Opinion: Cap on Pain and Suffering Is Wrong Cure for Medical Malpractice
Excerpt: "The medical-malpractice reforms that we need are impossible to discern from the current crusade ... [T]he fight over limiting noneconomic damages-- the current reform push-- is a tone-deaf debate between bad and worse. The proposal is indeed a cruel hoax. It feeds off the lie that the true victims of malpractice are the doctors who commit it, not the patients who suffer it." (The Miami Herald)
'Senate's Only Doctor' Prescribes Profit Motive
Excerpt: "[A] look at [Senator Bill] Frist's history suggests that his approach to numerous complicated health-care matters is shaped more by being a conservative Republican-- with a strong affinity for business and a family that founded a for-profit hospital chain-- than by being a physician." (Chicago Tribune via NewsAlert.com)
1.3 Million Long Term Care Insurance Policies Sold Through Employer Market
The number of employers offering long term care insurance as an employee benefit skyrocketed over the last decade, with more than 4,700 employers now making long term care insurance available for purchase by their employees, according to a survey recently released by HIAA. The survey, Long Term Care Insurance in 2000-2001, also found that the number of Americans who have purchased insurance against the catastrophic costs of long term care has increased more than tenfold in the last 15 years. (SpencerNet)
Links to Items on Executive Comp, Benefits in General
What ERISA Means by 'Equitable': the Supreme Court's Trail of Error in Russell, Mertens & Great-West
Working paper; available for downloading from SSRN.com at no cost. Excerpt: "This paper explains why and how the Court's interpretation of ERISA remedy law went wrong, beginning with the Court's earlier encounter with the field in Russell (1985).... Congress intended ERISA remedy law to replicate the core principles of trust remedy law in the regulation of pension and benefit plans, including the long-familiar make-whole standard of trust remedy law." (Prof. John Langbein, published by the Social Science Research Network)
Canadian Government Pension Plan to Oppose Use of Stock Options
Excerpt: "The investment arm of Canada's publicly funded pension plan warned on Monday it will start using its voting power to pressure companies to drop stock option plans and improve governance." (Reuters)
Newly Posted or Renewed Job Openings
Employee Benefits Attorney
for Womble Carlyle Sandridge & Rice, PLLC
in DC
Administrative Analyst
for ICMA Retirement Corporation
in DC
Director - Pension Management
for Travelers Property Casualty
in CT
401k Director
for ADP TotalSource in Miami, FL
in FL
401k Plan Specialist
for ADP TotalSource in Miami, FL
in FL
Newly Posted Conferences
(Post Yours!)
Consumer Directed Health Care Conference & Expo
in NV
April 7, 2003
The Emergent Group
Newly Posted Press Releases
(Post Yours!)
Alexander Hamilton Institute Releases New Free Report-- "Discipline Done Right"
(Alexander Hamilton Institute)
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