| The BenefitsLink Newsletter - Welfare Plans Edition |  |
July 11, 2001
Today's sponsor: EBIA's HIPAA & Other Federal Mandates for Group Health Plans (click)
Written by two leading employee benefits attorneys, HIPAA & Other Federal Mandates for Group Health Plans is the authoritative HIPAA resource for employers, administrators and advisors. In addition to HIPAA, this 772-page manual covers a wide array of other federal mandates that group health plans must worry about. HIPAA & Other Federal Mandates has all the information you need to bring your group health plans into compliance with HIPAA and other federal mandates. Click to order!
HMO Doesn't Have to Pay for Viagra
Excerpt: "The state Department of Managed Health Care had required Kaiser Permanente to provide coverage of Viagra and other sexual-dysfunction drugs. However, Superior Court Judge Lloyd Connelly said state law didn't require health plans to cover all prescription drugs, or to provide drugs for conditions not covered by health plan members' insurance contracts." (Associated Press)
Judge: Viagra Coverage Not Mandatory
Excerpt: "In a ruling that may affect prescription coverage at every HMO in California, a Sacramento Superior Court judge has ruled that state regulators cannot force Kaiser Permanente to pay for Viagra." (Sacramento Bee)
July/August Health Affairs Focuses on Consumers and Managed Care
Includes 'Consumers Versus Managed Care: The New Class Actions,' 'Parity Or Insurance Mandate? The Case For Mental Health Parity In Kansas,' 'Full Parity: Steps Toward Treatment Equity For Mental And Addictive Disorders." (Health Affairs)
PWBA Delays Applicability Date of Claims Procedures Rules For Group Health Plans Only
The Department of Labor's Pension and Welfare Benefits Administration (PWBA) has delayed 'for at least six months and not more than one year' the applicability date for its final regulations under ERISA Sec. 503 governing benefit claims procedures of group health plans. Notice of the delay was published in the July 9 Federal Register. (Spencernet)
Census Bureau Discounts Big Rise in Number of Same-Sex Couples
Excerpt: "One reason that there appeared to be a big increase in households with same-sex partners in the 2000 census is that in 1990 the government had placed many of those homes in the married-couple category, the Census Bureau said [Wednesday, July 10]." (New York Times; free registration required)
Four-Year Battle Over Patients' Rights Reduced to Money
Excerpt: "The four-year battle over patients' rights legislation has been narrowed down to the common Washington denominator: money. Lawmakers and lobbyists are arguing over how much a health maintenance organization should have to pay for wrongly denying care." (Knight Ridder/Tribune)
Bush Makes Case for Limits on Patients' Rights
Excerpt: "Bush hopes to convince the public that he is sensitive to patients' concerns, aides said. He also is eager to convey the logic behind his opposition to the lawsuit provision, which he believes would drive up health care premiums and jeopardize coverage for as many as 1 million Americans." (Knight Ridder/Tribune)
Ways and Means Committee Schedules Patients' Rights Hearing for July 16
Excerpt: "This hearing will focus attention on the major legislative alternatives before the House concerning patient protections in managed care. The hearing will explore whether common ground can be found on enforcement, and whether the House can pass legislation that will be signed into law." (U.S. House of Representatives, Committee on Ways and Means)
Bush Strikes a Positive Tone on Patients' Rights Legislation
Excerpt: "President Bush implored Congress [on Wednesday July 9] to pass and send him a patients' bill of rights that addresses his concern for limiting lawsuits, portraying himself as a proponent of -- and not an obstacle to -- legislation that most Americans support." (New York Times; free registration required)
Opinion: Patients Bill of Rights Helps, But Congress Must Do Much More
Excerpt: "It was three and half years ago that Helen Hunt brought cheers from movie audiences across the country when she spat out a string of expletives with the acronym 'HMO' nestled in the middle of it. She got the Academy Award for Best Actress ('As Good As it Gets'), and the industry's image has continued to slide downhill." (The [Bergen County, N.J.] Record)
HMO Decides to Reward Patient Satisfaction, Not Cost-Cutting
Excerpt: "Wait a minute. You mean to tell me that quality of care wasn't my HMO's first priority all along? In a major policy shift, Blue Cross of California announced Tuesday that it will link the bonuses it gives to physicians groups to patient satisfaction instead of to effective cost-cutting." (Time.com)
In a Shift, an H.M.O. Rewards Doctors for Quality Care
Excerpt: "Blue Cross of California, one of the nation's largest health insurers, announced yesterday that it would pay bonuses to doctors serving its health maintenance organization members based on patient satisfaction and other quality standards. It will also stop paying extra to physicians with the best cost-cutting records." (New York Times; free registration required)
Calif. HMO Abandons Cost-control Driven Incentives
Excerpt: "California's third-largest health management organization said Tuesday that it has scrapped an incentive system that rewarded physicians for controlling costs and will link their compensation to patient satisfaction instead, a sharp break with industry practice." (Reuters via Excite News)
Gauging Stress of Balancing Work, Family
Excerpt: "And according to a recent survey of 1,003 adults by the Families and Work Institute in New York, nearly one-third of American workers feel overworked. When you factor in parental responsibilities, stress levels rise." (Chicago Tribune)
Alert: U.S. Compensation and Benefits News Brief
Excerpt: "Our July 2, 2001 issue includes the following topics: Final Internal Revenue Service regulations on pension asset transfers to health accounts; IRS warns small business employers against not withholding on wages; Department of Labor opines on welfare fund's tax 'gross up' for domestic partner benefits; Brehner legislation would allow employer-provided investment advisors." (Andersen)
The Big Dogs Eat Fois Gras
Excerpt: "Don't look now but the political weather is changing, and it's moving to the left. The clearest indication is the July 2 Fortune magazine cover. It pictures Apple Computer's Steve Jobs and announces a special report: 'Inside the Great CEO Pay Heist.'" (Scott Burns of The Dallas Morning News)
Newly Posted or Renewed Job Openings (Post Yours!)
| Account Manager | for Benefit Plan Services, Inc. in GA |
| Pension Administrator | for Means & Associates, LLC in CA |
| Employee Benefits Administrator | for Kidder Benefits Consultants, Inc. in IA |
| Retirement Plan Services, VP | for Meeder Financial in OH |
| Senior Manager/Practice Leader-Compensation and Benefit Consulting | for Retained Executive search firm in NY |
| Defined Contribution Client Account Manager | for New York Life Benefit Services, LLC in MA |
| Employee Benefits Consultant | for Fidelity Investments in TX |
Newly Posted Webcasts (Post Yours!)
| Securing Executive Benefits | on July 18, 2001 presented by Clark Bardes Consulting - Compensation Resource Group |
Newly Posted Press Releases
| FIRST TRUST CORPORATION NAMES MANAGER OF QUALIFIED PLANS GROUP (FIRST TRUST CORPORATION) |
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