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April 3, 2003 - 8,085 subscribers
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States Can Force HMOs to Accept Any Qualified Doctor
Excerpt: "States can require managed health care plans to accept any qualified doctor who wants to be a participating provider, the Supreme Court ruled today in a unanimous decision that resolved a significant legal dispute about state health care regulation." (New York Times; one-time registration required)
Full Text: Supreme Court Unanimously Upholds Kentucky's 'Any Willing Provider' Law Despite ERISA Challenge (PDF)
14 pages; Kentucky Association of Health Plans, Inc., et al. v. Miller, Commissioner, Kentucky Department of Insurance. Excerpt: "Kentucky law provides that '[a] health insurer shall not discriminate against any provider who is located within the geographic coverage area of the health benefit plan and who is willing to meet the terms and conditions for participation established by the health insurer, including the Kentucky state Medicaid program and Medicaid partnerships.'" (U.S. Supreme Court)
Washington Post Coverage of 'Any Willing Provider' S. Ct. Decision
Excerpt: "[T]here was disagreement over the practical effect it would have on the health care system. Some experts said it would have little immediate impact, in part because of changes in the industry since the Kentucky enacted the law in 1994." (Washington Post)
NPR Coverage: High Court Gives States New Powers over HMOs
Audio report. (National Public Radio)
Health Plans Association Releases Statement on S. Ct. 'Any Willing Provider' Decision
Excerpt: "Today's ruling by the U.S. Supreme Court changes little in the current health care delivery system. In the nine years since Kentucky's 'any willing provider' legislation was passed, insurers responded to consumer demands, offered more product choices and built a higher quality health care system." (American Association of Health Plans)
Kentucky Association of Health Plans Expresses Disappointment at Losing S. Ct. Case
Press release. Excerpt: "The case was not a referendum on Any Willing Provider, but a procedural issue with respect to whether state law or federal law governs in this area. 'Today's ruling upholds Kentucky's current law, however, government mandates, such as Any Willing Provider are restrictions that prevent consumers from being offered affordable insurance options,' said Melodie Shrader, executive director of the Kentucky Association of Health Plans." (PRNewswire via Yahoo! Finance)
Industry Says S. Ct. Decision Won't Set Back Managed Care
Excerpt: "Insurance industry officials said yesterday that they would not let a Supreme Court decision on health plans hobble managed care, but some industry experts said the ruling was part of trend that is shrinking the role of insurers." (New York Times; one-time registration required)
S. Ct. Case Won't Affect Minnesota, Other States Without 'Any Willing Provider' Laws
Excerpt: "An effort to pass such a law in Minnesota failed in 1998, in part due to a barrage of opposition from health plans and business groups, which argued that provider networks were a way to keep costs down ... Yet provider choice has become somewhat of an outmoded issue because many health plans already have opened up their provider networks due to past consumer demand." (TwinCities.com)
Connecticut Weighs 'Any Willing Provider' Decision
Excerpt: "A decision by the U.S. Supreme Court that upheld a Kentucky law requiring health maintenance organizations to pay for out-of-network services may result in a renewed push for similar legislation in Connecticut." (The [Bridgeport] Connecticut Post via NewsAlert.com)
8th Circuit: Ending COBRA Coverage Due to Insurer Switch Improper
Excerpt: "When an employer/plan administrator switched insurers, it and/or other plan fiduciaries still had the duty to ensure that the COBRA coverage of existing qualified beneficiaries was maintained, according to the 8th U.S. Circuit Court of Appeals." (Thompson Publishing Company)
Another Attempt Made to Exempt Religious Groups from Domestic Partner Benefit Requirement
Excerpt: "A Portland city councilor has resurrected a proposal to exempt religious groups from an ordinance that requires them to offer benefits to their employees' domestic partners in order to receive federal grants through the city." (The Portland [Me.] Press Herald)
Rising Health Costs Putting Some Retirees on Edge
Excerpt: "Lobbying to upgrade living standards for retired General Electric workers, Kevin Mahar, a representative from Dow's union, Local 201 of the International Union of Electrical Workers, and other union officials will meet today with the company to ask for pension increases." (The Boston Globe)
United Auto Workers Chief Says National Healthcare Program Required
Excerpt: "The head of the United Auto Workers put automakers on notice Monday: You can't stem rising health-care costs by shifting the burden to workers and retirees. The auto industry alone can't solve 'America's health care crisis.'" (Detroit Free Press)
LTC Insurance Plans Gaining Acceptance, Study Shows
Excerpt: "The study indicates that interest in LTC coverage is broad. ACLI found that both white- and blue-collar employees are enrolling in employer-sponsored plans. It also found that interest in LTC insurance spans public- and private-sectors employers." (Thompson Publishing Company)
Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy?
Excerpt: "[This] report looks at how many working-age families can afford LTCI, whether it is a sensible investment for people who are decades away from requiring long-term care, and how LTCI policies can be made more flexible, to keep pace with changes in long-term care delivery and financing." (The Henry J. Kaiser Family Foundation)
Newly Posted or Renewed Job Openings
Retirement Services Internal Wholesaler
for Transamerica-The Winning Organization
in CA
Senior Account Manager
for Local Pension Administration Firm - Houston, Texas
in TX
Newly Posted Conferences
(Post Yours!)
Plan Compliance and Corporate Governance: Issues and Solutions
in CA
April 24, 2003
Western Pension & Benefits Conference - Orange County Chapter
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