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November 18, 2003 - 8,712 subscribers
Today's sponsor: EBIA's Tax Savings Calculator

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(Please visit our sponsors. We try to make sure their products and services will be of interest to you. Thanks! --Editor)
Medicare Conference Committee Reaches Agreement, Sends Bill To Congress For Consideration
On November 16, the congressional Conference Committee working on H.R. 1, the 'Medicare prescription drug and modernization' bill, approved a final agreement. Reportedly, only two of the seven Democrats on the Conference Committee--Sens. Max Baucus (Mont.) and John Breaux (La.)-were involved in the agreement. The bill will be filed and scheduled for floor consideration and final vote this week in both chambers of Congress, according to a spokesperson for Sen. Bill Frist (Tenn.). (Spencer Benefits Reports)

Summary of Medicare Conference Agreement
Excerpt: "A document from the House Ways and Means Committee that summarizes and agreement reached by Congressional leaders and conferees on Medicare prescription drug legislation." (ERISA Industry Committee (ERIC))

Drug Companies, Insurers Stand to Benefit from Medicare Bill Passage
Excerpt: "Pharmaceutical companies, health insurers and their shareholders would become 'big winners' if Congress passes a Medicare bill that would provide a prescription drug benefit for beneficiaries, USA Today reports." (KaiserNetwork.org)

AARP Gives Republican Medicare Bill Its Blessing
Excerpt: "Congressional Republicans' drive to redesign Medicare gained momentum yesterday when the nation's preeminent organization representing older Americans strongly endorsed the legislation. But the battle over the bill, which would add prescription drug benefits to the program, escalated as nearly all the Democratic presidential candidates, plus leading Senate Democrats, denounced the plan." (Washington Post)

Opinion: Medicare Monstrosity
Excerpt: "It's said that a camel is a horse designed by committee. But the camel metaphor doesn't do justice to the Medicare prescription drug bill that came out of a House-Senate conference over the weekend. It is not a compromise but a weird combination of conflicting policy preferences." (E. J. Dionne Jr. in the Washington Post)

The Battle Over Benefits
Excerpt: "The cost of health care is strangling companies, prompting strikes and leaving an increasing number of Americans without any coverage at all. Some companies are coping, but experts fear that a sick system will have to come close to collapse before there is reform." (Workforce.com)

Overview: Senate Delays Action on Enhanced Mental Health Parity Bill Until Next Year
Excerpt: "The Senate almost surely will pass S. 486 if and when it comes up for a vote. (In addition to Senators Domenici and Kennedy, the bill has 65 cosponsors.) But the House is another matter." (Deloitte's Human Capital Advisory Services)

U.S., Canada to Sign Imported Drug Enforcement Pact
Excerpt: "In an effort to curb imports of drugs from Canada, Commissioner Mark McClellan of the US Food and Drug Administration is expected to sign a cooperation agreement in Ottawa today with his Canadian counterparts for enforcement on both sides of the border." (The Boston Globe)

Green Light for COBRA Lawsuit Against Administrator and Plan Although Employer Was in Bankruptcy
Buchanan v. Golden Casting Corp. Hourly Health Benefit Plan (S.D. Ind. 2003). Excerpt: " This decision was a narrow one, focusing only on whether the lawsuit could continue despite the employer's bankruptcy." (Employee Benefits Institute of America (EBIA))

Health Care Claim Appeals Are Not Subject to HIPAA's Standard Transactions Rules
Excerpt: "EBIA Comment: This conclusion is not surprising, but is helpful to have CMS confirm that a health care claim appeal submitted by a provider is not subject to the EDI standards. (The EDI standards would not apply to claims or claim appeals submitted by participants.)" (Employee Benefits Institute of America (EBIA))

Medem Named "Best-Kept Secret" by U.S. News & World Report
Excerpt: "Medem, the secure physician-patient network featuring clinical information of the AMA and other medical societies, has been named a 'best-kept secret' in online health by the magazine U.S. News & World Report.... This service allows physicians to communicate securely with patients, providers, hospitals and others in the health care profession." (American Medical Association)

Errata: the Relationship Between Technology Availability and Health Care Spending
Excerpt: "A corrected PDF was posted on [the Health Affairs] site on November 17, 2003. If you previously downloaded the PDF of this paper, [you should] download an updated PDF." (Health Affairs)

COBRA Information Provided During Phone Call Served as COBRA Election Notice
Heebner v. Nationwide Mut. Ins. Co. (E.D. Pa. 2003). Excerpt: "Although the employer prevailed in this case, we caution plan administrators against relying on an oral COBRA election notice, whether provided by telephone (as in this case) or in person. As the court noted, the COBRA statute does not expressly require that COBRA election notices be in writing. But, as a practical matter ..." (Employee Benefits Institute of America (EBIA))

Workers' Compensation Carrier Could Disclose Health Information Pursuant to HIPAA Privacy Rules
Hutton v. City of Martinez (N.D. Ca. 2003). Excerpt: "EBIA Comment: The court's discussion of when protected health information may be disclosed in response to a subpoena or discovery request is straightforward and not unusual. What seemed unusual to us was for a workers' compensation carrier to object under the privacy rules to producing health information. Workers' compensation carriers generally are not 'covered entities' under the privacy rules ..." (Employee Benefits Institute of America (EBIA))

Change-of-Beneficiary Form Delivered After Participant's Death Was Not Effective
Life Ins. Co. of North America v. Leeson (6th Cir. 2003). Excerpt: "The question was whether the change-in-beneficiary form was effective under the terms of the policy. The policy provided that 'The Insured may change the beneficiary at any time by giving written notice to the Employer or the Insurance Company ... No change in beneficiary will take effect until the request is received by the Employer or the Insurance Company.'" (Employee Benefits Institute of America (EBIA))

Study Finds Lack of Organized Processes to Improve Quality in Chronic Disease Management
Excerpt: "Despite growing evidence that the use of organized care management processes for chronic illnesses is effective, most physicians use few and 15 percent use none, according to a study recently published in the Journal of the American Medical Association." (The Robert Wood Johnson Foundation)

CMS To Address Issue of the Uninsured After Passage of Medicare Bill, Agency Official Says
Excerpt: "CMS plans to address the issue of the uninsured next year after Congress passes a final Medicare bill, Thomas Barker, a senior advisor at the agency, told about 200 health care leaders at Des Moines University on Thursday, the Des Moines Register reports." (KaiserNetwork.org)

Opinion: It's Time for Universal Healthcare Vouchers
Excerpt: "What we need is a fair proposal that is simple, efficient and appealing to disparate constituencies. For more than a decade, as members of the medical and economics communities, we have advocated such an alternative: universal health care vouchers." (Ezekiel J. Emanuel and Victor R. Fuchs in the New York Times; one-time registration required)

Opinion: Your Doctor's Drug Problem
Excerpt: "[D]octors are taught about drugs by agents of the pharmaceutical industry, which works hard to persuade them to select the newest and most expensive medications -- even in the absence of scientific evidence that they are any better than older, less costly ones." (Arnold S. Relman in the New York Times; one-time registration required)


Newly Posted or Renewed Job Openings
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Health & Welfare Associate
for Towers Perrin
in CA, MA, TX

Project Manager-CCI
for Transamerica- The Winning Organization
in CA

Benefits Analyst - Integrated Disability Benefits
for Global Professional Services Firm
in CA

ERISA Attorney
for The412iCompany
in WA

Retirement Program Administrator
for City of Southfield - Fire & Police Retirement System Board
in MI

Retirement Plan Sales Consultant
for Invesmart, Inc.
in OR
Newly Posted Events

ERISA's Fiduciary Requirements in Today's Investment Turmoil: The Enron Decision and Mutual Fund Misconduct -- A 90-Minute Interactive Audio Conference
Nationwide on December 12, 2003
presented by Thompson Publishing Group, Inc.

Fourth Annual Intercompany LTCI Conference
in Texas on February 8, 2004
presented by Society of Actuaries
Newly Posted Press Releases
(Post Yours!)

PRG Opens Office in Seattle, Washington
(Pension Resource Group)

Employee Participation in 401(k) Plans Declines for Second Year
(PLANSPONSOR)

CalPERS Terminates Contracts with Putnam Investments
(Public Employees' Retirement System (CalPERS))

Council Survey Warns: 'Hard and Fast' Rule Could Adversely Affect Retirement Plans
(American Benefits Council)

Medicare, Prescription Drug Reform Bill Represents Historic, Positive Achievement
(American Benefits Council)

PSCA, Along with Others, Urges SEC to Avoid Unintended Consequences When Addressing Mutual Fund Problems
(Profit Sharing/401(k) Council of America (PSCA))
Movers and Shakers: Newly Posted Announcements of Promotions and New Personnel
(Post Yours!)

Evan Dallas, David Huffaker and Scott Shinn (Pension Resource Group)


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