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November 9, 2004
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Patient Data-Matching Software: a Buyer's Guide for the Budget Conscious
Excerpt: "This guide documents a detailed assessment and comparison of four commercially available, moderately priced products to help budget-conscious provider organizations solve their patient data-matching needs. The patient matching task is an important and challenging step in the creation of integrated clinical databases used for disease management and quality-improvement purposes.' The 30 page guide is at: http://www.chcf.org/documents/ihealth/PatientDataMatchingBuyersGuide.pdf (California Healthcare Foundation)
Clinical Information Technology Systems Play Larger Role in Chronic Disease Care
Excerpt: "HeartPartners, which began earlier this year, includes PacifiCare Health Systems, its pharmacy-benefit management subsidiary Pres.cription Solutions, home monitoring company Alere Medical and chronic care company QMed. The three-year program, which includes patients in California and Arizona, could be offered nationwide if it is successful. Patients who participate receive free monitoring equipment in addition to a low-cost pres.cription drug plan." (California Healthcare Foundation)
Overview: Compliance Deadline for Final COBRA Regulations Approaching (PDF)
14 pages. Excerpt: "Employers who are using model notices previously issued by the DOL should switch to the new model notices. The updated model notices are somewhat simpler and more accurately reflect the final regulations. Moreover, the DOL has stated that use of the model initial notice that it issued in 1986 is no longer considered good faith compliance with COBRA. Copies of the DOL's model notices are attached to this article." (von Briesen & Roper, s.c.)
11th Circuit Court Rejects Arbitration in Physicians' Class-Action Suit on Compensation
Excerpt: "The managed-care industry lost a key appeal intended to derail a sweeping class-action lawsuit claiming that the nation's largest health insurers systemically shortchanged some 900,000 doctors. The 11th U.S. Circuit Court of Appeals in Atlanta upheld a prior ruling by U.S. District Judge Federico Moreno rejecting the insurers' argument that the plaintiffs should be forced to settle their grievances individually through arbitration, as required under their contracts." (Modernhealthcare.com)
Supreme Court Refuses to Consider Antitrust Health Insurance Case
Excerpt: "The Supreme Court said yesterday it would not consider whether health insurers violate antitrust laws when they team up with doctors to adopt reimbursement policies that siphon business from chiropractors. At issue was whether Trigon Healthcare, Virginia's largest private health insurer, illegally conspired to develop clinical guidelines that unfairly favored doctors over chiropractors." (AP via The Washington Times)
Experiences of Uninsured People with Disabilities in the Two-Year Waiting Period for Medicare (PDF)
38 pages. Excerpt: "Unlike older Americans, who typically enroll and become eligible for coverage within months of turning age 65, disabled beneficiaries must wait two years before their coverage takes effect. Many who are in the waiting period face enormous problems. In this study, researchers talked to these individuals in focus groups and through in-depth telephone interviews." (The Commonwealth Fund and Christopher Reeve Paralysis Foundation)
Unscheduled Absenteeism Soars; Reasons and Solutions Vary
Excerpt: "Unscheduled absenteeism climbed to a five-year high of 2.4 percent in 2004--up from 1.9 percent in 2003--but it may not mean that employees are sick more frequently, according to the 14th annual CCH Unscheduled Absence Survey. 'There is a trend, and there has been for years, of people calling in at the last minute even though they knew weeks in advance that they needed to be away,' said Lori Rosen, CCH workplace analyst and author of HR Networking: Work- Life Benefits (CCH Inc., 2004)." (Society for Human Resource Management)
Web Site: State of Maine Healthcare Quality Forum
Excerpt: "In 2003 Governor Baldacci and your Maine Legislature created the Maine Quality Forum, as an independent division of Dirigo Health, to continue Maine's leadership in assuring high quality healthcare for its citizens. The Maine Quality Forum's mission is to advocate for high quality healthcare and help each Maine citizen make informed healthcare choices." (Dirigo Health Agency)
Docs Urged to Collect Fees -- Co-Payments and Deductible Payments -- Up Front
Excerpt: "The CEOs of the Tri-State's largest health insurers -- Anthem, Humana and UnitedHealthcare -- say doctors should be demanding co-pay and deductible payments from their patients, especially as consumers become responsible for a larger portion of the cost of care. Physicians, who once received most of their pay from insurance companies and government-run health plans such as Medicare, are now forced to collect more of their fees directly from patients." (MSNBC News)
Federal Workers Offered Catholic-Run Health Plan in 27 Illinois Counties
Excerpt: "Federal workers in 27 Illinois counties as of yesterday may enroll in a Catholic-run health insurance plan that does not cover abortions and contraceptives, and limits coverage of fertility treatments. The program is the first such national plan offered to federal employees. Although it is anticipated that most of the subscribers will be Catholics, there is no religious requirement for participation. 'This insurance plan is moving in the right direction ..." (The Washington Times)
Health Plans Expand With New Alternatives by Offering Acupuncture, Other Therapies Coverage
Excerpt: "As many people make choices about health insurance this fall, programs offering alternative therapies such as acupuncture and massage are growing in popularity. Employers say such therapies are popular with many workers, and some companies believe that providing access to alternative treatments may help curtail rising medical costs and help recruit and retain employees." (Los Angeles Times; one-time registration required)
White Paper: Encouraging a Responsible Approach to Consumer-Driven Health Care
Excerpt: "This white paper is the culmination of a colloquium sponsored by McDermott Will & Emery LLP on May 21-22, 2004 in Key Biscayne, Florida. It reflects the opinions and recommendations of the members of McDermott's Advisory Board on Consumer-Driven Health Care (CDHC).' Sign up is required to download the 38 page paper. (McDermott Will & Emery LLP)
U.S. Congress May Be the Next Battleground in Efforts to Cover the Millions Uninsured
Excerpt: "[M]any in the medical industry believe Congress will breathe new life into other efforts to extend coverage to the working uninsured. A powerful business lobby led by retail and restaurant organizations ... is looking to the Bush administration and the Republican-controlled Congress to cover uninsured workers through a combination of trade association health plans, tax credits and medical savings accounts." (The Sacramento Bee)
Another Shot at Reform: Washington State Still Has Hope After California Defeats Proposition 72
Excerpt: "Even as California's healthcare community mourned last week's defeat of Proposition 72, the razor-thin margin on the sweeping health insurance mandate gave hope to advocates in at least one other state with plans for a similar measure.... Meanwhile, a coalition of consumer groups, providers, businesses and labor in Washington state plan to introduce a near-identical 'pay or play' bill during the state's next legislative session, which begins in January." (Modernhealthcare.com)
Washington Health Policy Week in Review -- November 8, 2004
This issue includes: Election Results May Revive GOP Health Initiatives, Use of Medicare Claims to Profile Doctors Politically Touchy, Medical Malpractice: Front and Center, From CQ Today: Hill Newcomers Seek Impact on Health, Patient Safety Efforts Get a C+ in Wake of Landmark Study, and Report Finds Coverage Gaps Persist Among Latino, Black and White Americans. (CQ HealthBeat via The Commonwealth Fund)
Links to Items on Executive Comp, Benefits in General
Revised November 2004 -- National Compensation Survey: Employee Benefits in U.S. Private Industry (PDF)
17 pages. Excerpt: "The 2003 NCS benefits survey obtained data from 2,924 private industry establishments, representing nearly 102.2 million workers; of this number, nearly 79 million were full time workers and the remainder--slightly more than 24 million--were part-time workers. The NCS uses the establishment's definition of full- and part-time status to classify workers." (U.S. Department of Labor, Bureau of Labor Statistics)
Overview: American Jobs Creation Act of 2004 Limits the Deductibility of Entertainment Expenses
Excerpt: "Section 907 of the American Jobs Creation Act of 2004 (AJCA), which was signed by the President on October 22, 2004, has overturned the favorable result in Sutherland Lumber-Southwest Inc. v. Comr.... (2000), and in CCA 200344008, both of which permitted the full amount of employer provided air travel expenses to be deducted under §274(e) so long as the corresponding compensation income was included by employees (for the value of the air travel benefit received by them)." (BNA's Tax Management Inc)
Possible Lineups for Committee Chairmen in the Next Congress
Excerpt: "Possible lineups for House and Senate committee chairmen in the next Congress now that Republicans have expanded their majorities in both chambers." (AP via SFGate.com)
Senate Committee Chairmanships Set to Change -- Possible Effects on Social Policies
Excerpt: "[T]he elections coincide with turnover among Senate committees under relatively new rules ... Sen. Thad Cochran of Mississippi, for example, already is slated to take over the Senate Appropriations Committee, and if Gregg were to take the Budget Committee chairmanship as now expected, Sen. Michael Enzi, a Wyoming accountant with an interest in pension legislation, would likely succeed him as chairman of the Senate Health, Education, Labor and Pensions Committee." (Wall Street Journal via Seacoast Online)
Judge Rules New York City's Bloomberg Must Carry Out Equal Benefits Law He Vetoed
Excerpt: "State Supreme Court justice ruled yesterday that the administration of Mayor Michael R. Bloomberg must carry out a law requiring companies that do business with the city to extend the same benefits to employees' domestic partners that they provide to spouses. The city had vigorously fought the Equal Benefits Law, arguing it would prove costly to taxpayers because it would limit its ability to select low-cost bidders for city work." (The New York Times; one-time registration required)
Opinion from Steve Forbes: Sweeping Changes Ahead in Social Programs and Tax Code
Excerpt: "Steve Forbes ... sees some major changes in Medicare, Social Security, Federal tax code and personal savings accounts with the re-election of President Bush and the increase in the Republican majority controlling Congress.... Individuals should expect to be given a choice between Medicare or new health care savings accounts (HSA).... Initially a hybrid system would exist, consisting of both programs, as Medicare is phased out." (The City Paper, LLC)
Opinion: the Risk Society or the Ownership Society? Social Insurance Plans Could Be Dismantled
Excerpt: "[W]hat the President has in mind is nothing less than a radical overhaul of America's entire system of social insurance. In place of unwieldy government programs run by busybody bureaucrats, Bush wants Americans to have more independence and more choices regarding their health care, their savings, and their retirement. Social Security would be partially privatized, with people allowed to put aside money in individual accounts. Private health-insurance plans would compete ..." (The New Yorker)
Newly Posted Press Releases
ICC Plan Solutions Now Offers Print-On-Demand Enrollment Books with Binding
(Metrics Partners)
American Express® Individual(k) Introduced for Small Business Owners
(American Express Retirement Services)
American Express Adds New Stock Option Education Feature To Executive Financial Education Program
(American Express Retirement Services)
Plan Sponsors and Participants Gain Advantage with Latest CPI Internet Enhancements
(CPI Qualified Plan Consultants, Inc.)
Newly Posted or Renewed Job Openings
Director - Client Investment Services
for Diversified Investment Advisors
in ANY STATE
Client and Participant Services Manager - US Outsourcing
for Mercer Human Resource Consulting
in MA
Team Leader - US Outsourcing
for Mercer Human Resource Consulting
in MA
Data Consultant
for Fidelity Investments
in MA
Account Executive
for Transamerica
in PA
Benefits Manager
for Providian Financial
in CA
Pension Administrator
for Actuaries Unlimited, Inc.
in CA, NV
Senior Special Projects Actuary
for Nyhart
in IN
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