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March 29, 2005
Today's sponsor: Hay Group, Inc.

(Click on company name or banner to learn more.) 

Free Hay Group Web Seminar on Medicare Part D
Are you ready for the changes taking place later this year? Let Hay
Group's actuarial consultants help you decide how best to take
advantage of the Medicare Part D prescription drug program.
Register today for a free 1-hour web seminar, which explains,
in plain English, if your retiree plan qualifies for the federal
subsidy, what your options are, and how much you can expect to
save. Deadlines are rapidly approaching.
For more information go to:
http://www.haygroup.com/expertise/commitment/medicare_part_d.asp

(Please visit our sponsors. We try to make sure their products and services will be of interest to you. Thanks! --Editor)
Text: CMS Procedures for Non-Privacy Administrative Simplification Complaints Under HIPAA (PDF)
3 pages. Excerpt: "On March 25, the Centers for Medicare and Medicaid Services (CMS) published a Notice in the Federal Register regarding its HIPAA enforcement procedures. The notice sets forth the procedures for filing with the Secretary of Health and Human Services (HHS) a complaint of non-compliance with HIPAA Administrative Simplification provisions (except privacy). It also describes the Department's procedures in reviewing the complaints." (Federal Register via HIPAAdvisory.com)

Judges Question HIPAA Medical Privacy Rule: Sharing of Patient Information Considered by Court
Excerpt: "Patients, doctors, lawyers and judges are still struggling to understand the federal patient-privacy rule, which was the subject of a spirited appeal before the court's three-judge panel in Philadelphia [March 9, 2005]. Does it provide 'broad protections' for patients wanting to keep their records private, as Scarborough contends. Or does it open the gates for personal information to be widely shared without patient consent, as plaintiffs' attorney James C. Pyles insists." (The Philadelphia Inquirer; one-time registration required)

HMO Enrollment Continued To Drop In 2004, Study Finds
Excerpt: "HMO enrollment in all but one New England state continued to decline in mid-2004, according to the recently released New England Health Plan Analysis from HealthLeaders-InterStudy. HMOs' share of the commercial market declined between January and July 2004 in Massachusetts (from 65% to 62%), in Maine (from 26.9% to 23.1%), and in Vermont (from 24.5% to 24.2%); but increased slightly in New Hampshire (from 35.7% to 36.2)." (Spencer Benefits Reports)

Text: Managing Diabetes: Health Plan Coverage of Services and Supplies
36 pages. Excerpt: "GAO reviewed the extent to which (1) states require insurance policies to cover diabetes services and supplies, (2) health coverage not subject to state requirements includes diabetes services and supplies, and (3) individuals with diabetes ages 18 and older receive services and supplies. [Highlights - http://www.gao.gov/highlights/d05210high.pdf]" (Government Accountability Office)

WSJ Examines UnitedHealthcare's Physician Performance Evaluation Program
Excerpt: "The Wall Street Journal on Tuesday examined a multistate UnitedHealthcare program that allows employers to provide financial incentives to employees who visit physicians from a list selected by the company based on their ability to provide efficient and cost-effective care. According to the Journal, the UnitedHealth Performance Designation Program 'is part of a broader effort by insurers and employers to curb rising health care costs.'" (Kaiser Family Foundation)

Dow Jones/Wall Street Journal Examine Hospital Gain-Sharing Arrangements with Physicians
Excerpt: "The Dow Jones/Wall Street Journal on Tuesday examined 'an emerging trend of hospital 'gain-sharing' arrangements with physicians,' in which doctors share in savings achieved through greater efficiency in hospitals." (Kaiser Family Foundation)

Healthcare Consumers Show Little Interest in Chargemasters Under Mandated Price Disclosure Law
Excerpt: "When legislators in California enacted a law last July forcing all hospitals in the state to publish their charge-masters, or list of prices for services, they may have envisioned a rush by patients to comparison-shop. But at 655-bed Sutter Medical Center, Sacramento, not a single request for price information was made for about six months, until a reporter asked to view prices." (modernhealthcare.com)

New Hampshire Senate Passes Health Insurance Measure to Slow Increasing Costs
Excerpt: "The New Hampshire Senate on Thursday voted 17-7 to pass a bill (SB 125) that would amend the state's health insurance policies and reverse some provisions of a health insurance reform bill that increased costs and led to some insurers leaving the state, the Manchester Union Leader reports." (Kaiser Family Foundation)

Highlights of Mellon's Thirteenth National Health Care Trend Survey (PDF)
1 page. Excerpt: "Mellon's Human Resources & Investor Solutions has just released the results of its thirteenth National Health Care Trend Survey. The survey summarizes the trend factors used by 83 HMOs, Blue Cross/Blue Shield plans, health insurers and other plan administrators to project the rate of increase in employers' medical, dental, pres.cription drug, and vision plan costs for 2005." (Mellon Financial Corporation)

Pharmaceutical Industry Aims to Defeat Discount Drug Initiatives in California
Excerpt: "Facing pressure from many states to provide cheaper pres.cription drugs, the pharmaceutical industry has launched its most aggressive counterattack in California, where the issue is threatening to explode on the ballot as early as this fall." (Los Angeles Times; one-time registration required)

Illinois State Legislators Plan to Propose PBM Licensing and Disclosure Rules
Excerpt: "SB 1828 would create the Pharmacy Benefit Manager Licensure and Solvency Protection Act. The original version of the bill said this measure was to 'establish standards and criteria for the regulation, solvency, and licensing of pharmacy benefit managers.'" (DRUG BENEFIT NEWS via AISHealth.com)

N.D. Bill to Regulate Aspects of Contracts Between PBMs and Payers Generates Strong Opposition
Excerpt: "A pending North Dakota bill seeking to regulate certain aspects of contracts between Pharmacy Benefit Managers and payers is generating strong opposition from both the federal government and the PBM industry. On March 8, three Federal Trade Commission (FTC) bureaus urged North Dakota legislators to refrain from adopting House Bill 1332, saying it would 'limit a PBM's ability to reduce the cost of pres.cription drugs without providing consumers any additional protections.'" (DRUG BENEFIT NEWS via AISHealth.com)

A Benefit-Based Copay for Pres.cription Drugs: Patient Contribution Based on Total Benefits (PDF)
7 pages. Excerpt: "For any given drug, patients with a high potential benefit would have lower copays than patients with a low potential benefit. Implementation of such a system would provide a financial incentive for individuals to prioritize their out-of-pocket drug expenditures based on the value of their medications, not their price." (The American Journal of Managed Care)

Personal and Portable Health Insurance -- Health Insurance You Take with You
Excerpt: "John Goodman, the father of health savings accounts, has embarked on another crusade. He wants a new form of corporate medical insurance that goes with employees who leave their jobs or get fired." (The Dallas Morning News; one-time registration required)

Commentary and Background Links on Recent District Court Ruling on Retiree Health Benefits
Excerpt: "Almost a year has gone by since the EEOC originally announced its approval of a proposal to allow employers to coordinate retiree health benefit plans with eligibility for Medicare or a comparable state health benefit without violating the ADEA. Since that time, AARP filed suit seeking a preliminary injunction to stop the agency from issuing the proposed rule. The plaintiffs in AARP v. EEOC, No. 2:05-cv-00509, argued that the EEOC had exceeded its statutory authority to implement ...." (Attorney B. Janell Grenier via BenefitsBlog.com)

Health Savings Accounts Get Noticed by Families and Low-Income People
Excerpt: "High-deductible health insurance policies eligible for linking with tax-free savings accounts through a new federal program have attracted more families and low-income people than had been expected, a new study concludes. Almost half the purchasers of policies eligible for coupling with Health Savings Accounts were families and 40 percent had incomes of $50,000 or less, according to the study, which was conducted by ehealthinsurance.com, ...." (The Wichita Eagle via Council for Affordable Health Insurance)

Links to Items on Executive Comp, Benefits in General

Overview: 10 Critical Steps to SFAS 123R
Excerpt: "Now that the Financial Accounting Standards Board (FASB) has mandated that public companies must expense stock option grants for financial reporting periods after June 15, 2005, companies need to prepare, advises compensation consulting firm Pearl Meyer & Partners." (SmartPros Ltd.)

Newly Posted Events

Managing Law Firm Benefit Plans - Emerging Trends and Best Practices in Benefit Planning and Design
in California on April 20, 2005
presented by ArlenGroup

Sexual Harassment? 401(k) Plan Headaches? Payroll Tax Problems?
in District of Columbia on April 5, 2005
presented by Swidler Berlin LLP

Newly Posted Press Releases

Benefit Software Inc. Helps Insurance Firms Provide Value-Added Benefit Communication Services
(Benefit Software Inc.)

Outsourcing, Rising Health Care Costs and HSAs Highlight Media Coverage in First HR Intelligence Trend Report for 2005
(Fisher Vista)

Creating Living Will a Simple Task with ARAG Legal Plan
(ARAG)

New Harris Rothenberg White Paper Helps Employers Get Their Money’s Worth Out of EAP and Work/Life Programs
(Harris, Rothenberg International (HRI))

Countdown to SFAS 123R! 10 Critical Steps Companies Should Take Today
(Pearl Meyer & Partners)

Movers and Shakers: Newly Posted Announcements of Promotions and New Personnel
(Post Yours!)

Margaret Verna
(Pension Resource Group)

Newly Posted or Renewed Job Openings
Post a Help Wanted Ad

401(k) Plan Administrator
for Matthews Benefit Group, Inc
in FL

Senior Actuarial Analyst
for Conrad Siegel Actuaries
in PA

New Business Installation Administrator
for The Pension Group, Inc.
in CA

Plan Design & Document Manager
for Pension Specialists, Inc.
in CA

Pension Administrative Assistant
for North Dallas TPA Firm
in TX

Retirement Plan Service Coordinator
for Mammini Company
in CA

Plan Administrator
for Capital Investment Advisory
in FL

Senior Benefits Administrator (401k)
for SUPERVALU, the industry leader in distribution and retailing in the food industry.
in MN



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