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CBO Says Federal Health Care Costs Skyrocketing
"Healthcare programs are quickly outgrowing their historical share of the federal budget, CBO said, and the cost of those programs will only grow faster as more Baby Boomers reach retirement and underlying healthcare costs continue to soar.... Federal spending on major healthcare programs will reach 6.3 percent of gross domestic product by 2020, CBO said -- up from 4.7 percent this year, and far outstripping a 40-year average of just 2.7 percent."
(The Hill)
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16 Items to Consider Before Renewing Self-Insured Health Benefits Agreements
"Many self-insured employers are reviewing annual agreements for 2013 benefits. While not exhaustive, this quick checklist can serve as a handy reference before you sign on the dotted line. [Among the topics are:] Price and performance guarantees ... Claim audits ... Carve-out pricing ... Implementation and data transmission ... Pharmacy ... Network ... Capitation ... Disease, case management and nurse access ... Subrogration and shared savings ... Wellness ... Stop-loss[.]"
(Employee Benefit News)
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Republican Governors Scramble Over Next Obamacare Steps
"They have three choices. States can run their own insurance marketplace, using federal funding to set up the technology to allow consumers to compare and purchase health plans. They can leave the task to the federal government. Or, they can do something in between: A 'partnership' model allows state and federal governments to divvy up the responsibilities."
(The Washington Post; free registration required)
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Some States Must Play Catch-up on Health Overhaul
"State officials who held off implementing some aspects of the 2010 Affordable Care Act now face pressure to make decisions almost immediately. They have nine days to advise the federal government how they plan to manage state-run exchanges created by the law to provide medical coverage to the uninsured, or face a de facto U.S. takeover of their insurance markets."
(Treasury & Risk)
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The Outlook for Health Care Reform in Two Maps
"To a large extent, the success of the health overhaul lies in how many of the nation's uninsured get coverage. And that is largely in the hands of the states, which have been all over the map in their willingness to cooperate. [The authors of this article] mean that literally. The maps here show the lack of consensus on two key parts of the act: Creating insurance exchanges and expanding Medicaid."
(ProPublica)
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Curbing Costs, Improving Care: The Path to an Affordable Health Care Future (PDF)
"This document presents a seven-point strategy, accompanied by 50 specific, actionable policy recommendations. The elements of that strategy are as follows: 1. Change provider incentives to reward value, not volume; 2. Encourage patient and consumer engagement; 3. Use market competition to increase value; 4. Ensure that the highest-cost patients receive high-value, coordinated care; 5. Bolster the primary care workforce; 6. Reduce errors, fraud, and administrative overhead; and 7. Invest in prevention and population health. This strategy and the accompanying recommendations are designed to achieve two related, but distinct objectives: (1) reduce the impact of health care costs on the federal government's short-term (ten-year) fiscal balance and (2) simultaneously build a health system that is sustainable and affordable over the long term."
(National Coalition on Health Care)
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Results of Ballot Initiatives Challenging Certain Health Reforms, 2012
"[This November, five states voted on measures] to establish a formal state position, challenging or disagreeing with provisions in PPACA.... [R]esults were as follows: (1) Alabama: Constitutional amendment to 'Prohibit Mandatory Participation in any Health Care System' Passed with 59.0% Yes votes. (2) Florida: Constitutional amendment to 'prohibit laws or rules from compelling any person or employer to purchase, obtain, or otherwise provide for health care coverage.' Failed, with 48.5% Yes votes. (3) Missouri: State law change, 'Prohibiting a State-Based Health Benefit Exchange.' Passed with 61.8% Yes votes. (4) Montana: State law change to 'Prohibit Health Insurance Purchase Requirement.' Passed with 67.1% Yes votes. (5) Wyoming: Constitutional amendment titled 'Health Care Freedom.' Passed with 76.9% Yes votes."
(National Conference of State Legislatures)
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[Opinion]
What Does the Election Mean for Efforts to Revise Obamacare?
"Thus far, we have seen revelations of increasing costs, higher taxes, and a flood of directives from Washington bureaucrats -- yet there are countless major features of the law that have not been decided. Just a few of the questions that remain: What will a qualified health plan look like? What will be in the essential benefits package that insurers are required to provide? How will the employer and individual mandates to purchase insurance be implemented? The list goes on.... [T]here are ample reasons, as well as opportunities, to change the course of this law."
(The Heritage Foundation)
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Benefits in General; Executive Compensation
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Realized Pay: A New Approach for Measuring Executive Compensation (PDF)
"In evaluating whether or not to disclose a realized pay analysis, it is important to note that the SEC has recently cautioned companies regarding use of alternative definitions of pay in company proxy statements, which it believes, could be 'misleading to investors.' ... Even though it is currently unclear if and when a standardized definition of realized pay will be developed, investors are seeking ways to achieve uniformity of disclosure among companies to facilitate realized pay comparisons."
(Frederic W. Cook & Co., Inc.)
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Investment Advisors Sidestep Talk of Retirement Health Costs
"In [a] new survey, three out of four advisors said many of their clients don't seem to realize how crucial it is to plan for health care costs in retirement and nearly half of their do not have a plan to pay for those costs ... Some surveys have put lifelong out-of-pocket health care costs for an average 65-year-old couple at more than $200,000, not counting possible outlays for long term care."
(On Wall Street)
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Proskauer ERISA Litigation Newsletter, November 2012
"[The] lead article reviews the recent decision in Janese v. Fay, in which the Second Circuit held that the trustees of multiemployer plans act in a non-fiduciary capacity when amending the plans they administer.... [The] second article looks at the impact of the [ACA] on benefits claims under ERISA ... [and] considers two open issues that are likely to result in litigation: the fiduciary status of independent review organizations (IROs) established by the ACA, and the standard of judicial review applicable to those IROs."
(Proskauer Rose LLP)
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Special Benefits Apply to Federal Employees Hit by Hurricane Sandy
"Federal employees and retirees who are victims of Hurricane Sandy are eligible for several special benefits, including additional supplies of medications if needed ... The Office of Personnel Management said that fee-for-service health plans under the Federal Employees Health Benefits Program also are to relax certain restrictions such as deadlines for notifying the plan of an emergency hospital admission or treatment by a non-network provider."
(The Washington Post; free registration required)
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Press Releases
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