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Vol. 15, Nos. 1- 39, pp. 1-2046 Jan. 7 - Oct. 21, 2009 A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
HAWAII
Contract denial, plan has no claim against state for alleged violation of Medicaid Act (9th Cir.), 862
Mandated enrollment in Medicaid managed care organizations, suit proceeds against CMS and state over (D. Haw.), 622; request for temporary restraining order denied, 1031; contractors eligibility certified question, 1190 Medicare coverage for liver resection surgery performed out of plan without prior authorization, denial affirmed (D. Haw.), 1099
Centers for Medicare & Medicaid Services
Federal Coordinating Council on Comparative Effectiveness Research, members named, 335 Natl. Coordinator for Health Info. Tech.
ARRA implementation plans released, 611
Physician Blumenthal named, 336 Success, 2009 government decisions key, chief says, 562 Office of Civil Rights, HIPAA
Privacy rules modification re GINA, regulatory agenda, 589; proposed rules issued, 1152
Security rule enforcement responsibility, 916 Website revised, 181 Office of Recovery Act Coordination, created to manage economic stimulus law funds, In Brief, 311 Secretary
Sebelius nominated, 252; confirmation vote delayed, 407; MA plans may get less than fee-for-service providers, nominee says, hearing, 429
Senate panel sets Jan. 8 hearing on nominee Daschle, In Brief, 8; bipartisan cooperation promised, 33; Daschle withdrawal may delay reform efforts, 149
See QUALITY OF CARE
Accountable Care Promotion Act, bill introduced to create voluntary shared savings program with Medicare provider incentives, 740
Advertising, public policy advocacy campaign launched, 965 American Recovery and Reinvestment Act Attorneys at conference suggest employers be ready to understand and implement changes, 2013 Bipartisan Affordable Health Choices Act, proposed draft bill imposes major employer requirements, Special Report, 984 Children and older adults, needs critical, hearing, 699 Chronic illness
Care management and disease prevention key to delivery system revision, BCBS guide, 506
Treatment and prevention key focus, stakeholders meeting, 432; White House Office for Health Reform Director DeParle optimistic, 432 Comparative effectiveness research, efforts will include, seminar, 1036 Congressional action required after recess, Pallone (D-NJ) says, 182 Consensus, Baucus (D-Mont) promises effort during recess, 942 Consumer-directed plans
See generally CONSUMER-DIRECTED PLANS
Baucus (D-Mont) urges restraint, briefing, 484
Industry and business groups express concerns, hearing, 698 Cost reduction unlikely, CBO official says, hearing, 857 Delivery system, Baucus (D-Mont) and Grassley (R-Iowa) find consensus on goals but strategies differ, paper, 521; policy options to be released, 521; report issued, 554 Economic stimulus package
Baucus (D-Mont) plan outlined, 94
House package includes information technology and Medicaid funding boosts, 61 Information technology funding and COBRA assistance
Favored basis, report, 75
Mandates
Critics and supporters continue debate re reform proposals, Special Report, 1196
Efficacy challenged, study, 351 Retaining employer support, congressional leaders challenged, 787 Retention favored with cost shifting addressed, hearing, 308; Andrews (D-NJ) deems debate incomplete absent discussion of how to pay, hearing, 492 Tax exclusions for health benefits, Obama supports retention, 792
Consumer protections, President urges public support, 916
4-year delay absent success now, Grassley (R-Iowa) predicts, 333 Imperative, Obama says, forum, 279; follow-up forums set in 5 states, 279; stakeholders deem congressional flexibility key, 279 President pushes for completion as Medicare payment council is proposed, 852; Democratic senators ask insurers for billions to fund reform, 852 Senate will not pass bill by August break, 884 Timetable, Senate panel aides predict August passage, 310 Financing alternatives, Senate Finance Comm. considers elimination of medical deductions and flexible spending curb, 618; proposal defended, report, 643; panel considering options outside health sector to fund reform, 765; CBO financing options outlined, MedPAC report, 769; options analyzed, CRS reports, 773; markup delayed beyond August recess, 914; Schumer (D-NY) says reconciliation is possible, 915; Center on Budget and Policy Priorities supports tax on high-end plans, report, 949 Hospitals, $155 billion in Medicare and Medicaid cuts over 10 years under White House accord, 819 House Comm. on Education and Labor, insurance reforms and public plan emphasized in comprehensive legislation, 815 House Democrats release legislative framework, 697; business groups to halt negotiations absent affordable proposals, 804 Impact, HHS state-by-state analysis, 945 Individual mandate
Constitutionality concerns raised by critics, BNA Analysis, 1165
Employer mandates also included in House Democrats' drafts, 668 Enforcement issues explored, BNA Analysis, 836 Exemptions, Obama wants waivers in legislation based on affordability, 667; increased MedPAC authority possible, 667 Kaiser integrated care, model should be part of national effort, AFL-CIO chief says, forum, 930 Kennedy (D-Mass) plan, draft legislation includes comprehensive coverage and employer mandates, briefing paper, 641; Medicaid expansion and play-or-play mandates detailed, 665 Key principles, Rockefeller (D-WVa) outlines, 564 Large employers, most oppose current proposals, survey, 322 Legal issues project, Georgetown Univ. papers present possible solutions, In Brief, 414 Lobbying expenditures of insurance companies, AFL-CIO seeks state investigations, 1133 McConnell (R-Ky) chooses Senate GOP team leaders, In Brief, 67 Medicare key to legislative efforts, Leavitt says, 66 Medicare payment inequities, House Democrats release plan, 886; reimbursement formulas recalibration, agreement near, 1155 Obama Council of Economic Advisers, deficit would be lowered and spending reduced, report, 642 Out-of-network care, debate should address high fees, report, 968 Physicians can better care for patients with health care reform, Obama says, 1183 Play-or-pay option, House panel draft legislation includes employer requirement, 583 Policy options for coverage expansion, Senate Finance Comm. explores, 583 Post-claims underwriting, elimination recommended, hearing, 736 Preexisting conditions, legislation addresses unfair practices of denying and rescinding policies, HHS report, 968 Premium increases during the last decade, White House issues report, 1125 Private insurance lobby rebuts criticism as support for federal efforts is expressed, 942 Public plan
Accountability ensured, Senate report, 644
Administrative savings predicted, report, 888 AMA House of Delegates, resolution to support President's plan without reference to option, meeting, 749 Baucus (D-Mont) urges continued discussion of all options, meeting, 371; consensus principles outlined, 371 Bipartisan support, Baucus (D-Mont) says inclusion likely, 608; talks on compromise bill continue, 733 Cong. Progressive Caucus supports, 998 Cost reduction and coverage expansion, best method, report, 773 5 of 6 witnesses recommend but Republicans seek greater diversity, hearing, 490 House Democrats release 852-page draft bill, 734; ERISA-based plan concerns discussed, hearing, 761; insurers and hospitals criticize, hearing, 766; must be comprehensive to be successful, panel hearing, 771; provider payments and public plan option detailed, 790 House majority leader Hoyer (D-Md) supports, 998 Insurers oppose stating more regulation would stabilize market, Senate roundtable, 558 Key to keeping private insurers honest, Senate Democrats say, 527 Legislation, White House Office of Health Reform Director DeParle outlines effective construction, 457 Necessary choice, conference, 123 Obama supports inclusion, conference, 122 Option not essential element, HHS chief says, 967 Popular support but cost and quality key factors, panel discussion, 821 Private plan administrative costs compared, BNA Analysis, 509 Quality improvement and lower costs, study, 196 Rate structure, House Democrats continue discussions, 1155; multiple versions of rate structure in bill sent to CBO, 1178 U.S. Chamber of Commerce opposes and as campaign is launched to preserve ERISA, 887 Senate Health, Education, Labor, and Pensions Comm., 615-page draft bill released, 696; panel delays markup, 764; Democrats estimate coverage costs at $611 billion, 789; August deadline approval unlikely, analysts say, 791; GOP efforts to limit subsidies and eliminate public plan option fail, 817; panel revises coverage provisions as markup continues, 817; committee votes to report out, 855; employer mandates unlikely, 885; play-or-pay mandates impact on small businesses, CRS report, 1179; public plan, Harkin (D-Iowa) pushes for inclusion in merged bill, 2008; Am. Benefits Council lists priorities for reform in letter, 2015 Small businesses
See generally SMALL BUSINESSES
Budget panel chairman says efforts cannot add significant system costs, hearing, 182
Industry stakeholders pledge $2 trillion in savings over next 10 years but impact on legislation unclear, 553; savings and system streamlining detailed, letter, 639; CBO unable to confirm proposed savings, 736 Subsidies key, Kaiser Found. says, report, 1027 Tax issues
See TAXATION
Uninsured
See generally UNINSURED PERSONS
See also specific states
Federal reform impact, HHS state-by-state analysis, 945 Initiatives examined as nationwide reform efforts proceed, Senate panel hearing, 96
AARP indemnity health plans, Grassley (R-Iowa) calls for limits disclosures to policyholders, 486
Adults, most ages 55-64 have coverage, survey, 932 Aetna underpricing to gain market share, class securities action alleging misrepresentation dismissed (E.D. Pa.), 742 AMA
Code of conduct for insurers, group pushed to create, 899
Insurer improvements noted, but efficiency challenges remain, report card, 900 Markets dominated by 1 or 2 insurers, AMA report, 175 BCBS Children's health care, affordable coverage options
Policy benefits labeling system recommended, report, 570
President urges public support, 916 Profits valued over members, Senate panel hearing, 767; Rockefeller (D-WVa) calls for CIGNA clarification of small businesses policy purging, 941 Purging of small business policies, House panel investigates, 1056 Deceptive practices, Senate panel releases report on database creation, 768 Discount cards and programs
See generally DISCOUNTS
Employee Retirement Income Security Act
See ERISA
See generally FRAUD AND ABUSE
High-risk activities, coverage restrictions
See HIGH-RISK POOLS
Long-term care, tax benefit
See generally UNINSURED PERSONS
See MARKETING
Medical underwriting, industry willing to phase out practice, hearing, 366 Mergers
See generally MERGERS AND ACQUISITIONS
Coverage would be improved, report, 701
Market would shift from risk-based competition, study, 700 Outlook 2009, reform among top issues to be addressed, Special Report, 18 Plan mergers
See generally MERGERS AND ACQUISITIONS
Policy rescission, industry CEOs defend practice, hearing, 911 Preexisting conditions
See PROMPT PAYMENT
Retirees
See generally RETIREE BENEFITS
See SMALL BUSINESSES
See specific states
See generally SUBROGATION
Wellness programs
See PREVENTIVE CARE
ARRA
Attorneys at conference suggest employers be ready to understand and implement reform changes, 2013
Enforcement increase and contract changes required, meeting, 439 HHS guidance on information protection from unauthorized use, 454; groups say more specifics are required to ensure protection, 611 Disclosure, protected health information may be given to physician treating patient's family member, 66 Enforcement increase and contract changes, required under stimulus package, meeting, 439 Group health plan requirements
Preexisting condition exclusions notice, Labor Dep't seeks comments on information collection requirements proposed extension, 1122
Prior creditable coverage written certificate, Labor Dep't seeks comments on information collection requirements proposed extension, 1122 Special enrollment notice, Labor Dep't seeks comments on information collection requirements proposed extension, 1122 HHS Office of Civil Rights
Privacy rules modification re GINA, proposed rules issued, 1152
Security rule enforcement responsibility, 916 Website revised, 181 Pharmacists and pharmacies
CVS Caremark pays millions to settle privacy rights violations (FTC), 207
Professional group urges continued probe of CVS Caremark privacy rights violations despite FTC settlement, 339
BCBS
Class action alleges underpayment for services, sanction order vacated (3d Cir.), 1061 Colorado
Enrollment drops as profits increase, report, 223
Limited benefit plans, new law allows, 498 Credit for copayment discrepancy, plan beneficiary must exhaust administrative remedies before filing suit (N.D. Cal.), 1067 Databases and data banks
Computer theft of private information, 30,000 Kaiser workers affected, 191
Management, agreement with IBM cuts hundreds of Kaiser jobs, 352 Kaiser Permanente, Cal. job cuts, 982 Market conduct violations, Kaiser fined, In Brief, 955 Physician reimbursement, suit dismissed where capitation agreement between unlicensed firm and HMO was illegal and unenforceable (Cal. Ct. App.), 104 Projected premium increase of 12 percent in 2010, Hewitt analysis, 871 Tenn., proposed budget includes premium tax increase, 388 Top 3 insurers dominate business in 48 states, GAO analysis, 1054 Wis., enrollment increases as hospital patients and revenues decline, report, 193
Medicare payment errors source, conference, 306
Coverage, 8 million in 2009 in large and small group markets, 598
Employer comparable contributions, IRS final rule also provides excise tax guidance, 1057 Employer contributions, $1,680 average in 2007, report, 195 IRAs, slower growth, report, 225 Reform financing alternatives, Senate Finance Comm. considers elimination of medical deductions and flexible spending curb, 618; proposal defended, report, 643; panel considering options outside health sector to fund reform, 765; CBO financing options outlined, MedPAC report, 769; options analyzed, CRS reports, 773; markup delayed beyond August recess, 914; Schumer (D-NY) says reconciliation is possible, 915; Center on Budget and Policy Priorities supports tax on high-end plans, report, 949
N.J. law mandates coverage for children, 43
Or. children, mandated benefit, In Brief, 803 Wis., new law also requires cochlear implant coverage for children, 653
See CARDIOLOGY
Children with preexisting conditions, coverage eligibility under new S.D. law, 680
Mishandling by insurer alleged caused of rise in premiums, N.J. claim allowed and Cal. claims dismissed (D.N.J.), 1100 Proposal to expand role examined, GAO report, 996 Small businesses, competitive markets would also cut costs, Senate leaders say, 917 Wyo., new law expands coverage, 292
See AIDS AND HIV
Ariz. Medicaid, order upheld requiring state to improve home and community services for disabled recipients (D. Ariz.), 531
Telemedicine, new Wash. law allows Medicaid reimbursement, 594
Fla., website data comparison tool, In Brief, 505
Administrative services automation, initiative announced at AHIP teleconference, 1195
Antitrust
See generally ANTITRUST
Breach of contract, ERISA no bar to state law claims for benefits against health plan administrator (9th Cir.), 1062 Charity care
See CHARITY CARE
Class action certification denied, uninsured patients allege overcharges violate state law (Ala.), 1131 COBRA, early retirees entitled to notice although afforded other health benefits in retirement packages (W.D. Va.), 11 Colo. provider fee, governor proposes to cover expanded SCHIP and Medicaid, 107; house approves, 385; senate approves bill, 438; new law, 504 Discounts
See DISCOUNTS
Emergency room care Fla. profits up in 2007 but sustained growth questionable, report, 316 Gainsharing, medical device makers express concerns in letter to CMS, 212 Gifts
See generally GIFTS
ICD-10 coding conversion
See generally CODING
Information technology, implementation obstacles described, webinar, 465 Kidney transplant patients, Kaiser settles for $1 million, 494 Massachusetts health reform law
Agency approves subsidized Catholic-affiliated plan affording family services, 315; facility ends affiliation with insurer subsidizing coverage, 779
Diversion of funds to finance, facility sues state (Mass. Super. Ct.), 865
See MEDICAL ERRORS
Medigap, HHS IG approves proposal to create preferred provider networks, 944 Mergers
See generally MERGERS AND ACQUISITIONS
Quality
See QUALITY OF CARE
Reimbursement
External review organization and plan administrator, facility's claims alleging underpayment proceed (E.D. Cal.), 1002
Federal reform, $155 billion in Medicare and Medicaid cuts over 10 years under White House accord, 819 Medi-Cal rates increase, governor signs bill, 2023 Medicare Secondary Payer Act
State Farm's motion to dismiss qui tam suit properly granted where insurer did not avoid legal obligation to repay after accident (D. Idaho), 1005
Superior claim and first right before facility's claim to policy covering patient hit by uninsured motorist (N.D. Ind.), 100 Minn. net income, many lost money on operations, report, 596 Out-of-network care
Anthem BCBS, suit filed over use of manipulated information to underpay (Cal. Super. Ct., C.D. Cal.), 921
BCBS sues over waiver of patient costs (N.J. Super. Ct.), 677 ERISA plan participant not entitled to full coverage (N.D. Cal.), 126 Pay-for-performance programs
See TAXATION
Uninsured patients
Cal. passes health insurance coverage mandate bill for vaccinations, 1102
Vaccine for young women, Or. mandated benefit, In Brief, 803 Contact the Webmaster at webmaster@bna.com Copyright © The Bureau of National Affairs, Inc. All Rights Reserved. |