Health Plan & Provider Report Index Summary

NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)

– Physician rankings, plan reviews web posting under 2007 N.Y. settlement, 15

NCQA

See NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)

NEBRASKA

– Medicaid program, Mayo Clinic of Rochester, Minn. to disenroll, 2024

NEGLIGENCE

– Health insurance

– – Aetna released address to ex-husband who harassed insured, ERISA no bar to suit (C.D. Cal.), 621
– – Member claim against plan administrator over lung cancer treatment denial reinstated (Cal. Ct. App.), 498; right to independent medical review important to patients, 499

– Medical errors

See MEDICAL ERRORS

– Medical malpractice

See MALPRACTICE

– Misrepresentation

See generally MISREPRESENTATION

NEVADA

– Domestic partners, benefits effective in Oct. with veto override, 718

NEW HAMPSHIRE

– Electronic health records, new law allows sharing opt out, 978
– Health data marketing, new law limits use and requires breach notification, 978

NEW JERSEY

– Acute rehabilitative care decision delay by health plan alleged cause of injury, ERISA preempts state law claims (D.N.J.), 1066
– Children's health care

– – Autism, screening mandated benefit under new law, 1033
– – Hearing aids, mandated coverage, 43

– Horizon BCBS

– – Clinical laboratories, plan sues over fraudulent claims (N.J. Super. Ct.), 830
– – Eating disorders, settlement of coverage claims for dependents approved (D.N.J.), 494
– – Emergency services, Bayonne Hosp. sues over unethical tactics to deter use (D.N.J.), 891
– – Fraud and abuse, plan benefits terminated benefits arbitrarily over claims for psychiatric services (D.N.J.), 950

– Hospital charity care funding, new law raises health insurance premium tax rates for one year, 828
– Immigrant health coverage, state performance poor, report, 721
– Malpractice, ERISA preempts stroke patient's state law claims against plan over treatment denial (N.J. Super. Ct. App. Div.), 293
– Out-of-network care

– – Hospital waives patient costs, BCBS sues (N.J. Super. Ct.), 677
– – Patient incentives to change surgical services providers, ERISA no bar to BCBS claim (D.N.J.), 530

– Prescription drugs, 2-state BCBS/CVS pilot on giving instant access to prior authorizations, 570

NEW MEXICO

– Electronic health records, part of reform plan passed, 388; new law, 416
– Premiums and rates, house passes bill requiring 85 percent medical loss ratio for insurers, 296

NEW PRODUCTS

– Anthem BCBS Ind., affordable fixed-rate option, 391
– PPOs, BCBS of Fla. and Miami-Dade County launch coverage option for uninsured, 654

NEW YORK

– Bribes in exchange for confidential patient information, attorney general announces arrests, 1133
– COBRA, eligibility extended under economic stimulus package, 349
– Health insurance

– – Breach of contract, ERISA preempts employer's state law claim breach of contract claim alleging improper coverage termination (N.D.N.Y.), 621
– – Empire Plan for public employees, report suggests using dividends from excess premiums paid to offset future premiums, 1132
– – Free-market reforms, report calls for use to expand health coverage to uninsured, 1132
– – Limited benefit plans, probe launched as insurer is fined, 977
– – Quality of care, state public plans exceed national averages, report, 652
– – State worker plan outpatient consultant services and facility fees overpayment fraud recovery $9 million in 2008, report, 315

– Health plan assessments

– – Bills to increase signed, 160
– – Response, plans revising budgets, 746
– – State charges $4.2 billion in surcharges and assessments annually, report, 534

– Lobbying expenditures of insurance companies re health care reform, AFL-CIO seeks state investigations, 1133
– Managed care, new reform laws increase consumer and provider protection, 927; BNA Analysis, 1108
– No-fault insurance laws abuse alleged by auto insurer, RICO claims proper and motion to dismiss denied (E.D.N.Y.), 1127
– Out-of-network provider reimbursement

– – Capital District Physician's Health Plan, attorney general to sue, 161; settlement, 189
– – Neutral rate-setting, Guardian Life Ins. funds group, 294
– – Student health plans, Aetna pays millions to settle attorney general probe, 129
– – UnitedHealth Group and attorney general reach agreement on data system revision, 57; similar agreement reached with WellPoint and CIGNA, 221; 2 more insurer agreements, 295; greater transparency needed, hearing, 369; group plans must adjust, consulting firm says, 390; Rockefeller (D-WVa) calls for probe of industry calculation methods, 405; Health Net pays to settle, 746

– Physician rankings, NCQA plan reviews web posting under 2007 settlement, 15
– Prescription drugs

– – Generic, upstate use cut $369 million in costs, 223
– – Low-income persons, discount card program, 387

– Uninsured young adults, governor proposes age 19 to 29 coverage option, 44

NONPROFIT ORGANIZATIONS

– Conversion of BCBS from nonprofit status, plan may be entitled to partial tax refund (M.D. La.), 862
– Hospitals

– – Arbitration, hearing set in suit over sale of 3 facilities (Colo. Dist. Ct.), 73; 2 sales disallowed for violation of state nonprofit law but third proceeds, 712; agreement to transfer 2 Exempla properties to Catholic system, 1007
– – Health Alliance of Greater Cincinnati settlement agreement, 73

– Medicaid, possible solution for coverage continuity gaps outlined, 823
– Pa. Medicaid managed care agreements, nonprofit entitled to disclosure under state's right to know law (Pa. Commw. Ct.), 714
– Wellness programs, Carolinas HealthCare Sys. offers financial incentives for employees who meet criteria, 627

NORTH CAROLINA

– Health insurance, new law requires notice of contract amendments, 927
– Mandated lymphedema coverage, new law, In Brief, 897
– State health plan, smokers and overweight workers will pay more, 534
– Uninsured persons, online pilot project provides immediate price information for patients and physicians, 832
– Wellness programs, nonprofit Carolinas HealthCare Sys. offers financial incentives for employees who meet criteria, 627

NORTH DAKOTA

– BCBS, insurance regulator calls on company to review compensation and travel policies, 1074
– Mergers, MeritCare Health Sys. of N.D./Sanford Health of S.D., 871

NOTICE

– BCBS individual policies, judge bars release of confusing second directive in class action against Anthem over rescissions (Cal. Super. Ct.), 131
– COBRA

– – Early retirees of hospitals entitled to notice although afforded other health benefits in retirement packages (W.D. Va.), 11
– – Requirements, Labor Dep't seeks comments, 618; deadline Sept. 23, 1027

– Electronic health records security breaches

– – Data breach notification

– – – Mo., new law, 897
– – – Tex., new law extends requirements to health information, 801

– – Proposed FTC rule on consumer notice, 453; commission urged to adopt HHS approach, 668; final rule issued, 973; interim final HHS rule includes delayed enforcement date and risk of harm notification threshold, 995; harm provision, House committees leaders urge HHS to revise, 1180

– N.H. health data marketing, new law limits use and requires breach notification, 978
– N.C., new law requires notice of provider contract amendments, 927