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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
P4P
– Implementation
– – CMS seeks public comment in advance of future rulemaking, 488; business groups seek clarification, 644; industry representatives cite enforcement concerns, 671; senators call for prompt release of rules, 943; HHS aims to issue rules by Jan. 2010, 1177
– – EBSA seeks public comment in advance of future rulemaking, 488; business groups seek clarification, 644; industry representatives cite enforcement concerns, 671; senators call for prompt release of rules, 943 – – IRS seeks public comment in advance of future rulemaking, 488; business groups seek clarification, 644; industry representatives cite enforcement concerns, 671; senators call for prompt release of rules, 943
– Bonuses
See BONUSES
See PROMPT PAYMENT
– BCBS, Highmark and Independence halt merger effort, 103
– COBRA, access expansion bill set for vote, 416 – Dependents, bill to expand coverage for adult children reaches senate floor, 416 – Discount prescription drug cards, company settles charges over deceptive marketing practices (Pa. Commw. Ct.), 192 – Electronic health records, Highmark BCBS funding for small primary care practices, 571 – Lobbying expenditures of insurance companies re health care reform, AFL-CIO seeks state investigations, 1133 – Medicaid managed care agreements, nonprofit entitled to information disclosure under state's right to know law (Pa. Commw. Ct.), 714 – Medical errors, senate to vote on bill to deny payment, 416 – Quality of care improvement and cost reduction, new laws, 777
– Antitrust, long-term care pharmacy's claims against merged insurance companies dismissed for insufficient evidence (N.D. Ill.), 89; Omnicare to appeal, 89
– CVS/Caremark merger, FTC probe sought, 561 – Dual eligibles, reimbursement change under new Tenn. law, 896 – HIPAA rights
– – CVS Caremark pays millions to settle violations (FTC), 207
– – Professional group urges continued probe of CVS Caremark despite payment settle FTC charges, 339 – Part D, community pharmacists want federal incentives for e-prescribing, 489 – PBM
– Antitrust multidistrict litigation, transferee judge cannot vacate transferor judge's arbitration order (3d Cir.), 1158
– Conflicts of interest, federal law preempts D.C. disclosure law (D.D.C.), 331 – Express Scripts/WellPoint acquisition agreement, 441; community pharmacists file objections with FTC, 536 – Qui tam suits, state immunity from counterclaims in FCA suit at issue (5th Cir.), 893 – Specialty tiering, cost shifting effect necessitates biogenerics approval pathway, AARP report, 319 – TDI Managed Care Services, cross-motions for summary judgment denied in Eckerd Health Services reimbursement suit (M.D. Ala.), 346 – Vytorin and Zetia, state worker health plan sues drug makers alleging deceptive marketing practices (E.D. Pa.), 707
See also SPECIALISTS
– Administrative services automation, initiative announced at AHIP teleconference, 1195 – AMA
See ANTITRUST
– Electronic prescriptions
See E-PRESCRIPTIONS
– Gifts
See generally GIFTS
– HIPAA, protected health information may be disclosed to doctor treating patient's family member, 66 – ICD-10 coding conversion
See generally CODING
– Medical malpractice
See MALPRACTICE
See generally QUALITY OF CARE
– – Alternative pay system, BCBS of Mass. signs contract with Atrius, 896
– – HMO, suit dismissed where capitation agreement with unlicensed firm was illegal and unenforceable (Cal. Ct. App.), 104 – – Medicare cuts likely, summit, 211 – – Medicare payment fix – Survey findings on revenue sources and participation in managed care plans, 1076 – Telemedicine
See generally TELEMEDICINE
– Credit for copayment discrepancy, beneficiary must exhaust administrative remedies before filing suit (N.D. Cal.), 1067
– Network provider treatment denial, impact of ruling rejecting vicarious liability of plans discussed (Cal. Ct. App.), audio conference, 496 – OB/GYN group reimbursement, ERISA does not preempt Tex. law claims challenging pay rate (5th Cir.), 1002 – Wrongful death, Medicare has right to reimbursement from family's insurance settlement for medical costs of deceased beneficiary (8th Cir.), 156
See HIGH-RISK POOLS
– Employee Retirement Income Security Act
See ERISA
– BCBS
– – New products, Anthem Ind. offers affordable fixed-rate option, 391
– – Uninsured persons, Fla. insurer and Miami-Dade County launch new product, 654
– – Chiropractic services, claims proceed against insurer (S.D. Ill.), 347
– – Physician group denied class certification (C.D. Ill.), 157 – Tenn., new disclosure law, 801 – Top 3 insurers dominate business in 48 states, GAO analysis, 1054
– Fertility treatment, BCBS not required to cover (Cal. Ct. App.), 864
– Mass. health reform law, agency approves subsidized Catholic hospital-affiliated plan affording family services, 315; facility ends affiliation with insurer subsidizing coverage, 779 – OB/GYN group reimbursement, ERISA does not preempt Tex. law claims challenging pay rate (5th Cir.), 1002 – Octuplets' mother, Cal. agency fines Kaiser hospital for information breach, 595; fine for second privacy violation, 867
– Age ratings, restrictive rules would increase premiums by 50 percent, BCBSA analysis concludes, 1135
– Anthem BCBS hike, Dodd (D-Conn) and state attorney general set hearing and urge reconsideration, 829; approval process revision sought, 977 – CalPERS, 2010 increase of 2.9 percent is lowest in years, 745 – COBRA coverage
See generally COBRA (HEALTH CARE COVERAGE CONTINUATION)
– Del. health insurance rate increases, new law allows state regulators to approve, 828 – Discounts
See generally DISCOUNTS
– Employer-based plans, premiums predicted to double by 2020, report, 1008 – Employer did not pay premiums, former employees' claims for medical costs reimbursement denied but money submitted to BCBS by workers recoverable (W.D. Ark.), 1030 – ERISA fiduciary duty, employer breached by not forwarding contributions deducted from paychecks (S.D. W.Va.), 37 – Exhaustion of remedies, provider challenge to health care management services method of determining customary charges barred (D.N.J.), 460 – Federal Long Term Care Insurance Program with automatic compound inflation option, Senate hearing told enrollees face increases, 2017 – FEHBP, OPM says costs for enrollees to rise in 2010, 1154 – HMOs, projected premium increase of 12 percent in 2010, Hewitt analysis, 871 – Hospital charity care funding, new N.J. law raises health insurance tax rates for one year, 828 – Increases during the last decade, White House issues report as part of case for health care reform, 1125 – Individual policies
– – BCBS of Mich. rates, lawmakers adjourn without action, 16; insurer to cut jobs and seek increases to offset losses, 106; commissioner sets hearing, 681; increase approved, 978; Dingell (D-Mich) and Levin (D-Mich) ask for details on rate increases, 997
– – Cal. bills passed barring gender-based discrimination, 592 – – Coverage not affordable, study, 899 – – Gender-based prohibition, Cal. lawmakers pass bill, 1102; governor signs bill, 2022 – – Health insurance market rating factor, suit filed to end discrimination against women (Cal. Super. Ct.), 129 – – Increase once coverage in force for 2 years prohibition, Cal. lawmakers pass bill, 1102; governor signs bill, 2022 – – Regence BCBS of Or., premiums increase approved, 595 – MA, increases will prompt enrollees to change plans, poll, 418 – Medical loss ratio, Rockefeller (D-WVa) probes health insurance data on premiums collected compared with paid claim amounts, 1026 – N.M., house passes bill requiring 85 percent medical loss ratio for insurers, 296 – Offshore captive insurer owned by hospital group, insurance premiums paid to insurer not reimbursable by Medicare (D.D.C.), 1188 – Out-of-network services reimbursement
See generally OUT-OF-NETWORK CARE
– – Copayments from state board, no sanctions, IG advisory opinion, 999
– – Increase and formula change for low-income beneficiaries announced, 970 – – MedPAC to probe increases, hearing, 338 – – Reduction – Reduction unlikely result of reform efforts, CBO official says, hearing, 857 – Retiree benefits, former power company workers do not have vested right to pay the same as current employees (E.D. Wis.), 289 – Risk pool for major medical insurance policy, alleged mishandling caused rise, N.J. claim allowed and Cal. claims dismissed (D.N.J.), 1100 – Small businesses, bill passed limiting insurance increases, 745 – Tenn. HMOs, proposed budget includes tax increase, 388 – Uninsured persons, families paid $1,000 more in 2008 to offset, report, 655 – Usual, customary and reasonable rates information disclosure to patients, Natl. Ass'n of Ins. Comm'rs hearing, 1173 – Wash., increase for state-subsidized health plan due to budget constraints, 719 – Workers' coverage contributions, employer health benefits survey findings, 1106
– N.H. law banning sale of physicians' information, First Circuit ruling upheld (U.S., rev sought), 412; (rev den), 800
– Vt. law banning sale of physician information upheld (D. Vt.), 495; injunction pending appeal denied, 709
– AWP
– Comparative effectiveness research, consideration urged but not to limit or deny coverage, meeting, 409 – Discount cards and programs
See generally DISCOUNTS
– Generics
See GENERIC DRUGS
See generally MEDICARE DRUG COVERAGE
See generally PHARMACY BENEFITS MANAGEMENT (PBM)
– Tenn., bill passed allowing pharmacists to give patients actual cost information, 654
– Avastin, class action alleges regular payment denial by Anthem BCBS for ovarian cancer treatment drug (Cal. Super. Ct.), 292; approved in coverage reversal, 314
– BCBS, 2-state CVS pilot on giving instant access to prior authorizations, 570 – Celebrex and Bextra safety, global class action settlement approved (N.D. Cal.), 380 – Contraceptives
See CONTRACEPTION
See generally DISCOUNTS
See GENERIC DRUGS
See generally GIFTS
See MARKETING
See generally MEDICARE DRUG COVERAGE
See OFF-LABEL USE
– – Clinical study results delay caused plan losses, Merck employees ERISA claim can proceed (D.N.J.), 1064
– – Merck and Schering-Plough settle class action over failure to disclose unfavorable clinical test results (D.N.J.), 953
– Chronic illness, management and disease prevention key to overall health delivery system revision, BCBS guide, 506
– Healthy lifestyles, new Or. law allows insurers to pay dividends, 776 – State and local health reform initiatives examined as nationwide efforts proceed, Senate panel hearing, 96 – Wellness programs
– – Companies seek tax breaks, survey report, 901
– – Employer tax credits bill – – Implementation, legal issues explored, CRS report, 798 – – Plans may provide incentives under proposed Colo. bill, 161; new law, 500 – – Public sector employers also favor disease management programs over consumer-directed plans, report, 108 – – Worker participation incentives decline, report, 930
– Electronic health records, Highmark BCBS funding for small practices, 571
– Medical home pilot program, CIGNA partners with Tex. clinic, 1075
– BCBS, Del. regulator fines insurer for violations resulting from printing error, 74
– Bribes in exchange for confidential patient information, N.Y. attorney general announces arrests, 1133 – Cal. patients, ambiguity of privacy statute examined, BNA Analysis, 751 – Electronic health records
– – Breach notification
See NOTICE
– – Economic stimulus bill provisions, strict data breach provisions hailed and criticized by various stakeholders, 205; correction, 286 – – Insufficient protection and weak enforcement must be addressed, civil rights group chief says, 699 – – Legal framework for information protection and state regulation explored, BNA Analysis, 442 – – N.H., new law allows sharing opt out, 978 – – Octuplets' mother, Cal. agency fines Kaiser hospital for information breach, 595; fine for second privacy violation, 867 – – Patient protections should not block provider and insurer information exchange, report, 133 – – Peer-to-peer file sharing networks, sensitive data leaks, report, 195 – – Privacy and security rules tightened – – Secure data sharing, new Wash. law, 594 – – Security protocols, CMS says health care organizations should strengthen, meeting, 795 – HIPAA – Laptop computer stolen from employee car has personal information on doctors, BCBSA confirms, 2026 – Medical identity theft
See IDENTITY THEFT
– N.H. health data marketing, new law limits use and requires breach notification, 978 – Pharmacists and pharmacies
– – CVS Caremark pays millions to settle violations (FTC), 207
– – Professional group urges continued probe of CVS Caremark despite payment to settle FTC charges, 339
– BCBS, ERISA preempts Mo. physician's state law claims (S.D. Fla.), 158
See also specific providers
– Discounted rates
See DISCOUNTS
– Exhaustion of remedies, provider challenge to health care management services method of determining customary charges barred (D.N.J.), 460 – Mass., recommends end to fee-for-service method, 594; payment system revision outlined, 865; global payment system transition, providers cite difficulties in meeting timetable, 2024 – Out-of-network rates
See generally OUT-OF-NETWORK CARE
– Prompt payment
See PROMPT PAYMENT
– Usual, customary and reasonable rates information disclosure to patients, Natl. Ass'n of Ins. Comm'rs hearing, 1173
See also specific providers
– Cost of health care, Mass. officials probe link between increase and insurer payments to practitioners, 43 – Data quality, errors and remedies described, BNA Analysis, 135 – Derivative standing, sleep clinic receiving assignment of benefits from ERISA participant entitled to copies of plan documents (E.D. La.), 99 – Health care information vendor liability for adverse events, shift to providers noted, article, 418 – Information technology
– – Focus, regulatory compliance not patient care improvement, report, 45
– – Penalties, more effective than incentives to prompt provider use, report, 466 – N.C., new law requires notice of contract amendments, 927 – Or. tax to fund health coverage expansion, no consensus for hospitals and governor, 193; legislative panels approve bills, 681 – Pa. Medicaid managed care agreements, nonprofit entitled to information disclosure under state's right to know law (Pa. Commw. Ct.), 714 – PPOs – Tenn. health care facilities, new laws, 717
– HHS
– Public program savings, $64 billion annually, trade group study, 832
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