Health Plan & Provider Report Index Summary

TAXATION

– Benefits and expenses, Joint Comm. on Taxation summarizes health care treatment, 1201
– Consumer-directed plans, 401(k) strategies may be applicable, study, 914
– Employee benefits, tax preferences factor in 2009 budget debates as federal revenue need grows, report, 232
– Health care provider tax

– – Managed care, final CMS rule cuts rate states can impose, 229
– – Uninsured persons, Or. board recommends increase, 999

– Health insurance

– – BCBS, reform proposal includes federal tax credits, 122
– – Employee benefits, half of firms surveyed support tax changes, 1183
– – High-deductible health plan tax credit, Ga. lawmakers approve bill, 424; new law, 525
– – Mass. coverage mandate, higher tax penalties for noncompliance, 36; over 2 percent of filers paid, 649
– – Minn. employers, new tax credits law, In Brief, 653
– – Payroll tax exemption, AMA supports continuation, meeting, 702
– – Related benefits update, reports, In Brief, 172
– – Republican Party, draft platform tax changes, In Brief, 964
– – Small business tax credits, inefficient coverage expansion tool, 1022
– – Tax treatment key legislative issue, conference, 995

– HSAs

See generally HEALTH SAVINGS ACCOUNTS (HSAs)

– Mental health parity compromise language

See LEGISLATION, FEDERAL, HR 6049, S 3335

– N.Y. children's health care, governor proposes using state funds for coverage expansion, 61; Medicaid spending cuts, SCHIP growth, and HMO tax increase outlined, 118
– State and local government, sustained health care fiscal challenges examined, GAO report, 114
– Universal coverage, Ill. governor proposes business tax to fund, 238
– Wellness programs incentives, legal and regulatory issues for employers discussed, meeting, Special Reports, 1067; correction, 1125

TELEMEDICINE

– Colo. Telehealth Network, FCC award used to create, 935

TENNESSEE

– BCBS

– – Experimental knee surgery, coverage denial upheld (6th Cir.), In Brief, 70
– – Hospitals, administrator overpaid participating Medicare facilities millions, IG report, 1170
– – ICD-10 coding conversion, BCBSA raises timing concerns, 958; medical technology and hospital groups support, 1169; state medical group and BCBS urge delay, 1170
– – Physician-specific price and quality data, 205; release delayed, 300; providers may review information before release, 806

– Dental care, Medicaid managed care plan may not compel arbitration in retaliation action by pediatric provider over agreement termination for criticizing plan (M.D. Tenn.), 1147
– Developmental screening, CIGNA to reimburse pediatricians, In Brief, 555
– Discount medical cards, consumer protection suit against Tenn. firms settled (Wis. Cir. Ct.), 782
– Electronic health records, AT&T and state launch provider-to-provider data exchange network, 263
– Humana/Carlten Healthcare merger, MA expansion, 890
– Long-term care policies, new law limits, 651
– Small businesses, health insurance

– – Group cooperatives, senate approves bill, 372; lawmakers pass, 550; new law, 608
– – Program eligibility expanded, 121
– – Uninsured persons, state program participation allowed, 1027; number of authorized primary care physician visits increases to 12 in 2009, 1095

– TennCare

– – Fraud, senate bill increasing penalties passed, In Brief, 500; new law, 728
– – PBM, Ill. firm awarded contract, In Brief, 500
– – Private duty nursing, costs limit care, In Brief, 913
– – Request for medical and behavioral provider proposals, In Brief, 62; contracts awarded, 471

TERMINAL ILLNESS

See CHRONIC AND TERMINAL ILLNESS

TESTS AND SCREENING

– AIDS and HIV, Cal. mandated coverage bill passed, 966
– Ala. workers, common risk factors screening awareness program, 970
– Anesthesia for colonoscopies, Del. mandated benefit law, 837
– Colorectal cancer

– – Me., new coverage law, 400
– – Pa., new mandated benefits law, 775

– Developmental, CIGNA to reimburse pediatricians, In Brief, 555
– Genetic Information Nondiscrimination Act, legal issues related to test data use, reports, 1145
– SNFs, proposed class action over glucose test claim denial based on invalid local coverage determination dismissed (D.D.C.), 214

TEXAS

– Health insurance

– – Maternity, state attorney general sues firm over fraudulent policy sales (Tex. Dist. Ct.), 505
– – Mental health parity, code requires, state attorney general opinion, 1208
– – OB/GYN provider, ERISA no bar to reimbursement claims against Aetna (W.D. Tex.), 618
– – Policy group recommendations on state system improvement, report, 730

– Hospitals

– – Coverage misrepresentation, ERISA no bar to state claims against insurer (S.D. Tex.), 812
– – Discounts, plan forfeited where administrator did not notify facility of preexisting condition exclusion (S.D. Tex.), 330
– – Medical errors, no BCBS reimbursement, 865

– PBM

– – Audits, contract revisions to increase agency authority recommended, report, 998
– – FCA, claims scope limited in Caremark action over Medicaid denials (W.D. Tex.), 1005

– Pharmacists and pharmacies, ERISA preempts claim alleging plans violated state AWP law by denying out-of-network coverage (5th Cir.), 918
– Physicians

– – Medical board sued for misconduct (E.D. Tex.), 61
– – Price fixing, FTC finding of illegal contract negotiation by independent association upheld (5th Cir.), 556

– Weight loss programs, laparoscopic gastric band surgery group contract with center valid despite percent-of-fee clause (Tex. App.), 758

TOBACCO INDUSTRY

– Wrongful discharge, ERISA claim over firing for violating no-smoking policy proceeds (D. Mass.), 158

TORTS

– Appropriation of identity, physicians' claims over PPO use of names and practice information on medical discount cards proceed (11th Cir.), 377
– Settlements, subrogation issues

See SUBROGATION

TRANSPARENCY

– Aetna network provider agreements, guidelines released, 612
– Clinical policy bulletins, Aetna CEO urges medical devices providers to check for coverage questions, meeting, 267
– Health care prices, impact prediction difficult, report, 495
– Hospitals, N.J. financial monitoring and care access expansion bill signed, 933
– Ky. physician-insurer contract negotiation, new rules, 549
– Minn. health care prices, bill passed, 581
– Physician-specific price and quality data, BCBS of Tenn. provides for members, 205; release delayed, 300; providers may review information before release, 806
– Price, impact on slowing increase unclear, CBO report, 675

TRANSPLANTS

See ORGAN TRANSPLANTS

TRANSPORTATION SERVICES

– Emergency services, ERISA does not preempt out-of-network air firms' state law reimbursement claims against HMO (M.D. Fla.), 943

TRAUMA CARE

See EMERGENCY SERVICES