Health Plan & Provider Report Index Summary

WAIVERS

– Individual health insurance mandates, Obama wants exemptions in legislation based on affordability, 667; increased MedPAC authority possible, 667
– Out-of-network care, BCBS sues hospitals over waiver of patient costs (N.J. Super. Ct.), 677
– Part D, erroneous premium refund recipients must repay (D.D.C.), 382
– TennCare, long-term care integration approved, 929

WASHINGTON

– Discounts

– – Health plans, disclosure requirements under new law, 533
– – Regence BS suit alleging members are not given negotiated rates dismissed absent provider participation in suit (W.D. Wash.), 710

– Electronic health records, new secure data sharing law, 594
– Health insurance, carriers fined for violations, 568
– Premiums, raised for state-subsidized health plan due to budget constraints, 719
– Telemedicine, new law allows Medicaid reimbursement for home care, 594

WASHINGTON, D.C.

See DISTRICT OF COLUMBIA

WELLNESS PROGRAMS

See PREVENTIVE CARE

WEST VIRGINIA

– Children's health care, Medicaid eligible may sue managed care program (S.D. W.Va.), 623

WISCONSIN

– BadgerCare

– – Expansion of health coverage plan for adults with no dependent children, 654
– – Managed care organizations, state agency to require competitive bids, 1034

– Children's health care, new law requires hearing aid and cochlear implant coverage, 653
– Hospitals

– – Patients and revenues drop as HMO enrollment increases, report, 193
– – State plans laud agency assessment proposal to allow state to capture more federal Medicaid funds, 104; new law, 267

– Medigap policy provision ambiguous, plan must pay hospital's standard rate rather than lower Medicare charges (Wis.), 590
– Retiree benefits, former power company workers do not have vested right to pay the same premiums as current employees (E.D. Wis.), 289
– SeniorCare discount drug program, application filed for extension to 2012, 192

WOMEN'S HEALTH

– Breast cancer education and patient care bills

See LEGISLATION, FEDERAL, HR 995, HR 1691, HR 1740, and HR 2279

– Cervical cancer screening tests, Cal. passes health insurance coverage mandate bill, 1102
– Contraceptives

See CONTRACEPTION

– HPV vaccine for young women, Or. mandated benefit, In Brief, 803
– Insurance, access barriers would be eased by reform efforts, report, 948
– OB/GYN group reimbursement, ERISA does not preempt Tex. law claims challenging pay rate (5th Cir.), 1002
– Ovarian cancer, class action alleges regular payment denial by Anthem BCBS for Avastin treatment drug (Cal. Super. Ct.), 292; approved in coverage reversal, 314

WORKERS' COMPENSATION

– Blue Cross network use for claims by insurance fund no violation of antitrust laws (Cal. App. Ct.), 1103

WRONGFUL DEATH

– Insurance settlement, Medicare has right to reimbursement from family for medical costs of deceased beneficiary (8th Cir.), 156

WRONGFUL DISCHARGE

– Health insurance, some claims proceed against employer who fired worker after surgery to prevent future benefits use but ERISA claim over promotion denial barred (E.D. Pa.), 623
– Informal complaints about health plan administration, fired worker has no retaliation claim under ERISA Section 510 (E.D. Pa.), 924
– Jurisdiction, ERISA preempts disabled participant's claim but amendment allowed for remand to state court (N.D. Va.), 10

WYOMING

– High-risk pools, new law expands coverage, 292