Pension & Benefits Reporter Index-Summary

MADOFF SCANDAL

MANAGED CARE

– Copayment and coinsurance improperly charged (W.D. Mo.), 1459
– ERISA, out-of-network provider accused of interfering with in-network providers, MCO's claim not preempted (D.N.J.), 1093
– N.Y. reform bill signed, 1821
– Premium hike predicted for 2010, 1756

MANAGEMENT AND BUDGET, OFFICE OF (OMB)

– Rule review comment period, In Brief, 689

MARYLAND

– Baltimore County, higher contributions from older new hires no violation (D. Md.), 249
– Misclassification of workers, In Brief, 1750

MASSACHUSETTS

– Health reform program

– – Barriers remain, study finds, 1288
– – Criticized by single-payer advocates, 416
– – Declining revenues and enrollee spike puts strain on program, 1654
– – Discussed at conference, 1136
– – Distribution of spending unchanged, report finds, 903
– – Legal immigrants coverage will be scaled-back, 2052
– – Payment system revisions urged, 1703
– – Penalty schedule for uninsured issued, 561
– – Public option urged, 695
– – Results evaluated, 2052
– – Subsidy numbers reported, 848

– Overhaul of health care payments urged, 2395
– Small businesses, governor seeks authority over health insurance rates, 2435
– State and local government plans, governor pushes reform, In Brief, 295
– Unemployed workers, health trust fund to run out of money, 2395

MEDICAID

– Budget for FY2010 includes cuts, 483; cuts proposed, 1134
– Stimulus funding

See LEGISLATION, FEDERAL, HR 1, S 1

MEDICARE

– ACOs cut costs, MedPAC reports, physician incentives urged, 899
– Buy-in option subject of paper, 1228
– Changes in program could help reform, Senate panel told, 1027
– Dialysis treatment rate cut, no violation of Medicare as Secondary Payer Act (N.D. Ga.), 510
– Enrollee documents, In Brief, 1864
– FY2010 cuts proposed, 1134
– Health reimbursement arrangements source of payment errors, 637
– Hospital trust fund to exhaust assets in 2017, 1215; health care policy panel discusses cost control methods, 1230
– Improved counseling urged, 553
– Out-of-pocket burden reported, 307
– Overcharges due to plan bid errors, CMS says not refunds for enrollees, 1028
– PET scan coverage, In Brief, 903
– Premiums

– – Part B premium hike predicted, 1144
– – Part D premium hike announced, 1913
– – Tax credit

See LEGISLATION, FEDERAL, S 960

– Primary care coordination pushed at Senate hearing, 1229
– Reform

– – Baucus (D-Mont) and Grassley (R-Iowa) report near unanimity on reform goals, 1080
– – Doughnut hole, plan to raise $106M from drugmakers scrapped, 2238
– – Drug benefits changes said to be unlikely, 1760
– – Effect on participants predicted, 1760
– – Hospital group opposes cuts, 1293; White House announces deal with hospitals, 1644; Obama says no benefit cuts, 1905
– – Savings estimated by CBO, 1653; CBO reports, In Brief, 1822
– – Slowing cost growth, reform across health care system needed, reports say, 414
– – Tax on investment income, In Brief, 2247

– Traditional program drug coverage

See LEGISLATION, FEDERAL, HR 684, S 330

– Value-based purchasing urged, 636

MEDICARE ADVANTAGE (MA)

– Alternative payment arrangements criticized, 134
– Briefing held on reform options, 1291
– Budget proposal criticized by industry, 493; defended by OMB chief, 634
– Competitive bidding

– – Lower payments likely, MedPAC reports, 635
– – Spending cuts, CBO predicts, 1283

– Cost adjustment program, CRS reports, 637
– Cutting choices, In Brief, 1764
– Draft CMS call letter includes 2010 guidance, 132; withdrawn, 177; revised, 487
– Goals of program, MedPAC urges Congress to settle, 901
– Higher pay to MA plans than fee-for-service predicted for 2009, 1143
– New rules planned by CMS, 1226
– Rate cuts, bipartisan senators urged moderation, 842
– Reporting requirements revised by CMS, 415
– Technical and policy changes proposed by CMS, 2393

MEDICARE PART D

– Access to drugs, effect of program studied, 559
– Appeals process changes, CMS issues draft, 2004
– Biologics use rising, MedPAC reports, 900
– Briefing held on reform options, 1291
– Choice of plans, CMS says fewer in 2010, 2393
– “Doughnut hole” population cuts back on prescriptions, 305; AARP offers options, 1285
– Draft CMS call letter includes 2010 guidance, 132; withdrawn, 177
– Formularies, CMS says fewer in 2010, 2393
– Gap in coverage

– – Democrat proposal evaluated, 1647
– – Drug makers promise discounts for some enrollees, 1565; Boehner (R-Ohio) criticized, 1957

– Marketing, new CMS programs and procedures planned for 2010, 2436
– Negotiated prices

– – Cost sharing rule issued by CMS, 76
– – Opposed by ex-CMS chief, 354

– New rules planned by CMS, 1226
– Off-label use, state Attys. Gen. support CMS proposal to block insurers' requirement, 769
– Outlook 2009, 199
– Oversight a significant management challenge, HHS IG says, 75
– Performance of plan evaluated, 2003
– Premium hikes under scrutiny by MedPAC, 697
– Pricing tool criticized, 1701
– Protected drug classes, CMS finalizes rule, 190
– Reform, cost fluctuations cited, 1600
– Reporting requirements revised by CMS, 415
– Technical and policy changes proposed by CMS, 2393

MENTAL HEALTH

– Fraud, benefits arbitrarily terminated (D.N.J.), 1869
– Guidance sought on parity, 2289
– Increased mental health coverage leads to some reduced health benefits, 1634
– Memory loss, 24-month benefit limit upheld (7th Cir.), 1869
– Parity

– – Comments on parity sought by agencies, 1080; received, 1369
– – Conference addresses parity, 1136
– – Guidance sought on parity, 2289
– – Regulatory agenda published by Labor Dep't, includes parity, 1208; Senators seeks timely release of regs, 1862
– – Rules delayed, 2343; details offered, 2430

MEWAs

See MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (MEWAs)

MICHIGAN

– Detroit city worker sues over bad pension investments (Mich. Cir. Ct.), 1154
– ERISA

– – Apprentice electrician law, injunction lifted (U.S., rev den), 785
– – Discretionary clauses, Mich. law not preempted by ERISA (6th Cir.), 704

MILITARY PERSONNEL

See ARMED SERVICES

MINORITIES

– Disparities in health care, employer wants better strategies to address, 1030
– §401(k) plans, minorities have lower participation rates, study finds, 1638
– Health insurance, demographics and coverage, census reports, 2245
– Native Americans groups seek exclusion of health coverage from gross income, 2245
– Racial discrimination feared due to mandates, 1859

MISSOURI

– Exemptions for retirement benefits, In Brief, 1749

MULTIEMPLOYER PLANS

– Adverse selection violation, expulsion of firms for using independent contractors upheld (8th Cir.), 1963
– Austin Capital, In Brief, 1980
– Civil penalties for failures related to mandatory funding improvement and rehabilitation, Labor Dep't proposes rule, 2037
– Class exemptions, Labor Dep't seeks comments, 1591
– Construction workers, AFL-CIO seeks consideration, 1282
– Delayed retirement calculation upheld, 188
– Election and notice, In Brief, 2233
– ERISA, fraud claim against insurance agent no preempted (N.D. Tex.), 188
– Funding

– – Elections, IRS issues revenue ruling, 2083
– – Financial crisis effects, survey reports, 1065
– – Guidance, IRS issues, 741; deadline extended, 1057
– – Low levels reported by survey, 2271
– – Status freeze at 2008 levels for most plans, 1589

– General contractor liable for subcontractor's unpaid contributions (9th Cir.), 2011
– Golfing supply maker not required to make contributions for golfer's commercial appearances (9th Cir.), 1715
– Gopher News, “adverse selection” violation claim rejected (D. Minn.), 2304
– Kellogg, participant cannot estop plan from reducing pension benefit (W.D. Mich.), 1977
– Managing costs, advice offered, 2107
– Nabisco pension benefits denial upheld (E.D. Pa.), 2123
– N.Y.C. hospitals seek to renegotiate union pacts, 1066; reach agreement with SEIU, 1762
– Restitution claim by trust fund, summary judgment denied (E.D. Cal.), 2072
– Underfunded liabilities

– – FASB panel seeks action, 1411
– – Negotiation and withdrawal liability issues, Special Report, 1838

– WRERA zone status freeze denied by arbitrator, 1765

MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (MEWAs)

– ERISA, fraud claim against insurance agent no preempted (N.D. Tex.), 188

MUTUAL FUNDS

– Capital gains

See LEGISLATION, FEDERAL, HR 1082

– Fiduciary duty

– – Ameriprise fee structure, breach alleged (8th Cir.), 913
– – Edison Intl. and Southern Edison workers allege fiduciary breach in offset arrangements (C.D. Cal.), 1612
– – Summary prospectus approved, 2084
– – Wal-Mart, negotiation of fees, Special Report, 922