Pension & Benefits Reporter Index-Summary

MAINE

– Health program funding package raises beverage taxes and revises insurance assessments, 909
– Workers' compensation, ERISA does not preempt substantive provisions of Me. law, penalties preempted (D. Me.), 681

MANAGED CARE

– Boca Raton Community Hosp. claim may proceed against insurer that withdrew from network without notice (S.D. Fla.), 690
– Brain cancer treatment, HMO must cover (Wis.), 1229
– Out-of-plan treatment denial an abuse of discretion by HMO (9th Cir.), 376
– Overcharging for copayments alleged, plaintiff must exhaust administrative remedies (E.D. Mo.), 372
– Self-pay requests denied by HMOs, employer lacks standing to sue (E.D. Pa.), 1043

MANDATORY RETIREMENT

– Firefighters, Chicago mandatory retirement, no due process violation (U.S., rev den), 138

MARITAL PROPERTY

See generally SPOUSES

MARYLAND

– Children's health program, notice on state check stubs, bill signed, 981
– PBM requirements bill signed, 981
– Stop-loss insurance carrier certification, bill signed, 981

MASSACHUSETTS

– 401(k) plans, revenue agency issues draft directive on contributions, 458
– Fringe benefits and imputed income, state will not follow federal law, 33
– Health care reform

– – Costs

– – – Overruns and lack of controls cited by consumer advocates, 80; cost containment a primary problem, 1220
– – – Subsidized plan costs estimated, 414; numbers reported, 1290

– – Expanding aid to working poor considered, 1132
– – Tax penalties announced for noncompliance with insurance mandate, 80; 2.5 percent of filers pay penalty, 1290

MEDICAID

– Dual-eligibles to get Medicare drug benefits under proposed CMS settlement (N.D. Cal.), 1520
– Federal budget, White House to propose cuts, 298; budget released, 357
– N.Y. budget calls for cuts, 241
– Waivers for states, Democratic senators want more public comment, 1497

MEDICARE

– Appeals procedure, CMS extends timeline for rule publication, 519
– Baucus (D-Mont) wants physician payment hike, In Brief, 1082
– Budget

– – Senators criticize budget proposal, 353
– – White House spending reduction proposal

– – – CBO reports, 572
– – – Cuts proposed, 298; HHS chief comments on fiscal unsustainability of program, 352
– – – Legislation

See LEGISLATION, FEDERAL, HR 5480, S 2662

– CalPERS subsidies announced, 1031
– Cost control, increasing coordination and reducing overuse suggested, 571
– Cost sharing by wealthier beneficiaries proposed, 465
– Flood-stricken states, Medicare rules waived in, 1498
– Grassley (R-Iowa) bill would increase physician payment, 1405
– Marketing

– – Abuses, House staff reports says CMS reforms inadequate, 1227
– – Commissioners want more state control, 1129
– – Reform promised by insurance group, 571

– Medicare Advantage

See MEDICARE ADVANTAGE (MA)

– Part D

See MEDICARE PART D

– PPOs, enrollment up, 1498
– Prescription drugs

See MEDICARE PART D

– Private fee-for-service plans criticized by House Democrats, 1495
– Privatizing program, Democrats accuse White House, 411
– Quality, HHS effects to promote described, 978
– Reform pushed by HHS chief, 1025
– Savings reported, In Brief, 1291
– Secondary payer reporting, CMS guidance planned, 234; amendments implemented, 461
– Trust fund, exhaustion predicted by 2019, 715

MEDICARE ADVANTAGE (MA)

– Baucus (D-Mont) bill

See LEGISLATION, FEDERAL, S 3101

– Consumer protections proposed by CMS, 1076
– Costs subject of House hearing, 619
– Cutting pay may prolong trust fund solvency, 768
– Draft CMS call letter includes 2009 guidance, 190
– Efficiency and quality, MedPAC issues recommendations, 573
– Extending service areas of employer plans, CMS publishes policy change, 903
– Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information, In Brief, 1490
– Increased enrollment reported, 1288
– Marketing

– – “Catch-all” proposal expected, 910
– – Fraud by sales agents persists, 354; guidelines planned, 910
– – Options for regulation, CMS considers, 414
– – Reform promised by insurance group, 571

– Private fee-for-service plans accused of payment delays, 300
– Rate increase projected for 2009, 515
– Special plans pushed by industry, 978
– White House opposes cuts, 194

MEDICARE PART D

– Appeals, GAO urges revision of requirements, 462
– Consumer protections proposed by CMS, 1076
– Costs

– – Generic drugs prices down in 2007, 1124
– – Increased Medicare spending blamed on drug benefit, 119
– – Lower 10-year projections announced by CMS, 296
– – Tracking out-of-pocket spending by beneficiaries inadequate, HHS IG reports, 27
– – Understanding of cost rules lacking in enrollees, 977

– Data for researchers not likely before 2009, 1403
– Democrats in Senate offer revisions, 1401
– Draft CMS call letter includes 2009 guidance, 190
– Dual-eligibles to get drug benefits under proposed CMS settlement (N.D. Cal.), 1520
– E-prescriptions

– – Call letter postpones deadline, 670
– – Protocol standards finalized, 769

– Efficiency and quality, MedPAC issues recommendations, 573
– Enrollment

– – Draft guidance issued, 977
– – Growth reported for 2008, 296

– Formulary, average plan covers only 83 percent of required drugs, study finds, 1080
– Marketing reform promised by insurance group, 571
– Markup by pharmacies reported, 192
– Off-label use, Feinstein (D-Cal) and Brownback (R-Kan) want to expand, 1224
– Performance measures

– – MedPAC offers draft, 571
– – Most plans meet enrollee and regulatory standards, CMS reports, 572

– Premiums

– – Cuts for low-income enrollees proposed by CMS, 121
– – Larger share of Social Security benefits assumed by Medicare premiums, 296

– Prompt payment

See LEGISLATION, FEDERAL, HR 1474

– Safety, CMS final rule allows sharing of claims data, 1224
– Small providers testify at House hearing, 1130
– Trends, Kaiser studies, 773
– Tying with federal retiree benefits, savings predicted, 1128
– Utilization better, spending down, study reports, 120

MEDIGAP

– Heavier use of services alleged, 618

MENTAL HEALTH

– Parity

– – CRS report on history of federal law, 81
– – Legislation

See LEGISLATION, FEDERAL, HR 1424, HR 4848, S 558

– – Out-of-network care needed, study says, 30
– – Outlook 2008, 264

– Special education benefits improperly denied based on billing codes for psychiatric treatment (D. Colo.), 319

MERGERS AND ACQUISITIONS

– AT&T severance pact, post-merger exercise of stock options no violation (D. Colo.), 484
– Delta merger with Northwest, promises no layoffs or hub closures, 970
– ESOP, firing before merger no benefits interference (M.D. Pa.), 789
– Fiduciary duty

– – Coal firm did not breach duty in statements about effect of merger on benefits (4th Cir.), 124; (U.S., rev den), 1513
– – Macy's accused of material misrepresentations after merger, transfer of suit denied (S.D. Ohio), 992
– – Public utility directors did not breach duties by failing to tell employees directly that they had decided to sell stock in utility before merger (7th Cir.), 83

MICHIGAN

– Contingent employees, task force to address misclassification, 347
– Coordination of benefits, Mich. law preempted by ERISA (E.D. Mich.), 689
– Decretionary clauses, no ERISA preemption of Mich. ban (D. Mich.), 574
– Public plans, Tyco sued by Atty. Gen. over losses (E.D. Mich.), 427

MINNESOTA

– Health insurance tax credit bill signed, 1291

MINORITIES

– Black workers, unionized more likely to have health care and pension, 764
– Disparities, HHS and business groups seek to reduce, 413

MISSOURI

– Military pension tax exemption, In Brief, 187; House approves, In Brief, 972; Senate approves, In Brief, 1072

MONTANA

– Decretionary clauses, no ERISA preemption of Mont. ban (D. Mont.), 574

MULTIEMPLOYER PLANS

– Adverse selection policy and expulsion of firm upheld (N.D. Iowa), 988
– Allocating unfunded vested benefits to withdrawing employers, PGGC proposes rule, 648
– Comments sought by IRS, In Brief, 1214
– Correction notice from IRS, In Brief, 854
– Delayed benefit clause omitted by SPD, benefit calculation upheld (D.N.J.), 985
– Endangered or critical status, IRS issues guidance, 601
– Information collection extension sought by PBGC, 509
– Net experience losses, In Brief, 1121
– P&O Ports bond/escrow variance, In Brief, 513
– Trade school instructors denied service credit (N.D. Ill.), 742
– Trustees not properly monitored, employer group breached duties (D. Conn.), 789
– Upward trend in funding reported, 651

MUTUAL FUNDS

– Disclosure

– – Applicability of new Labor Dep't rules questioned, 398
– – New rules proposed by SEC, 1194

– Mutual Fund Reader launched by SEC, 843
– N.Y. Life employees settlement approved (E.D. Pa.), 578
– Prudential limits on mutual fund transfer methods no contract breach (E.D. Pa.), 805
– Summary prospectus, SEC proposal favored by investors, survey finds, 659