Lockton Joins GoHealthInsurance’s Workplace Program
Posted in: What's in the news today! | Comments (0)
Lockton Benefit Group recently joined the GoHealthInsurance Workplace program to provide consumers across the nation with a convenient online solution to find a quality health insurance plan. More than 15,000 Lockton clients will now be able to leverage the GoHealthInsurance technology used by more than 20 million consumers to obtain the right health coverage.
With GoHealthInsurance tools, Lockton clients will be able to instantly compare health plans from the largest insurers in the nation including UnitedHealthOne, many Blue Cross and Blue Shield companies, Aetna and more. The GoHealthInsurane platform represents more than 10,000 health plans nationwide. Lockton members can also speak with a licensed agent for professional service and advice as they explore coverage options.
To find out more information you can read the entire article here.
admin @ July 14, 2010
Health Care Reform in the News
Posted in: Health Insurance Reform, What's in the news today! | Comments (0)
Top 6 Challenges for Managed Health Care in 2010
The top issue, within the managed health care system, is to define the role of government. This issue should be a top concern of the citizens of the United States whether you are insured or not.
This following list was recently released by the Managed Care Executive Group (MCEG) which is a leadership group of U.S. managed health care executives. The 2010 list is dominated by defining the role of government, affordability, and collaboration between agencies.
MCEG’s top 6 list is as follows:
- Define the role of state and federal government with regard to health care: Government support, intervention, and regulation are having an increasing impact on the payer, cost, and marketplace strategies. According to MCEG, their intent is to focus on legislative and compliance demands from the government.
- Healthcare reform: Overall reform legislation; regardless if it’s comprehensive or piecemeal, at the state or federal level, will result in several new agencies and grant programs. Also adjustments to the insurance market and payments will be affected. The group tends to monitor this affect.
- ICD-10: MCEG feels the impact of changing to ICD-10 for medical record coding and billing is being underestimated and suggests the impact will be equivalent to the industry as Y2K. This impact will push many other Healthcare Information Technology programs to lower priority.
- Data analytics and informatics: The investment in analytics will be driven by disease management, real-time decision support, case management, and customer segmentation. Clinical information will be broad that will enable caregivers to more precisely identify diagnoses and target treatment.
- HIPAA (Health Insurance Portability and Accountability Act) 5010: New HIPAA requirements will present substantial changed in the content of the data submitted with claims as well as the data available in response to electronic inquires. The implementation of the HIPAA will require changes to the software and the systems.
- Consumer response to healthcare changes: It is projected that a wave of consumers voicing their opinion on products, costs, networks, and reform will happen quickly as parts of the health care laws are rolled-out. Consumers will demand integration between Web-based technology and administrative services to improve their customer experience.
Old heath care is out; the new health care is coming in.
All citizens should watch closely as the new programs and reform is implemented. Most of these concerns listed above are with regard to information technology and the ease of obtaining real information. These are valid challenges for the health care reform laws as we live in a fast-paced information world. These new laws affect all citizens in one way or another.
admin @ May 5, 2010
May 2010 News – Health Care Insurance Industry will end Rescission
Posted in: Health Insurance Reform, What's in the news today! | Comments (0)
Rescission, as defined by Webster, means “the cancellation of a contract and the return of the parties to the positions they would have had if the contract had not been made.” Health insurance news coverage has been abuzz with this word and the reason is that under the health reform laws, this practice will be illegal.
The health insurance industry has decided to end the practice of canceling (rescinding) claims once a patient is sick and this new policy is to take effect in May 2010. The new health care laws will go into effect in September 2010, so the May date is well before the deadline. After September 2010, any questionable case will be reviewed by a third-party to investigate for fraud or misrepresentation.
“While many health plans already abide by the standards outlined in the new law, our community is committed to implementing the new standards in May 2010 to ensure that individuals and families will have greater peace of mind when purchasing coverage on their own,” America’s Health Insurance Plan President Karen Ignagni said in a letter to top House Democrats.
The decision came on the heels of WellPoint being targeted because of reports that it had singled-out breast cancer patients for rescission. WellPoint announced they would end the practice on May 1, 2010 along with UnitedHealth announcing they had eliminated the practice.
The practice of rescinding policies has actually been illegal for some time now. Under law, health insurance companies only use that practice when they suspect fraud or inaccurate information. WellPoint stands by the fact that they don’t single out breast cancer patients and that the company is actually a strong advocate for breast cancer research.
admin @ May 5, 2010
Protect yourself – Health Insurance Scams in the News
Posted in: Insurance Fraud, What's in the news today! | Comments (0)
For every good program, there is a better scam. In the time since President Barack Obama passed the Patient Protection and Affordable Care Act, state insurance departments and law enforcement have been busy investigating several reports of criminal fraudulent activity, trying to capitalize on the reform act.
The Coalition against Insurance Fraud spokesman, Jim Quiggle, says he is not surprised by the sudden influx of health insurance scams. “Crooks are exploiting the mass confusion over what the health reform means to the average consumer. With each new aspect of reform, another opportunity for fraudulent marketing opens up.”
One of the most common scams the government is seeing are fraud artists going door-to-door and blast faxing fake insurance policies and telling unsuspecting customers that they’re selling “Obama Care.” To create a sense of urgency, the scammers are invoking the legislation’s individual mandate provision, telling potential victims that the new law requires them to buy the insurance they are selling and do it before a supposed enrollment period closes.
As more of the reform act is put into action, the scams may become more frequent, more creative, and involve more citizens. However; a consumer can take some basic common-sense strategies to ward off any potential scammers:
- Trust your instincts- Like the old saying goes, “If it seems too good to be true, it probably is.”
- Suspicious Signs- Beware of the words “ObamaCare.” This is not an official name for the health care reform act it is simply a tag name that was created in health care news articles and reports.
- Make a call and compare- Verify the legitimacy of the insurer you are speaking with by calling your state insurance department. The state insurance department can also provide any complaints they have received on the insurer.
- Slow down- Don’t make hasty decisions or fall for the “limited time only offer” claim.
- The Bottom Line – Read the fine print. This can not be emphasized enough; always read the fine print of a health insurance contract.
Dealing with scam artist happens in many realms of going about your daily life. The experts are warning that the scams will become more aggressive and creative, so “Buyer Beware!”
admin @ May 5, 2010
New Health Care Laws in the news
Posted in: Health Insurance Reform, What's in the news today! | Comments (0)
High-Risk Pools, Party-line Split
Under the new health care law, the first major decision for the states was to establish high risk insurance pools. The deadline was April 30, 2010 and the deadline has come and gone with decisions being made primarily down party lines.
As of the April 30 deadline, most Democratic governors had largely decided to help the Department of Health and Human Services (HHS) by creating the pools themselves with federal funding. On the other side of the aisle, Republican governors however, decided to allow the federal government to create its own high-risk insurance pool in their states.
The high-risk pools need to be in place by the summer of 2010 which will assist adults with pre-existing conditions find and purchase health insurance coverage. The health insurance news of recent months has fully covered the difficulty adults, who have pre-existing conditions, face when trying to buy health insurance. Most will tell you the costs of health care are exorbitant, making it nearly impossible to obtain good coverage.
Forty-three states have responded to HHS and 15 have said they would leave the job to HHS and 28 states and the District of Columbia said they would work under contract.
The 15 states that turned down the contract cited concern that the $5 billion HHS has set aside for the contracts would not be enough money to cover the cost and the state would be left responsible for the cost. The 28 states that said they would do the work themselves will pursue federal contracts and get a piece of the $5 billion allocated to the program.
The assumption had been made by HHS that some states would opt to let HHS implement the program. Smaller states could benefit from having their residents in a larger, federal pool so the risk is spread amongst more people.
admin @ May 5, 2010
E-Prescribing – What is it?
Posted in: Health Insurance Technology, What's in the news today! | Comments (0)
If you are a constant reader of health care news and the current events surrounding health care, it’s likely you will start hearing more about e-prescribing in the upcoming months. E-prescribing is the electronic prescribing of controlled substances via health information technology (IT) systems.
A pending Drug Enforcement Administration (DEA) rule, permitting the electronic prescribing of controlled substances, is expected to give healthcare providers added incentives to adopt health IT systems. This rule is set to take effect on June 1, 2010.
The new rule would over-rule the current barrier—most prescribers did not want to maintain a separate paper-and-fax system alongside the new e-prescribing system. For many physicians, it has been easier to avoid e-prescribing and stay with a single, very simple, work flow.
The new DEA rule is to make prescription workflow for controlled and standard drugs more seamless and downplays the difficulties faced by physicians and pharmacists. Difficulties include such things as identity proofing, audit trails, and certification of e-prescribing software.
One of the most pressing questions is regarding identity protection and information protection for the consumer. The program is being offered on the premise of how an ATM bankcard works; it includes two-factor protection.
“These controls need not be feared,” said Michelle Ferritto, chief of the regulatory drafting unit in the Drug Enforcement Administration’s (DEA) Office of Diversion Control. “It’s not that much more difficult than using your ATM,” she said, “To withdraw cash a person must enter their pin number and insert their ATM bankcard, an example of two-factor authentication. We would probably be very uncomfortable if anyone could walk up to an ATM and just punch in a 4-digit code, and money spit out. That’s our same concern on electronic prescribing of controlled substances.”
Most believe physicians will adopt e-prescribing much more rapidly when there is a singular workflow. The DEA rule will go into effect at about the same the Office of the National Coordinator finalizes its criteria for EHR (Electronic Health Records).
Providers must comply with the EHR rules before they can receive federal health IT incentives. The timing of the two programs will allow an additional push for physicians that are upgrading their systems to qualify for financial incentives to also purchase e-prescribing software.
E-prescribing is the up-and-coming next technological advancement in the medical industry and it will have an impact on the health insurance industry as well. There are, however, several hurdles to overcome first, so pay attention to the health insurance and industry news for updates.
admin @ May 5, 2010
Employer’s and Group Health Insurance News
Posted in: Past Health Insurance News | Comments (0)
How did this relationship start?
Have you ever wondered how the whole health insurance program started? Who started it and how did employer’s become so involved? If so, let’s take a trip back to the past. And note, these are not the type stories you will hear or read in current health insurance news articles.
The earliest record of offered insurance coverage was during the Civil War (1861 – 1865). These early offerings only covered accidents related to traveling by rail or steamboat. These plans did, however, pave the way for more comprehensive plans that included illnesses and injuries.
The first group policy was offered by Massachusetts Health Insurance of Boston in 1847 and the first individual policies were not issued until 43 years later, in 1890. You may have thought individual policies came first, but no, it was group policies! These individual policies included disability and illness protection for the policy holder.
Flash forward to 1929 when the first modern group health insurance plan was formed by a group of teachers in Dallas, Texas. These teachers contracted with Baylor Hospital for room, board, and medical services in exchange for a monthly fee.
The 1930’s and 1940’s saw an increase in popularity of health insurance and several large life insurance companies entered the health insurance field. It was in 1932 that Blue Cross and Blue Shield first offered group insurance policies. The Blue Cross and Blue Shield policies were very popular and successful because they involved discounted contracts that were negotiated with doctors and hospitals. (Their method of operation hasn’t changed much, has it?) Blue Cross and Blue Shield offered an increased base of patients for the doctors and hospitals and the providers offered discount fees to Blue Cross and Blue Shield policy holders.
Wartime (1939-1945) wage freezes imposed by the government accelerated the spread of group health care. By law, employers were unable to attract workers with increased wages, so they had to improve their benefit packages by adding health care as an incentive. Strong worker’s unions were also bargaining for stronger benefit packages including, tax-free, employer-sponsored health insurance.
As you can see in this brief history lesson, the practices set forth in the 1940’s are very similar to the modern day practices of group health insurance and employer benefit packages. Employer’s are still in competition with each other for the best employees, insurance companies are still negotiating contracts, and group insurance is usually the most attractive option for many people.
admin @ May 5, 2010
Insurance in the News
Posted in: Health Insurance Technology, What's in the news today! | Comments (0)
Electronic Medical Records vs. Charts
The advent of the computer has brought about many advantages but have you ever stopped to think about the disadvantages and how technological advances are making a difference in your health care? The subject of Electronic Medical Records has doctors (and patients) talking!
With the new health care reform laws, Electronic Medical Records (EMRs) are set to be implemented by 2015. If doctor’s offices are not compliant they will face fines.
There are, of course, federal grant incentives for physician’s to bite the bullet and make the investment now. The investment being software, equipment, consultants, and training; which is going to be costly. Some physicians are of the mind-set that it won’t matter since they are planning on retiring before the deadline arrives, others are contemplating retiring early to avoid the perceived “hassle of the transition.”
The broad issue of EMR’s involves so much more than simply entering patient information via a keyboard. Experts from the medical industry, health insurance industry, government, and private enterprise are already pondering the need for a national database. The basis of the dilemma is overcoming the technological and regulatory barriers in creating one.
The Health Insurance Portability and Accountability Act (HIPPA) is very far-reaching, as it stands and is currently cumbersome in transferring health records from one hospital to another. Other obstacles in creating a national centralized database is the fact that not all computers can communicate with one another and patient record numbers vary from facility to facility.
Ultimately, there is the question of who owns a patient’s medical records and who may have access to them? No matter what side of the political aisle you are on concerning the new health reform laws, they will take effect and these will become mainstream media health care news stories. Gone will be the days of a physical “medical chart.”
admin @ May 5, 2010
Health Insurance Reform News
Posted in: Health Insurance Reform | Comments (0)
Although many of the new programs and policies associated with the new health care reform laws won’t go into effect for a few years, there is one incentive that will make it worth the wait. It’s the potential improvement in preventive medicine coverage!
This incentive won’t take effect until 2014, but if you are employed and have your family covered under a group health insurance plan, this incentive could mean thousands of dollars in savings for you. The new law will let employers offer wellness incentives to their workers of up to 30% of a plan’s total premiums—both the employer’s and worker’s portions. This increase is up from the current rate of 20% of the total premium.
How does this equate to money in your pocket? Let’s assume, in the year 2014, your plan is $10,000. In theory, your employer could offer you a discount or rebate of up to $3,000 for taking a proactive approach about your health. This proactive approach could include simple things as seeing a health coach or taking a health-risk assessment.
“Currently, most incentives are far less than $1,000 for a family plan and much lower for people who have individual coverage,” states Dr. Dobro, a physician consultant with Towers Watson, a benefits consulting firm. “But the new law is likely to increase the level of incentives employees may receive.”
The logic behind corporate wellness programs is simple: employees who are in better health spend less money on healthcare. It’s no surprise that the number of companies starting wellness programs is growing. Ultimately, the company costs associated with health care benefits decrease and some of the savings is passed onto the employee by way of incentives.
In heath insurance news, wellness is a topic worth watching to see what the new health care reform laws put in to place. In the meantime, you can check with your employer’s Human Resource Department or Benefits Coordinator to see if your company has a wellness program already in place. We all enjoy saving money, right?
admin @ May 5, 2010
Health Insurance News – Current Scams!
Posted in: Insurance Fraud | Comments (0)
Health insurance news is ramped with the word ‘fraud’. As a consumer you hear the word daily in your reading, no matter the subject. However, health insurance has topped the scam list as the new health care reform legislation has been passed. It is important for consumers to become aware of these issues to avoid such scams.
Now that the health care legislation is law, fraudulent marketers are out in force. Some of the typical fraudulent tactics being used are blast faxes, telephone marketing, and knocking on doors. One of the more sophisticated means of deception is where a fraudulent insurance company actually sets-up a storefront in a community. These companies sell policies, issue health insurance cards, collect premiums, and file bogus claims. It’s not very long before the company vanishes and the victim is left with hefty medical bills. These companies look extremely professional with very professional sales materials.
Everyone likes a discount and with discount cards for “memberships” being very popular, the insurance criminals have jumped on the bandwagon. Several of these discount cards do actually provide discounts on some expenses such as prescription drug costs and dental services through a network of providers. However, some of the unscrupulous marketers are overstating the size of the networks, or offering unbelievable discounts—sometimes up to 85 percent.
Oftentimes, discount cards only work at certain health care providers and only cover a fraction of the cost. The cards may cover $500 in hospital fees a day but if a person has a $5000 procedure done, the consumer is left with a huge bill.
The unsuspecting consumer is drawn into the plan on the falsehood that the discount card will pay for major medical expenses. Hospitals are reporting that people are coming to the hospital, for admittance or emergency care, and presenting their discount card for health insurance purposes.
As people are confused over the passage of health care legislation, criminals have been able to persuade consumers to purchase these fake health insurance plans. Consumers should become aware of these criminal activities and check with the Department of Insurance to make sure a company is licensed to sell insurance.
admin @ May 5, 2010
