Posts Tagged ‘America’s Health Insurance Plans’

Medicare, Medicaid Head Rallies Insurance Companies

Thursday, September 30th, 2010

Controversial CMS chief wants insurers to work with healthcare providers to make reform work.CMS administrator Donald Berwick has asked the insurance industry to work in good faith to implement healthcare reform in a timely manner. Dr. Berwick made his plea at a Medicare conference sponsored by America’s Health Insurance Plans, the health insurance industry’s trade group.

“We need your help, our nation needs your help,” Dr. Berwick said, noting that companies, CEOs, healthcare professionals and managers all play a role in achieving the objective, yet the insurance industry “can be among the keys of our success, the central part in navigating the success of healthcare reform.  We have a job to do, we need to make care better for America.”  Berwick told the audience that he plans to work with others at CMS to build relationships and partnerships to assure that the Patient Protection and Affordable Care Act works as intended.  “If we steadily work together to make care what it can become, trust will resurface and the rest will follow,’ he said.

Dr. Berwick, who President Barack Obama named to his post in a recess appointment that bypassed the Senate confirmation process, is not well liked by Republicans because he once wrote an article that praised Britain’s National Health Service, raising concern that he will introduce healthcare rationing.  He tried to allay those fears by saying “I urge lower costs without harming a hair on any patient’s head.  It’s a clear, stark reality.  Our healthcare system, in its current form, is not up to that job.  We cannot, with our current system of care, give Americans the care that they need and want and deserve.”

The most pressing issue is improving patient safety and cutting deaths that result from unnecessary medical errors, a specialty that Dr. Berwick developed when he headed the Institute for Healthcare Improvement.  He also called for improved prevention and treatment of diseases like obesity and depression.

HealthCare.gov Debuts on a Computer Near You

Tuesday, July 20th, 2010

New HHS website a source for all things healthcare reform.  The Department of Health and Human Services (HHS) has launched a new website to help Americans better understand and explore the options open to them as healthcare reform legislation takes effect.  The website was mandated in the healthcare reform bill passed in March; in October, there will be a tool that lets people compare pricing for various insurance plans.

Insurance companies aren’t entirely happy with some of the content on the new HHS website.  The industry’s lobbyist, America’s Health Insurance Plans (AHIP) told HHS that they were not comfortable about the insurance plan information that might be detailed on the website.  One of the sore spots was the government’s request for data on how many claims are denied by healthcare plans.  According to Robert Zirkelbach, an AHIP spokesman, “Providing information about claims denials without providing proper context does not begin to tell the whole story.”  Zirkelbach said that claims are often denied because of duplicates or submitting a claim to the incorrect health plan.

HHS Secretary Kathleen Sebelius, writing on the White House blog, said “The site makes a system that thrived on complication and confusion easier to understand.  This kind of transparency helps create informed consumers, which increases competition, reduces prices and improves quality.”  The website’s two-minute video explains the law and its provisions, while a tab on the home page provides in-depth information on the law.  HealthCare.gov even has its own Twitter account.

Kids With Pre-Existing Conditions May Get Insurance Coverage Before September 23

Thursday, June 24th, 2010

Starting in September, the approximately five million Americans under the age of 19 who have pre-existing medical conditions cannot be denied health insurance coverage. The healthcare reform law also gives these patients expanded physician choices because many previously had to rely on government programs such as Medicaid.  Children account for approximately nine percent of the 57.2 million Americans under the age of 65 who have pre-existing conditions.

Although Congress wanted to implement this section of the bill immediately instead of waiting until September 23, some private insurers are showing signs of stepping up to the plate and providing coverage as soon as the Obama administration issues regulations on final implementation.  According to Illinois Insurance Director Michael McRaith, “It would not surprise me if insurers would undertake this earlier.”

Although there were some concerns that insurers might try to deny coverage to children with pre-existing conditions or set rates too high, Secretary of Health and Human Services Kathleen Sebelius sent a letter to Karen Ignani, CEO of America’s Health Insurance Plans directing the trade organization to comply with the new law.  “To ensure there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term ‘pre-existing condition exclusion’ applies to both a child’s access to a plan or to his or her benefits once he or she is in the plan,” Sebelius wrote.

“This is a confidence builder in what healthcare reform does,” said Ron Pollack, executive director of Families USA, a consumer health advocacy group that backed expanding healthcare coverage.  “It’s a popular group to reach out to…and it’s not going to have as big of an impact on costs as, say, somebody between the ages of 56 and 64 who has multiple chronic conditions.”

“The Big Dog” Challenges Healthcare Insurers to Rein in Costs

Tuesday, June 22nd, 2010

Bill Clinton tells health insurers they need to make coverage more affordable.  Former President Bill Clinton warned the healthcare insurance industry that they need to move towards being an “in the future business” rather than holding on to obsolete, unsound business models.  In a recent keynote speech to America’s Health Insurance Plans’ annual conference, Clinton told the insurers’ trade group that he respected their support for healthcare reform.  He cautioned, however, that there is still work to be done.

“We now have to go after the cost in a way that improves the quality,” Clinton said.  “You did your part but it’s all gong to be for nothing unless we bring down the cost of healthcare.”  Clinton called on Congress to enact an amendment to the new healthcare law that specifically establishes a bipartisan commission whose goal is to determine the best practices in healthcare.  Clinton suggested that the panel be patterned after the National Commission on Fiscal Responsibility and Reform, which President Barack Obama created in February.  Its goal would be to devise solutions that rein in costs and improve the quality of care.  According to Clinton, the commission would ideally meet between its creation and 2014, when most of the reforms become effective.

“I don’t really care who’s at fault,” Clinton concluded.  “We need to figure out how to fix this healthcare thing.”

Democrats Taking On Healthcare Insurers’ Antitrust Immunity

Wednesday, November 18th, 2009

If Democrats get their way, healthcare insurers will lose their immunity from antitrust laws.  Democrats in the House and Senate are trying to strip the insurance industry of its decades-old exemption from federal antitrust laws, in the fight to overhaul the way healthcare is delivered in the United States.  If the legislation is passed, it will end the “price-fixing, bid-rigging and market allocation in the health and medical malpractice” insurance areas, according to Senator Patrick Leahy (D-VT), chairman of the Senate Judiciary Committee.  Leahy’s statement coincided with the House Judiciary Committee’s 20 – 9 vote to end the industry exemption.

Health insurers are fighting back, with Karen Ignagni, president and CEO of America’s Health Insurance Plans (AHIP) claiming that “We believe that health insurers have not been engaging in anti-competitive conduct and that McCarran – Ferguson does not provide a shield for such conduct” in a letter to Representative John Conyers (D-MI), who chairs the House Judiciary Committee.  The McCarran – Ferguson Act of 1945 gives states the ability to regulate the insurance industry for antitrust matters.  As a result, insurance companies currently are exempt from federal jurisdiction.

The moves to revoke healthcare insurers’ long-term immunity from antitrust laws reflect the Democrats’ anger in response to the industry’s attempts to shape reform legislation.  The action came shortly after AHIP issued a report asserting that a measure in the Senate Finance Committee would result in significantly higher premiums for people who current have healthcare insurance.  Democrats and President Obama attacked the study as flawed and motivated by politics.  According to the president, insurers are earning “profits and bonuses while enjoying a privileged exemption from our antitrust laws, a matter that Congress is rightfully reviewing.”