HHS Selects 73 Advisors To Improve Healthcare

January 9, 2012 tarpey Insurance News

The Health and Human Services Department announced that 73 “innovation advisors” were selected to spend up to 10 hours per week working to change health systems in ways that will improve care. These advisors, made up of health care executives, academics, and other health care professionals, will work with the Center for Medicare and Medicaid Innovation to try to improve healthcare quality and lower costs.

Each advisor will be paid $20,000 to perform this task. During the first six months of the program, the 73 members will attend seminars and spend the remaining time testing new ways to implement their proposed changes.

These 73 people were selected from over 900 applications. What are your thoughts on this decision? Leave a comment below and let us know what you think!

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The Top Reasons Every Working American Needs Paycheck Protection

January 5, 2012 tarpey Insurance News

 

 

 

 

 

 

 

Below are the top 15 reasons why every working American should have paycheck protection in case of becoming disabled:

  1. At age 32, the chance of being disabled for 90 days is 6.5 times greater than the chance of death.
  2. More than 51 million Americans – 18 percent of the population – are classified as disabled.
  3. Almost one-third of Americans entering the workforce today – three out of 10 – will become disabled before they retire.
  4. 34,017 fatal crashes occurred in 2008, the lowest rate since 1961. But what about those who survived the carnage? In 2008, 2.35 million people were injured in car accidents. Car crashes are the leading cause of acquired disability in the United States.
  5. Seventy-five percent of disabilities are caused by an illness rather than an accident.
  6. Seventy percent of American workers in the private sector have no long-term disability protection.
  7. A Harvard University report reveals that 62 percent of all personal bankruptcies filed in the U.S. in 2007 were due to the inability to pay for medical expenses.
  8. The likelihood of being disabled for more than three months is greater than dying in any given year.
  9. Accident or illness will force 1 in 5 U.S. employees to miss work for at least a year before they turn 65. Furthermore, the average long-term disability absence lasts 2 years.
  10. In the past hour, almost 3,000 Americans became disabled. That’s 49 disabilities every minute.
  11. Every year, 350,000 personal bankruptcies are attributed to injuries and unexpected illnesses.
  12. In the first year following paraplegia, living expenses average $259,531 per person.
  13. Stroke is the leading cause of serious, long-term disability in the United States. From 1995 to 2005, the stroke death rate fell 29.7 percent and the actual number of stroke deaths declined 13.5 percent.
  14. Only a small fraction – 10 percent – of disabling accidents and illnesses are work related. The other 90 percent are not, which means workers’ compensation doesn’t cover them.
  15. The average monthly benefit paid by Social Security Disability Insurance (SSDI) is $1,004 a month.
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Bonuses Awarded to States for CHIP Enrollments

December 30, 2011 tarpey Insurance News

On December 28th, 2011, the Obama administration awarded $296 million to 23 states as a bonus payment for exceeding the enrollment targets for the Children’s Health Insurance Program (CHIP). HHS Secretary Kathleen Sebelius praised the program, noting the benefits that health coverage provides for children and the security it provides for parents.

This money was allotted in different ways. For example, the state of Maryland received $28.3 million due to their superior performance in streamlining the children’s health coverage enrollment process by omitting the face-to-face interview requirement for applicants. Also, the state uses electronic databases as a way to verify family information which speeds up the process.

Alaska’s award amounted to $5,660,544 and North Carolina received $21.1 million as a performance bonus. New Jersey will be awarded $16.8 million for continuing to successfully enroll and keep children in Medicaid and FamilyCare. North Dakota and Idaho received $3,195,768 and over $1.3 million, respectively. Furthermore, Montana received nearly $6.5 million, which is the first time Montana has been given a bonus.

What are your thoughts on these recent bonuses given by the Obama administration? Is it a reasonable reward for high CHIP enrollments? Let us know what you think by leaving a comment!

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The Impact of Health Care in 2011

December 29, 2011 tarpey Insurance News

Many people have heard of the 2010 health care law, but few actually realize the impact that it has made. Already, large segments of the new law have been enacted which are affecting millions of people. Don Berwick, the former administrator of the Center for Medicare and Medicaid Services, stated, “It’s complicated, but there are very many benefits affecting millions of people. They will not know it’s the Affordable Care Act, but it is.”

There are five major changes in health care that occurred in 2011 due to the health care law, as well as countless other smaller changes. The first one of these important changes is the recent crackdown on health care fraud. The government showed a 69% increase in cases prosecuted for health care fraud in 2011. This increase was a result of the law increasing prison terms for health fraud, an increase in strike force teams that specialize in this field, and greater funding for more advanced technology to detect suspicious patterns in claims.

The second major change is greater relief for those who are 25 years old or younger. This relief stems from the part of the law that allows those under 25 to remain on their parents’ health insurance policies. This will allow young people to take jobs they like, instead of taking jobs just for the benefits. It also prevents youth from attempting to live without health insurance because they are young and healthy and feel “invincible.” If a medical emergency does occur, they could be left in severe debt without insurance.

The health care law also benefits the opposite end of the spectrum: senior citizens. Not only has the cost of prescription drugs been reduced by half, but seniors are also eligible for annual exams and certain screenings without paying a co-pay. They can also receive free counseling if they screen positively for obesity in an effort to decrease the risk of heart disease, diabetes, and strokes.

Next, those who are privately insured can now go for annual exams, screenings, and immunizations with no co-pay, deductible, or co-insurance. However, many plans already offered these services with the hopes that preventing problems early will help save money later.

Finally, those with pre-existing conditions who were denied insurance coverage in the past could be eligible for the government’s Pre-existing Condition Insurance Plan. Those without insurance for at least 6 months can use this program. The program is now easier to join due to cheaper premiums and less strict requirements.

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Special Education Can Cost Less In A Private School

December 15, 2011 tarpey Special Education

Believe it or not, a private school education for a child in need of special education can be cheaper than a public school education.

At the surface, it seems true that a private school is more costly. In fact, many specialized private schools for children with disabilities are charging tuition rates over $80,000 per student. However, this does not mean that your child has to pay this price, and here is how it works:On average, it costs $45,358 to educate a disabled child in a state-approved private school, while it costs $50,146 to educate a pupil in a public school. The costs for county special service schools are even higher, and these estimates do not include transportation costs.

However, law requires that if the local public school cannot provide a “free and appropriate” education to a child in need, the district must pay to send the child to a school outside the district that can effectively educate the student. This usually means the child will be sent to a state-approved private school, which is done at the taxpayers’ expense.

However, students may also be relocated to out-of-district public schools. This allows special needs children to interact with their non-disabled peers, which is a positive advantage for the development of the child. This option may also provide some cost savings, although this may not prove to be true according to Gerard Thiers. Thiers is the executive director of ASAH, which is a non-profit group that represents over 125 special-education private schools around New Jersey. He believes that the public school option may not be cheaper due to the cost of pensions, Social Security, and various health benefit costs. On the contrary, private school tuition rates are all inclusive. Thiers noted that while it is admirable for public schools to create programs for children in need of special education, it would probably be more costly to do so in a public sector. These findings will influence the recently proposed legislation that is intended to reduce waste and improve the quality of special education programs.
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Requirement To Carry Health Insurance Ruled Constitutional

November 16, 2011 tarpey Insurance News

Another challenge facing the 2010 health-care overhaul was overcome recently, giving the Obama administration more momentum before the Supreme Court sets out to determine the  law’s constitutionality. The challenge was directed towards “the law’s requirement that most Americans carry health insurance or pay a penalty” and was unanimously rejected by the U.S. Court of Appeals for the District of Columbia Circuit.

Judge Laurence H. Silberman issued a 37-page opinion, citing that the law is “part of the fundamental tension between individual liberty and legislative power.” However, Judge Brett M. Kavanaugh stated that the courts do not have jurisdiction until 2015 when the law’s tax penalties come into effect. This split increases the likelihood that the Supreme Court will ultimately hear the case.

Stephanie Cutter, who is an advisor to president, applauded the decision, saying that those “who claim that the ‘individual responsibility’ provision exceeds Congress’ power to regulate interstate commerce are simply wrong,”

USA Today clarified the gravity of the case’s decision.  ”The stakes are huge going into the case,” said law professor Pamela Karlan of Stanford University. “The case will determine how much power the federal government has to deal with life in the 21st century, health care being among the most important issues.”

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New York Now The 29th State to Require Insurers to Cover Autism Expenses

November 3, 2011 tarpey Insurance News

Beginning on November 1st, 2012, New York State will begin mandating that health insurers provide coverage for the screening, diagnosis, and treatment of autism spectrum disorders (also known as ASDs). The Governor, Andrew Cuomo, signed the bill on November 1st, helping the families of autistic children to save tens of thousands of dollars in out-of-pocket expenses. This is great news for the 30,000 autistic children in New York and their families.

However, there is a drawback to this new bill. The state Health Plan Association speculates that premiums for businesses and families may increase so much that they may be priced out of coverage all together. For that reason, the association wants to reduce the coverage and costs before the law takes effect next year.

In response, Governor Cuomo said that there would be a $45,000 cap on the coverage that insurance companies would have to fund, and supporters believe that premiums will only increase by $1 a month for all New Yorkers.

Paul Macielak, president and CEO of the New York Health Plan Association, believes otherwise. He estimates that it could cost families hundreds and businesses thousands. However, the advocacy group “Autism Speaks” said that they believe the bill could ultimately save taxpayers $13 million over a six year time period due to the reduction of Medicaid costs and the money needed to fund early intervention and special education programs for autistic children.

What is your reaction to the new bill? Post your comment and let us know what you think.

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Medicare Premium Increase for 2012 is Surprisingly Small

November 3, 2011 tarpey Insurance News

The recent announcement about Medicare premium increases was met with positive and satisfied reactions. The increase was announced to be smaller than expected. Multiple news outlets reviewed the story and added their own opinions and perspectives on this developing story.

 

The New York Times clarified how the increase for monthly Medicare premiums for beneficiaries would only increase by $3.50, meaning they will pay $99.00 a month. From a political standpoint, the appraisal of the small increase by administration officials could help President Obama “as he tries to win the votes of older Americans in his bid for re-election.”

 

The Wall Street Journal makes a note of a remark made by Kathleen Sebelius, secretary of Health and Human Services. She said that the higher Social Security benefit, in combination with the smaller-than-expected Medicare premium increase, means the typical retiree could have about $40 more to spend each month.Also, while this new Medicare premium is an increase for about three-quarters of seniors and disabled people, “people who turned 65 in 2009, 2010 or 2011 have been paying $115.40 a month.” For those people, their premiums will decrease.

 

Sebelius also claimed that this lower-than-expected increase was “the latest round of good news” mostly due to the Affordable Care Act.

 

Most of those affected by Medicare were pleased by this small increase. It is allowing administrators to offer people better, more affordable Medicare.The Washington Post wrote that “The announcement was the third piece of good news about Medicare premiums this year.” AARP’s legislative policy director, David Lerner, stated, “This small increase is welcome news.”

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New Rules For Health Insurance Exchanges

August 16, 2011 tarpey Insurance News

The Obama administration recently released three proposed rules that will be critical to the establishment of health insurance exchanges. For those unfamiliar, the overarching purpose of health insurance exchanges is to make health insurance easier to purchase by individuals and small businesses, while making it more affordable. By pooling insurance risks and premiums, it is expected that these new exchanges will allow individuals and small businesses to have the same purchasing power as big businesses.

The department o f Health and Human Services (HHS) created two of these three rules. The first rule outlines exchange eligibility and employer standards. In other words, it determines who is eligible for exchange participation. The second addresses the Medicaid eligibility increase and the proposed enrollment system. The Internal Revenue Service (IRS) proposed the third rule which provides guidance on premium subsidies for coverage obtained through exchanges. These three rules will be important to shaping these enchanges and will impact those who are affected by them.

Additionally, buying a health plan in the future will become similar to the process of shopping for an airline ticket or booking a hotel online. By 2019, it is predicted that 24 million Americans who do not get health insurance from their employment will obtain their insurance using these exchanges.

These rules are merely propositions at the time. Comments on all three rules are being accepted until October 26, 2011.

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Recent Debt-Ceiling Agreement May Impact Medicare

August 3, 2011 tarpey Insurance News

According to a recent report from the Wall Street Journal, the recent debt ceiling agreement reached by Congress may impact older Americans reliant on Medicare or those with disabilities. Legislators may begin using means testing (in which wealthier people pay more for the program) and raising the eligibility age for Medicare.  Hospitals might even have to eliminate services due to a deal provision which would allow reimbursement cuts to clinicians treating Medicare patients. The deal also included a fall back spending-cut provision which includes Medicare cuts capped at 2%. While this directly impacts healthcare professionals, some medical groups say they cannot make these cuts without seriously affecting patients.

Washington wants more savings from medical providers, hospitals, and doctors in this debt deal that President Obama signed Tuesday (8/2/11). This deal is designed to protect seniors and others who rely on Medicare, but may in fact hurt those who need it most. If Congress cannot create a plan to reduce the deficit by $1.5 million dollars over the next ten years, the aforementioned debt ceiling plan will require a 2% across-the-board reduction in payments to Medicare providers beginning in 2013. Even though this Medicare cut is small, advocates for the elderly fear that this reduction could cause medical providers to reduce their services or stop serving them entirely.

 

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