HCPro Health Plan Insider - September 24, 2008 | Sky is Not Falling in Managed Care View as a Webpage | Subscribe for Free
Sky is Not Falling in Managed Care
Les Masterson, Senior Editor-Managed Care
The current financial calamity may not affect health insurers as much as other industries, but there is an impact to managed care. A credit rating company has proposed new ratings criteria to analyze financial leverage of health insurers. [Read More]
  September 24, 2008

Editor's Picks
Medicare paid billions in suspect claims
Smiley faces, question marks, and assorted other invalid codes cost Medicare more than $1 billion in questionable claims for medical supplies, according to a Congressional report. The review of claims from 2001 to 2006 found problems such as Medicare paying for blood glucose strips to treat sexual impotence and special diabetic shoes for leg amputees. The report is the latest to highlight lax oversight of Medicare, which government auditors have claimed led to alleged fraud and waste. [Read More]
Premiums to pinch wallets
If sagging stock prices and rising energy costs aren't depressing enough, Americans' health insurance costs are expected to climb nearly 9% in 2009. Hewitt Associates says the average healthcare costs will rise to $3,826 for individuals while companies will see an increase of 6.4% to $8,863 per employee. [Read More]
Medicare premium for 2009 remains unchanged for most
About 95% of Medicare beneficiaries will pay the same premiums in 2009, which is the first time since 2000 that rates will not rise. The good news is because Medicare has been building up its reserves in recent years and the government discovered an accounting error that will benefit next year's rates. Medicare officials expect the premiums to increase again in 2010. [Read More]
Aetna to let outside doctors decide on rescissions
Three-member physician panels will have the final say on whether to rescind Aetna health insurance policies of those suspected of obtaining policies through false or incomplete information. The Connecticut-based insurer is the first to set up binding outside reviews. The move comes after backlash concerning health insurers' rescission policies, most notably in California. [Read More]
CMS launches site for caregivers
A new Web site will help family members who care for Medicare and Medicaid patients navigate through the healthcare system. The Ask Medicare site was launched to help caregivers with Medicare enrollment, billing, drug plans, financial concerns, and selecting a nursing home. One in five adults provide care to a relative, friend, or neighbor, according to CMS. [Read More]
Health savings accounts expand as care costs rise
Health savings accounts (HSAs) have become an increasingly popular tool as a way to decrease healthcare costs. Nineteen percent of employers will offer HSAs in 2009 and enrollment in those accounts has risen to 6.1 million. Businesses view HSAs as an important healthcare savings tool as part of consumer-driven health plans. [Read More]
Managed Care Headlines
Congress approves mental health bill
Washington Post, September 24, 2008
Insurance giants have own ideas on reform
St. Louis Post-Dispatch, September 17, 2008
Hospice faces cuts in Medicare reimbursements
Orlando Sentinel, September 18, 2008
18 arrested in alleged $33-million Medicare fraud schemes
Los Angeles Times, September 19, 2008
Physician's aide admits role in Medicare fraud
Miami Herald, September 19, 2008
Candidates fail to address quality, cost of healthcare
Chicago Tribune, September 23, 2008
BlueCross of Tennessee launches online physician database
The Tennessean, September 17, 2008
Kaiser, Mid Atlantic top managed-care rankings
Baltimore Sun, September 23, 2008

October 29: In-sourcing vs. Outsourcing Disease and Health Management: What's the Right Mix
On Demand: Health Literacy: Four Ways to Create a Successful Program
On Demand: Legal and Tax Implications of Incentive Program Designs
On Demand: Value-based insurance design: Alternative to high-deductible plans
Listen Up
Time is right for CDH
Frank Hone, founder and CEO of Healthcentric Partners, Inc., a healthcare consumerism strategy and training company, talks about what is needed to educate a healthcare consumer and why the environment is right for consumer-driven healthcare. [Listen Now]
From HealthLeaders Media
An Odd, Bad Feeling

I had a great column set to go this week. But in the midst of Wall Street's financial meltdown last week, I saw something so disconcerting that I just had to scrap it and write something else. [Read More]
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