Benefits.....Opinion, Hearsay & News Review
A retired Alabama chiropractor is
suing 45 Blue Cross plans nationwide. The suit alleges that BCBS license
agreements not to sell in each other's markets violates federal anti-trust laws
and limits competition in those markets. He claims the BCBS Association rules
have driven up insurance costs and reduced payments to doctors and hospitals,
especially in places like Alabama where the Blues have a 90% market share. From
our perspective, he appears to have
Several health insurers are
asking HHS to not include fraud prevention costs as part of the Medical Loss
Ratio (MLR rules). HHS announced an initiative to share claims data among
insurers to fight fraud, so the insurance industry responded
by requesting this change. No word on the HHS response.
Health Savings Accounts are
estimated to have grown to more than $14.1 billion in assets over 7.1 million
accounts according to a recent survey. That's an average of $1,986 per account.
The data came from the top 50 HSA providers surveyed in July 2012. That is a 12%
increase in the number of accounts from last year and a 21% increase in assets
from last year. HSA account holders have retained about 30% of their
contributions in 2012, up from 24% in calendar year 2011.
The 4th annual report
for the Generic Pharmaceutical Association found the use of generic drugs
has reduced U.S health care costs by more than one trillion dollars in the last
decade and $193 billion in the last year alone. Last year, nearly 80% of the
4 billion in prescriptions dispensed were generic drugs and those drugs
accounted for just 27 % of Rx spending. Where both brand and generic drugs were
available for the same diagnosis, consumers opted for generics 94% of the time.
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Aetna has announced it will
buy Coventry Health Care for $7.3 billion. The acquisition is primarily to
expand Aetna's Medicare and Medicaid business by Coventry's membership of 4
million medical members and 1.5 million Medicare Part D members. The deal is
expected to close in mid-2013, further limiting competition in the health care
How the game is played with
the big boys: After Rush Health System in Chicago refused Aetna's request for a
30% cut in reimbursement rates for Aetna patients, Aetna cancelled its provider
contracts with Rush, effective last January 1st. Aetna also covered Rush System
employees. Now Rush has dropped Aetna from administering their self-funded plan
and chosen Cigna to administer the program for their approximate 17,000 workers.
The Council for Disability
Awareness released its latest survey. Forty-three percent of participating
insurance companies reported increased claim incidence from 2010 to 2011. Only
19% reported a lower claim incidence. 2011 was the first year since 2008 where
the number of private corporations offering LTD increased. The total number of
disabled workers receiving Social Security disability
payments has continued to increase. Does anyone blame current economic
conditions for this?
The Social Security
Administration paid a record $120 billion to disabled workers in 2011, up 4%
from 2010. Over 2.5 million workers in the 20-49 age group were receiving SSDI
payments, out of a record 8.6 million total workers (5% of the U.S. workforce!)
who were receiving SSDI benefits. The average monthly benefit was $1,111.
Wellpoint's CEO- Angela Braly
has resigned. Stock in the company rose.
After President Obama declared
in June that 800,000 young undocumented immigrants could remain and work in the
United States, HHS has quietly issued a rule last week that blocks these
undocumented immigrants from taking advantage of the health reform law. The
workers will not be able to join pre-existing conditions plans or the
coming exchanges. There seems to be some irony in this position, since the
administration clearly wants them to vote.