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PHYSICIAN GROUPS PROPOSE PERMANENT “DOC FIX”
In an October 15 letter, the American Medical Association (AMA) and more than 100 other medical societies and physicians’ organizations urged Congress to consider a permanent replacement for the Medicare physician payment system. Under the Sustainable Growth Rate (SGR) formula used for Medicare Fee Schedule payments, doctors’ reimbursements for services are scheduled to be cut by 27% as of January 1, 2013. …
Read More Healthcare Update: Physician Groups Propose Permanent “Doc Fix”; HIPAA/HITECH Enforcement Expected to Increase in 2013

We previously reported on AB 999. This bill revises the premium rate development process for long-term care insurance in order to address the dissatisfaction of policyholders with rate increases on in-force coverage.
Read More California Insurance Commissioner Dave Jones Has Sponsored Seven Bills That Have Been Enacted and Will Become Effective on January 1, 2013

CONGRESSMEN PUSH HHS TO RESPOND TO STATES’ PPACA QUESTIONS
In an October 4 letter to Kathleen Sebelius, the Secretary of the Department of Health and Human Services (HHS), the leaders of the House Energy and Commerce Committee renewed their request that HHS respond promptly to all outstanding questions from states regarding implementation of the Patient Protection and Affordable Care Act (PPACA). Reps. …
Read More Healthcare Update: Congressmen Push HHS to Respond to States’ PPACA Questions; HHS Awards New Exchange Grants While Congressmen Call for Increased HHS Oversight; New York Governor Vetoes Bill to Amend Anti-Kickback Law

Recently, on August 6, 2012, Massachusetts Governor Deval Patrick signed into law Senate Bill 2400. The Bill, which states that it is “An Act improving the quality of healthcare and reducing costs through increased transparency, efficiency and innovation,” goes into effect on November 4, 2012. …
Read More Healthcare Update: Massachusetts Bans Mandatory Overtime for Nurses

HOUSE COMMITTEE APPROVES MEDICAL LOSS RATIO BILL
On September 20, the House Energy and Commerce Committee approved a bill that would exclude brokers’ commissions from the calculation of a health insurance plan’s medical loss ratio (MLR). …
Read More Healthcare Update: House Committee Approves Medical Loss Ratio Bill; New York Court Dismisses Challenge to Wage Parity Law

In a case challenging the California Department of Insurance’s (CDI) accusation against life and health insurers of multiple unfair and deceptive practices in violations of the California Insurance Code and the Fair Claims Practices Regulations (FCPR), an administrative law judge ruled that the CDI had overstepped its powers deriving from the Fair Claims Settlement Practices Regulations, and particularly Section 790.03 of Insurance Code. …
Read More California Judge Spares Insurers Heavy Fines for Alleged Unfair Acts Violations

HEALTHCARE HEARINGS SCHEDULED AS CONGRESSIONAL RECESS ENDS
Congress’s annual August recess ended today and both House and Senate groups have scheduled hearings this week relating to implementation of the Patient Protection and Affordable Care Act (PPACA). …
Read More Healthcare Update: Healthcare Hearings Scheduled as Congressional Recess Ends

CMS RELEASES MEANINGFUL USE STAGE 2 FINAL RULE
On August 23, the Centers for Medicare & Medicaid Services (CMS) released a final rule outlining the Stage 2 criteria for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet these requirements to receive EHR incentive payments. CMS issued a fact sheet on the rule. …
Read More Healthcare Update: CMS Releases Meaningful Use Stage 2 Final Rule; Medicare to Pay Bonuses to Primary Care Physicians; ICD-10 Delayed One Year; States Receive New HHS Grants for Healthcare Exchanges

On August 6, 2012, Gov. Deval Patrick (D-MA) signed into law a nearly 350-page bill that builds on the health reform legislation signed into law by Gov. Mitt Romney in 2007, and supports the Patient Protection and Affordable Care Act. The legislation’s cost containment provisions are estimated to save Massachusetts up to $200 billion in healthcare costs over the next 15 years. …
Read More Client Advisory – Massachusetts Governor Signs Healthcare Payment Reform Bill

FEDERAL HEALTH INSURANCE EXCHANGES TO BE OPERATIONAL BY PPACA DEADLINE
The Patient Protection and Affordable Care Act (PPACA) mandated that online health insurance exchanges be created and operating in all states by October 1, 2013, so that individuals and small groups can enroll in plans in advance of a January 1, 2014 start date. In states that do not create their own exchanges, the federal government will be required to implement federally operated exchanges. …
Read More Healthcare Update: Federal Health Insurance Exchanges to be Operational by PPACA Deadline; Congressional Recess Nears, Election Looms