AHA goes after ‘two-midnight’ rule in court

The controversial “two-midnight” rule just got a little more controversial; the American Hospital Association Monday filed two lawsuits against the rule and was joined in its suit by several state hospital associations and individual hospitals. “The two-midnight rule undermines medical judgment and disregards the level of care needed to safely treat patients,” said Richard Umbdenstock, president and … Read more

PPACA costs fall as premiums beat forecast

The health law will cost $104 billion less over the next decade, the Congressional Budget Office said after premiums for private Patient Protection and Affordable Care Act (PPACA) plans came in lower than the agency expected. The premium for a benchmark “silver” level plan, the second-most generous available, will average $4,400 in 2016, the CBO … Read more

How to minimize taxes when positioning a client’s funds into an annuity

CLICK HERE to learn more about the tax advantages of using the “Bundle Theory” with annuities.  The bundles provide you and your client the flexibility of moving some or all of their accounts if their financial goals change.  Plus, separating the money could keep the future values below the threshold for the Guaranty Association.  For … Read more

Supplemental sales booming for agents

The Patient Protection and Affordable Care act is creating enormous opportunities for agents to sell supplemental plans, not only to help cover increasing deductibles in employer-based and exchange-based plans, but also as a cheaper alternative to both. The opportunities to sell supplemental health plans to cover out-of-pocket expenses when illness or accidents occur are coming from a … Read more

HHS Secretary Kathleen Sebelius resigns

HHS Secretary Kathleen Sebelius has resigned her post barely a week after the close of the tumultuous initial open-enrollment period for the healthcare reform law’s insurance exchanges. The six-month signup period was plagued by technology problems that initially thwarted consumers’ attempts to enroll in coverage. But it closed with a surge of interest that ultimately saw the … Read more

Exchange enrollees sicker than average

Those who enrolled in health coverage through the exchanges aren’t as healthy as some would like, according to new data. Analysis from Express Scripts shows that, based on their medication usage, PPACA enrollees are sicker than patients off the exchanges, often requiring specialty drug prescriptions. The pharmacy benefit manager said that six of the top … Read more

Insurers still see Medicare Advantage cuts on horizon

Insurers and Wall Street analysts still see cuts ahead for Medicare Advantage plans even though the Obama administration says that tweaks to its draft policy mean the rates will rise.  “It’s not as clear-cut a win for the industry as some are making it out to be,” John Gorman, executive chairman of Gorman Health Group, a consulting firm, … Read more

Consumers can opt out if Medicare Advantage networks drop their docs

Lost in Monday’s announcement by the CMS of 2015 Medicare Advantage rates was another significant decision it issued to allow consumers an opt-out option when their health plans narrow their MA networks. The agency “is establishing a policy to allow enrollees to switch plans when they are affected by significant mid-year provider network terminations initiated by their Medicare … Read more

PPACA Medicaid sign-ups reveal disparities

Just 10 states accounted for more than 80 percent of the 3 million Medicaid enrollees who’ve signed up under the Patient Protection and Affordable Care Act this year, according to fresh analysis. Consulting firm Avalere Health analyzed government numbers, finding a wide disparity in Medicaid enrollment totals from state to state. From October through February, California, Florida, … Read more

CMS to increase Medicare Advantage pay rate by 0.4%

After an aggressive lobbying push from the insurance industry, the CMS announced Monday that it would increase the overall rate it pays Medicare Advantage plans by 0.4% in 2015, despite a proposed policy issued in February that signaled a 1.9% rate cut.  The positive change is the result of “various policy changes” and “new estimates,” Jonathan Blum, CMS principal … Read more

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