Implementing Health Reform: Final 2016 Letter To Federal Exchange Issuers
Each year the Centers for Medicare and Medicaid Services (CMS) releases a letter to issuers (insurers) in the federally facilitated marketplace (FFM) setting out the ground rules for coverage through the FFM for the coming year. A draft letter is published for comments, followed by the final letter. The letter addresses insurers that issue qualified health plans (QHPs) in the FFM, including stand-alone dental plans (SADPs), and covers the small business (FF-SHOP) marketplace as well as the individual marketplace.
On December 19, 2014, CMS published the draft 2016 letter which I covered here. On February 20, 2015, CMS...
Source: Health Affairs Blog - February 23, 2015 Category: Health Management Authors: Timothy Jost Tags: Access All Categories Consumers Disparities Health Reform Insurance Pharma Policy States Source Type: blogs
Bully Doctor “Loses It” After Informed Mother Asks Questions About Vaccines
Conclusion
Luckily my error was in that assumption, not in a permanent, irreversible decision of letting my kids get injected with harmful substances. I will find a doctor who partners with me on my children’s health, not against me.
I hope your pediatrician is more professional and adept at discussing recommendations than mine. If not, perhaps it is time to look for a new doctor as well. You are your children’s best advocate.
Follow your heart. Follow your instinct. Don’t be pressured to do something you are unsure about. Ask questions. And by all means, do what is necessary for the health and welfare of your childr...
Source: vactruth.com - February 15, 2015 Category: Allergy & Immunology Authors: Jeffry John Aufderheide Tags: Jeffry John Aufderheide Logical Top Stories adverse reactions Bullying informed consent Source Type: blogs
Are Actuaries in Fact Paragons of Rationality When It Comes to the Prospects for Radical Life Extension?
The output of the actuarial community often demonstrates its members to be ahead of the curve when it comes to the near future of medicine and great uncertainty over coming trends in life expectancy. This is a time of very rapid progress in the underlying biotechnologies applicable to medical research, and also a time in which both the aging research community and broader medical community are beginning a sweep change in their approach to age-related disease. There is every reason to expect that the near future of human adult life expectancy will look nothing like the past fifty years of slow and fairly steady growth: once...
Source: Fight Aging! - February 6, 2015 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
Another Installment of: That's NOT how it works
It seems like only a week ago that we referenced our 2nd ever post - wait, it was a week ago that we did that! And here we are again, talking about insurance fraud. And this one's a doozy:"Irina Vorotinov has been charged by ... with defrauding Mutual of Omaha Insurance Company of more than $2 million in life insurance proceeds by falsely claiming that her former husband had died."Turns out - Spoiler Alert! - the ex- was, in fact, very much alive, and caught on film years after his alleged death.Ooops.Original content copyright © InsureBlog (Source: InsureBlog)
Source: InsureBlog - January 30, 2015 Category: Medical Lawyers and Insurers Source Type: blogs
Implementing Health Reform: Wraparound Coverage Excepted Benefits And Draft 2016 Letter To Issuers (Updated)
Update, December 21, Draft 2016 Letter to Issuers: Each year CMS releases a letter to issuers (insurers) in the federally facilitated marketplace setting out the ground rules for coverage through the FFM for the coming year. A draft letter is published for comments, followed by the final letter. The letter covers insurers that issue qualified health plans (QHPs), including stand-alone dental plans (SADPs), and covers the small business (FF-SHOP) marketplace as well as the individual marketplace.
On December 19, 2014, CMS published the draft 2016 letter. Not surprisingly, since it covers the third year of operation ...
Source: Health Affairs Blog - December 20, 2014 Category: Health Management Authors: Timothy Jost Tags: All Categories Employer-Sponsored Insurance Health Reform Patient Safety Pharma Policy States Source Type: blogs
Attractive Modern Websites for the Cryonics Providers
Cryonics involves the low-temperature preservation of the recently deceased, and as an industry it has been around for some decades. Using modern techniques and if the preservation is accomplished with speed, this can result in a good preservation of the fine structure of the brain, and thus of the data that makes up the mind. There is a lot more to it than just the technology, however. Like all major medical procedures it requires considerable organization, legal, financial, and logistical, and much of the focus of a cryonics provider is on the work needed make such a one-time event, occurring on an unpredictable schedule...
Source: Fight Aging! - October 24, 2014 Category: Research Authors: Reason Tags: Healthy Life Extension Community Source Type: blogs
Cigna Sues Embattled HDL Laboratory For $84 Million
The Cigna Health and Life Insurance company is suing Health Diagnostic Laboratory Inc. for $84 million. As reported previously, the embattled lab company is the subject of an ongoing Federal investigation concerning kickbacks and fraudulent billing. The charges against HDL in the suit filed last week in federal court closely echo the earlier allegations against the company. … Click here to read the full post on Forbes. Previous Stories About HDL: Beyond Kickbacks: More Questions About Unnecessary Cardiovascular Biomarker Tests Way Beyond Kickbacks: More Serious Misconduct Alleged Against Medical Testing C...
Source: CardioBrief - October 20, 2014 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Cigna fraud HDL laboratory tests Source Type: blogs
BioWatch News on Rejuvenation Biotechnology 2014
BioWatch News is a market analysis venture focused on biotechnology, especially medical research and development. This is a fairly common business model: find a niche and help to explain it to investors. People with a lot of money at stake in the market will pay a proportionally greater price for good articles and analysis. Biotechnology is a field that is changing so fast and for which the course of the near future is so very unpredictable that there is considerable demand for vision, knowledge, and explanation on the part of those who know more about what is going on than your average fund manager.
Interestingly, invest...
Source: Fight Aging! - October 6, 2014 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
Amateur Religious Engineering and Longevity Science
There exists a very long history of people starting explicitly religious movements to achieve secular goals in the mundane world. A very broad range of such ventures can be found even in recent history, in this apostate age of comparatively weak and apolitical mainstream religious institutions. For every group who set out to achieve their ends through political advocacy, such as by starting a single issue political party, you'll find another who choose to start a church. Those who do this outside the established religious mainstream are looked at askance, and often deservedly so, but really you're just as likely to be take...
Source: Fight Aging! - August 29, 2014 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
E-fun-ephrine
So the family went to King’s Dominion the other weekend. As a teen, between 1975 and 1979 my friends and I went once or ten times every summer. Roller coasters, flume rides, hideously overpriced food (we thought at the time – how little we knew). It was fun. But that was before EMS.
Now-me arrives with the family, and the first ride I get on is the Drop Tower. Sit in your chair, which raises you to almost 300 feet. Nice view. Then it drops you.
During the second or two I fell, I thought, “Well, this is fun.” But afterwards? Meh.
The roller coasters teen-me had loved were worse. Whether it ...
Source: DTsEMT - August 23, 2014 Category: Ambulance Crew Authors: dtsemt Tags: Uncategorized Source Type: blogs
Trending: Disability stats
Thanks to our friend Andy Linneman, we learn that:■ More than 30 million Americans between the ages of 21 and 64 are disabled■ 44% of employees say they have about a 1% chance of becoming disabled during their working years.■ 60% of consumers are concerned about their ability to support themselves if they were to become disabled and unable to workI just met with a client who, as the result of a recent stroke, has lost 95% of her hearing. She's struggling to make ends meet, and we even had to tap into her life insurance policy to help pay bills until Social Security Disability kicks in (if it ever does).One surefire w...
Source: InsureBlog - August 4, 2014 Category: Medical Lawyers and Insurers Source Type: blogs
Incorporate empathy in patient interactions
A popular television commercial shows a group of older women playing cards. One woman talks about her friend who is struggling financially since her husband died (the husband only had a small life insurance policy). Another lady said that she doesn’t have to worry about that happening since her husband has an XYZ insurance policy. The other ladies immediately ask about the policy. Then a TV pitchman describes the policy details and how to purchase it. What this commercial illustrates is that the viewers were first captured by the emotional element of the story, then the viewers received the information. We connected ...
Source: Kevin, M.D. - Medical Weblog - July 25, 2014 Category: Journals (General) Authors: Edward Leigh Tags: Patient Patients Source Type: blogs
Heroic Carrier Tricks: CNA edition
Back in the day, the Cincinnati Life Insurance Company sold Long Term Care insurance (LTCi), and a colleague (since retired) sold a number of these. Recently, a Cincinnati LTCi client called to complain about a claims problem, and I was happy to try to help out.Note: I had understood (mistakenly, as it turned out), that Cincinnati had actually sold its block of business to another carrier. This is a not-infrequent occurrence in the LTCi biz, but was not the case here. Instead, they had turned over policy service to a Third Party Administrator, LTCG, which also services other carriers' policies, including CNA. Unfortunately...
Source: InsureBlog - July 24, 2014 Category: Medical Lawyers and Insurers Source Type: blogs
Why the individual mandate is important
Be careful
As a reasonably young and healthy person, freelance social worker Tammy Boudreaux wasn’t a big believer in health insurance. But then she hurt her finger. She paid out of pocket for emergency room care, but then when the finger didn’t get better she realized she’d have to pay a heck of a lot more for additional medical treatment and rehab.
Thanks to Obamacare she was able to get reasonably priced health insurance even though she had a pre-existing condition –in her case a finger that was certain to need surgery and therapy. A week after signing up for an Obamacare plan on the exchange s...
Source: Health Business Blog - June 5, 2014 Category: Health Managers Authors: David Williams Tags: Health plans Patients Policy and politics Source Type: blogs
