Medical Price Transparency Update 08-19-19

Proposed Law Can Help Lower Your Medical Costs By Allowing You to Shop Around! On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed policies that follow directives in President Trump’s Executive Order, entitled “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” that lay the foundation for a patient-driven healthcare system by making prices for items and services provided by all hospitals in the United States more transparent for patients so that they can be more informed about what they might pay for hospital items and services. Included in this proposal is also a redefinition of what “Preventative Care” means. Why is this… Read More

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Senators Call for Closing “Loopholes” That Make Health Care Fraud Easy

Following a detailed account of how scam artists can easily gain access to health care cash, six Democratic senators this week sent a letter to federal regulators urging them to “close loopholes” that allow “bad actors” to commit fraud. The letter came in response to a recent story by ProPublica and Vox that traced the brazen scam of a Texas personal trainer, who despite having no medical credentials was able to submit a blizzard of fake bills with some of the biggest insurance companies in the country and recoup millions. The story revealed not only how David Williams exploited weaknesses at each step, but how slowly the insurers responded to his ongoing fraud.… Read More

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Health insurance premiums to drop under Affordable Care Act

  Health insurance premiums are set to drop next year under the Affordable Care Act. The Department of Financial Services (DFS) announced Premium Rates for 2020 on Monday. According to a news release issued by the department, “rates for individuals are more than 55% lower than prior to the establishment of the NY State of Health in 2014, adjusting for inflation but not counting federal financial assistance that the ACA makes available to many consumers purchasing insurance. Approximately 326,000 New Yorkers are currently enrolled in individual commercial plans.” The DFS, “reduced overall Insurers’ Requested Rate for Individual Coverage from 9.2% to 6.8%, saving consumer over $50million.” Overall, according to DFS,… Read More

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NEW HRA RULES FOR 2020

New Rules for 2020 to Pay Attention To Many Employers offer things such as HRAs, FSAs or HSAs to help Employees offset the out-of-pocket costs and gaps in their Health Benefits. I’ll give a quick summary of each: -A Health Reimbursement Arrangement (HRA) is an employer-funded account that helps employees pay for qualified medical expenses not covered by their health plans. HRAs are compatible with all types of health insurance plans and since they are solely funded by the employer, they also own it. -A health savings account (HSA) is a tax-advantaged medical savings account available to people  enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not… Read More

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2020 ACA Plans PLUS A New Insurer Enters the Five County Area

Important Update! 2020 ACA Plans Offer Consumers More Choice, Modest Requested Increases Harrisburg, PA – Insurance Commissioner Jessica Altman today released the 2020 requested rate filings for health insurance plans under the Affordable Care Act, highlighting that consumers in all Pennsylvania counties will now have more options, markets will have greater competition, and average rate increase requests are modest in comparison to some previous years. “As filed, all 67 counties will maintain the insurers currently offering coverage in 2019 for the 2020 coverage year,” Altman said. “Pennsylvania’s market has seen great increases in competition and choices for consumers in recent years, and the trend will continue into 2020. Based on their… Read More

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New Executive Order Addresses Healthcare Issues

On June 24, 2019, President Trump issued an Executive Order (“EO”) directing the relevant federal agencies to issue regulations or other guidance to make available more meaningful information related to the price and quality of healthcare. This summary highlights aspects of the EO that may be relevant to employer-sponsored group health plans and their covered participants.   • By October 22, 2019, the Treasury shall issue guidance to expand the ability of patients to select a qualified high deductible health plan (“QHDHP”) that can be used alongside a health savings account (“HSA”), and that cover low-cost preventive care, before the deductible, for medical care that helps maintain health status for… Read More

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The Exact Types of Insurance You Need In Your 20s, 30s, and 40s..

Insurance isn’t the most thrilling to think about, but it’s necessary for protecting yourself, your family, and your wealth. Accidents, illness, and disasters happen all the time. At worst, events like these can plunge you into deep financial ruin if you don’t have insurance to fall back on. Some insurance policies are unavoidable (think: car insurance in most US states), while others are simply a smart financial decision (think: life insurance). Insurance is largely personal, though, and the type of policy or amount of coverage that’s right for you and your financial situation usually won’t match your friend’s or relative’s. Plus, as your life changes (say, you get a new job or have… Read More

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Vision and Dental Insurer, Dominion National’s Security Breach Compromises Information of Almost 2.9+ Million People

Delaware’s insurance department says social security numbers and other personal data of more than 2,900,000 people may have been comprised over nearly a decade due to a breach at a large vision and dental insurer. The Delaware News Journal reports someone may have obtained bank account and routing numbers, social security numbers and insurance and tax information from the insurer Dominion National. The company says the information may have been compromised when a server was accessed by an “unauthorized third party” in 2010. Dominion National says there’s “no evidence that any information was in fact accessed.” The Department of Health and Human Services breach reporting tool listed 2.96 million patients have been notified their… Read More

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Can You Still File an Appeal for a Medicare Coverage After the Deadline?

Did Medicare deny you coverage on a service or medication you need? What happens if for one reason or another, you miss the deadline they give to appeal their decision? Is there anything you can do? The good news is, you may still be able to appeal Medicare’s decision to deny coverage for your care. For all levels of appeals through Medicare, there is a limited time to file. However, if the deadline has passed and you can show good cause for not filing on time, your late appeal may still be considered. It’s called “a good cause extension”  Extension requests are considered on a case-by-case basis, so there is… Read More

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How Big Data Can Help You Choose Better Health Insurance

There are plenty of easy consumer choices. Paper clips: easy. Dish sponges: easy. Those products sit at one end of the spectrum. At the other end, impossibly distant, is health insurance. That’s difficult. “Tons of evidence suggests that people have a hard time making choices when it comes to health insurance,” says Kate Bundorf, associate professor at Stanford School of Medicine with a courtesy appointment at Stanford Graduate School of Business. The complexity can be overwhelming and, as a result, people often choose sub-optimal plans that punish them with higher costs and create inefficient markets. “So we wanted to figure out what types of tools would help people make decisions,” says… Read More

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Bipartisan Bill to Address ‘Surprise’ Billing Moves Forward (and hospitals aren’t happy)..

    The Senate Health, Education, Labor and Pensions (HELP) Committee on Wednesday voted 20-3 to advance a bipartisan legislative package to address so-called “surprise” medical bills, but senators have suggested the bill could undergo more changes before it reaches the Senate floor next month. Background Sens. Lamar Alexander (R-Tenn.), the committee’s chair, and Patty Murray (D-Wash.), the ranking member on the committee, last week unveiled the Lower Health Care Costs Act. The wide-ranging bill contained nearly three dozen proposals to lower prescription drug prices, bolster transparency and data sharing in the U.S. health care system, and address surprise medical bills. Alexander and Murray had considered several ways to curb… Read More

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Medicare Won’t Cover This Key Expense…

Dental costs can take a huge bite out of seniors’ finances, even if they have Medicare. And many Seniors have to tap into their Retirement Funds to cover treatment.

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The Future of Employee Benefit Offerings: Student Debt Repayment Assistance

When looking for a job, the benefits offered to an Employee are definitely a big factor in consideration of accepting an offer of employment. Most people are willing to choose a company with a slight pay decrease if the benefit package compensates for the lost wages. With unemployment the lowest it has been since 2000 in the United States, attracting new talent isn’t as easy as it used to be and Employers are looking for ways to snatch up qualified applicants. When you think of benefit packages, you usually think of the basics: Health Insurance (with possibly an HSA, HRA, or FSA included), Dental and Vision coverage. “Good” benefit packages… Read More

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IBC to Reach Agreement with Providers in Our Area!

We are pleased to share that Mercy Health System, St. Mary Medical Center, Saint Francis Healthcare and Independence Blue Cross (Blue Cross) anticipate coming to an agreement on a new, long-term contract this week, meaning there should be no interruption to your care or coverage at the following facilities: Mercy Fitzgerald Hospital Mercy Philadelphia Hospital Nazareth Hospital St. Mary Medical Center Saint Francis Healthcare in Delaware We thank you for your continued support and patience throughout this process, and apologize for any anxiety or inconvenience this negotiation may have caused you or your family – that was never our intention. We look forward to continuing to provide you the care… Read More

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Why Offer an HRA to Your Employees?

Healthcare Reimbursement Arrangement, typically referred to as an HRA, can be utilized by employers to reduce their overall healthcare costs without placing additional financial burden on their employees. An HRA allows the employer to pay for eligible expenses with pre-tax dollars. The employer decides what expenses are eligible, within the IRS guidelines, leaving a lot of flexibility in plan design. Typically an HRA is coupled with a High Deductible Health Plan and the HRA pays for either the entire deductible or a portion of the deductible. With this type of a plan the premium savings often outweigh the potential claims that the employer would have to pay if every employee… Read More

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The Hidden Costs of Smoking

It’s easy to loose track of the actual costs associated with smoking. When you look behind the scenes, you will realize why the utilization of Smoker Cessation Programs are important and how Employees and Employers can benefit from this type of Wellness Program . Healthcare $3,400 in excess expenses each year in the form of premium pricing, deductibles or copays/insurance due to conditions associated with one person’s use. Smoke Breaks (Average) 1.25/hrs per day 6.25/hrs per week 291/hrs per year Family Health Parents who smoke have a higher rate of children with Respiratory and ENT issues. They are also more likely to become smokers themselves. Lifetime Costs On average, a… Read More

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10 Companies with Innovative Benefits Packages

From retirement and health plans to unlimited paid time off, work flexibility and hot new benefits such as student loan repayment and professional development, these 10 companies are leading the pack when it comes to innovation in the field. Here’s what they are doing differently.         Netflix Their unique offering: Unlimited paid time off Perks include: Up to one year of paid time off to new mothers and fathers, and unlimited-time-off for vacation and sick days. Why they do it: “Netflix’s continued success hinges on us competing for and keeping the most talented individuals in their field. Experience shows people perform better at work when they’re not worrying about home,”… Read More

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Do You Need an Rx? Best Treatments for Top 7 Health Issues

Pharmaceutical Companies spent $5.6 billion in 2015 for advertisements.. and those advertisements seem to work. 1 in about 7 people who take at least one Rx have admitted they specifically asked their Doctor about a medication they heard on the Tv, Radio, online, or in print. 2/3rds of those Doctors wrote the prescription for the drug requested. The problem with advertisements is that you do not know if this more expensive drug works better than a less expensive generic or if you can achieve the same results with simple lifestyle changes.  Consumer Reports has piled tons of research, recommendations and reviews from credible sources to compile what they deem are… Read More

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Walgreens agrees to pay $269 million in fraud accord

Walgreens Boots Alliance agreed to pay $269.2 million to settle U.S. claims that the drugstore chain defrauded a federally funded health care program over insulin drugs and a consumer-discount initiative. The two settlements, announced Tuesday, cover allegations over improper billing. In the first one, the company agreed to pay $209.2 million to resolve claims it billed Medicare, Medicaid and other programs for hundreds of thousands of insulin pens it distributed to people who didn’t need them. In the second, Walgreens said it would pay $60 million for overbilling Medicaid by not disclosing lower prices it offered in a discount program. To read more, click here.

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Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter

The Office of Civil Rights (“OCR”) of the Department of Health and Human Services (“HHS”) has posted an alert warning employers, and others, of a fake communication involving the OCR audit program under HIPAA. The email falsifies HHS departmental letterhead and the signature of the OCR Director and directs individuals to a non-governmental website marketing the cybersecurity services of a firm that is not associated with HHS or OCR. This phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us. This is a subtle difference from the official email address for the real HIPAA audit program, OSOCRAudit@hhs.gov Phishing is a scam typically carried out… Read More

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Be Prepared for Medical Appointments

Are you going to a new Doctor? Get a recent diagnosis? Or looking into new Hospital Systems? There are tons of important questions to ask when dealing with your health, but most don’t know where to start.  The Agency for Healthcare Research and Quality has put together the important questions to ask for many health-related issues. Please click here to find out which questions you should be asking!

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