It’s the start of another year here at the Central California Association of Health Underwriters, and it’s going to be an exciting year. We will be faced with some challenges this year with the start of the Health Care Reform going into effect, but rest assured that CCAHU along with CAHU and NAHU will be here to support you. Our website along with our state and national has great information and pieces that can help you with these upcoming changes.
NAHU is fighting on your behalf with the federal government on a daily bases to and our CAHU lobbyist are doing the same in Sacramento. They are pushing the role of the broker, and how important it is that we are involved during this process. CCAHU will be having a Health Reform update in October, so please keep an eye out for further information on that meeting. We will also be asking for your help with upcoming activities. We need volunteers to help with the different activities CCAHU will be holding throughout the year, so your help is greatly appreciated.
We thank you for being a member and your board is here to serve you. If there is anything we can do for you please contact me or one of the other board members. We want to hear from you. Any ideas or suggestions you may have we welcome.
Monday, September 27, 2010
Monday, March 17, 2008
President’s Message
Greetings, and Happy Independence Day,
Just yesterday, I was flying home from the NAHU National Convention with my mind occupied in looking forward to our upcoming year. When we met with our Region 8 cohorts, our CAHU officers, various other state chapter members and officers and our own Catherine Lumsden, Christina Castro and NAHU Distinguished Service Award winner Chuck Trogdan during the convention one prevailing attitude was evident; optimism and enthusiasm for the coming year.
I know that much of what emanates from Washington D.C. creates a gloomy forecast; yet our organization is fighting a strong battle to ensure not only that we continue to have a career in a fantastic field, but that each of us, our associates, our families and our clients have an opportunity to reach the goal stated in our Declaration of Independence, "the pursuit of happiness." I might add that you may want to consider making a small (or large) contribution to PAC to help continue the work (I believe a link exists on our page to enable you to do so; if not, I know one is at www.CAHU.org); you may even want to make a monthly contribution of $5 or $10 or more. Please give it careful consideration.
Some of the information below, if you read it carefully and consider many of the implications, indicate that we have reason to be somewhat optimistic. Please read it and enjoy.
Finally, again I wish you and your family a fun, safe and happy 4th of July. Let's celebrate it heartily with the confidence that at the end of the day, our country will remain the "Land of the Free."
I'll see you soon,
Rick
New information courtesy of the NAHU daily news digest: the good news for us as agents and brokers is that these type of adjustments to reimbursement rates bolster our argument that a public option can never be considered to be playing on a “level field.” No one really wants to have to compete with an opponent who can make the rules, enforce them and print their own money to boot.
Of course, if you read further, you can see that the incredible amount of fraud that has tradtionally accompanied Medicare further strengthens the argument against any sort of public (read government operated) health plan.
CMS proposes Medicare payment reforms for physicians, hospitals.
The Wall Street Journal (7/2, Zhang, subscription required) reports, "The Obama administration said Wednesday that it plans to cut Medicare payments for imaging services and specialists, and will use the savings to increase payments to physicians providing primary care." The proposal would "put specialists' payments for evaluating and managing illnesses on par with those of primary-care physicians starting in January." The move, "combined with other changes, would boost payments to internists, family physicians, general practitioners and geriatric specialists by six percent to eight percent next year," according to the Centers for Medicare and Medicaid Services.
Bloomberg News (7/2, Greene) notes that "one of the additional steps proposed by" CMS "is removing physician-administered drugs from the definition of doctors' services" in order to "'reduce the number of years' in which doctors will be slated for fee cuts." CongressDaily (7/1, subscription required) noted that "the American Medical Association has called for removal for physician-administered drugs from the formula since 2002 and praised CMS' announcement." AMA President J. James Rohack said, "Instead of yet another Band-Aid fix, today's action paves the way for Congress to ensure stable payment rates that reflect increasing medical practice costs and preserve seniors' access to care."
The Hill (7/2, Young) reports, "The Congressional Budget Office (CBO) has estimated that such a change would cost the federal government $87.5 billion over 10 years." Those dollars, however, "would be excluded from the CBO's calculations on how much fixing Medicare payments to doctors would cost." Furthermore, "the administration's actions could ease the path toward healthcare reform by making it a little cheaper." Rohack called the move "a major victory for America's seniors and their physicians."
Under a separate proposal by the CMS, "hospital outpatient departments will see a 1.9 percent increase in their Medicare payments," Modern Healthcare (7/2, Lubell, subscription required) reports. The rule would allow hospitals to "be able to bill Medicare for pulmonary and intensive cardiac rehabilitation services in outpatient departments starting next year." In addition, "CMS is...proposing to pay rural hospitals for providing kidney disease education services in their outpatient departments for Medicare beneficiaries with Stage IV chronic kidney disease."
Crain's Detroit Business (7/2, Greene) reports that CMS announced "a proposed rule that physicians could receive up to a 21.5 percent cut to their Medicare payments." But, David Fox, a Michigan medical society spokesman, noted that "the 21 percent cut is similar to past cuts that have been halted by Congress because it recognizes that it is the flawed 'sustainable growth rate' formula that is used in calculating the proposed cuts over the past four or five years."
Critics see move as $87 billion budget gimmick. CQ HealthBeat (7/2, Reichard, subscription required) reports, "In a move that will curry favor with the American Medical Association, federal officials announced Wednesday a proposed regulation that will lower the cost of revamping a physician payment formula that tees doctors up for deep cuts in Medicare payments for years to come." In a statement reacting to the rule change, AMA President J. James Rohack said, "President Obama, HHS Secretary Sebelius and White House Health Reform Director DeParle clearly understand that fixing the Medicare payment formula once and for all is fundamental to comprehensive health reform." However, "Republicans are likely to attack the regulatory proposal as a budget gimmick that does nothing to actually lessen the cost of overhauling the Medicare physician payment formula."
Widespread Medicare fraud seen as argument against government-run insurance. The Wall Street Journal (7/2, A12, subscription required) editorializes that "the White House made a big show last week about 'turning the heat up' on Medicare fraud, as Jane Friday -- er, HHS Secretary Kathleen Sebelius put it." An HHS/DOJ "dragnet resulted in 53 indictments in Detroit for a $50 million" Medicare-fraud scheme and the "busting up a Miami ring that [stole] some $100 million. As welcome as this is, the larger issue is what such plots say about President Obama's plans for a new government-run insurance program." According to the Journal, "one reason entitlement programs are so easy to defraud" is that they "have lower administrative expenses" and "they automatically pay whatever bills roll in with valid claims numbers." Private insurers, meanwhile, spend lots of time and money "building networks of (honest) doctors and other providers." Therefore, the "arrests in Detroit and Miami are another argument against importing [government-run insurance] to the rest of the health economy," because fraudsters "will continue to swindle our sclerotic entitlement system, no matter how far the government turns up the after-the-fact heat."
Just yesterday, I was flying home from the NAHU National Convention with my mind occupied in looking forward to our upcoming year. When we met with our Region 8 cohorts, our CAHU officers, various other state chapter members and officers and our own Catherine Lumsden, Christina Castro and NAHU Distinguished Service Award winner Chuck Trogdan during the convention one prevailing attitude was evident; optimism and enthusiasm for the coming year.
I know that much of what emanates from Washington D.C. creates a gloomy forecast; yet our organization is fighting a strong battle to ensure not only that we continue to have a career in a fantastic field, but that each of us, our associates, our families and our clients have an opportunity to reach the goal stated in our Declaration of Independence, "the pursuit of happiness." I might add that you may want to consider making a small (or large) contribution to PAC to help continue the work (I believe a link exists on our page to enable you to do so; if not, I know one is at www.CAHU.org); you may even want to make a monthly contribution of $5 or $10 or more. Please give it careful consideration.
Some of the information below, if you read it carefully and consider many of the implications, indicate that we have reason to be somewhat optimistic. Please read it and enjoy.
Finally, again I wish you and your family a fun, safe and happy 4th of July. Let's celebrate it heartily with the confidence that at the end of the day, our country will remain the "Land of the Free."
I'll see you soon,
Rick
New information courtesy of the NAHU daily news digest: the good news for us as agents and brokers is that these type of adjustments to reimbursement rates bolster our argument that a public option can never be considered to be playing on a “level field.” No one really wants to have to compete with an opponent who can make the rules, enforce them and print their own money to boot.
Of course, if you read further, you can see that the incredible amount of fraud that has tradtionally accompanied Medicare further strengthens the argument against any sort of public (read government operated) health plan.
CMS proposes Medicare payment reforms for physicians, hospitals.
The Wall Street Journal (7/2, Zhang, subscription required) reports, "The Obama administration said Wednesday that it plans to cut Medicare payments for imaging services and specialists, and will use the savings to increase payments to physicians providing primary care." The proposal would "put specialists' payments for evaluating and managing illnesses on par with those of primary-care physicians starting in January." The move, "combined with other changes, would boost payments to internists, family physicians, general practitioners and geriatric specialists by six percent to eight percent next year," according to the Centers for Medicare and Medicaid Services.
Bloomberg News (7/2, Greene) notes that "one of the additional steps proposed by" CMS "is removing physician-administered drugs from the definition of doctors' services" in order to "'reduce the number of years' in which doctors will be slated for fee cuts." CongressDaily (7/1, subscription required) noted that "the American Medical Association has called for removal for physician-administered drugs from the formula since 2002 and praised CMS' announcement." AMA President J. James Rohack said, "Instead of yet another Band-Aid fix, today's action paves the way for Congress to ensure stable payment rates that reflect increasing medical practice costs and preserve seniors' access to care."
The Hill (7/2, Young) reports, "The Congressional Budget Office (CBO) has estimated that such a change would cost the federal government $87.5 billion over 10 years." Those dollars, however, "would be excluded from the CBO's calculations on how much fixing Medicare payments to doctors would cost." Furthermore, "the administration's actions could ease the path toward healthcare reform by making it a little cheaper." Rohack called the move "a major victory for America's seniors and their physicians."
Under a separate proposal by the CMS, "hospital outpatient departments will see a 1.9 percent increase in their Medicare payments," Modern Healthcare (7/2, Lubell, subscription required) reports. The rule would allow hospitals to "be able to bill Medicare for pulmonary and intensive cardiac rehabilitation services in outpatient departments starting next year." In addition, "CMS is...proposing to pay rural hospitals for providing kidney disease education services in their outpatient departments for Medicare beneficiaries with Stage IV chronic kidney disease."
Crain's Detroit Business (7/2, Greene) reports that CMS announced "a proposed rule that physicians could receive up to a 21.5 percent cut to their Medicare payments." But, David Fox, a Michigan medical society spokesman, noted that "the 21 percent cut is similar to past cuts that have been halted by Congress because it recognizes that it is the flawed 'sustainable growth rate' formula that is used in calculating the proposed cuts over the past four or five years."
Critics see move as $87 billion budget gimmick. CQ HealthBeat (7/2, Reichard, subscription required) reports, "In a move that will curry favor with the American Medical Association, federal officials announced Wednesday a proposed regulation that will lower the cost of revamping a physician payment formula that tees doctors up for deep cuts in Medicare payments for years to come." In a statement reacting to the rule change, AMA President J. James Rohack said, "President Obama, HHS Secretary Sebelius and White House Health Reform Director DeParle clearly understand that fixing the Medicare payment formula once and for all is fundamental to comprehensive health reform." However, "Republicans are likely to attack the regulatory proposal as a budget gimmick that does nothing to actually lessen the cost of overhauling the Medicare physician payment formula."
Widespread Medicare fraud seen as argument against government-run insurance. The Wall Street Journal (7/2, A12, subscription required) editorializes that "the White House made a big show last week about 'turning the heat up' on Medicare fraud, as Jane Friday -- er, HHS Secretary Kathleen Sebelius put it." An HHS/DOJ "dragnet resulted in 53 indictments in Detroit for a $50 million" Medicare-fraud scheme and the "busting up a Miami ring that [stole] some $100 million. As welcome as this is, the larger issue is what such plots say about President Obama's plans for a new government-run insurance program." According to the Journal, "one reason entitlement programs are so easy to defraud" is that they "have lower administrative expenses" and "they automatically pay whatever bills roll in with valid claims numbers." Private insurers, meanwhile, spend lots of time and money "building networks of (honest) doctors and other providers." Therefore, the "arrests in Detroit and Miami are another argument against importing [government-run insurance] to the rest of the health economy," because fraudsters "will continue to swindle our sclerotic entitlement system, no matter how far the government turns up the after-the-fact heat."
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