HHS Accepts More Employers Into Program Subsidizing Retiree Health Benefits.

CQ HealthBeat (10/5, Reichard, subscription required) reports, "Almost 3,000 employers and unions have been accepted by the program created by the healthcare overhaul law to help pay the medical costs of early retirees," HHS "announced Monday." This represents an increase of 1,000 since "August, when the first round of acceptances were announced for applications to the Early Retiree Reinsurance Program." HHS Secretary Kathleen Sebelius stated in a press release, "I am incredibly pleased to see so many employers embrace this important new program to maintain coverage for people who often have a difficult time finding affordable coverage."

        The AP (10/5) notes, "More than 40 more Michigan employers and unions will get help providing health coverage to early retirees and their families. They're among nearly 1,000 additional employers and unions approved nationwide to participate in the $5 billion Affordable Care Act's Early Retiree Reinsurance Program." To date, "there are...142 participants from Michigan in the program."

        The Pittsburgh Tribune-Review (10/5, Fabregas) reports that "Sebelius yesterday used a visit to Mine Safety Appliances Co. to shore up support for the much debated federal healthcare law. During a stop at the company's Cranberry headquarters, Sebelius touted a program that aims to help employers pay for health insurance coverage for early retirees." Sebelius said about retiree health coverage, "It's often difficult to get and impossible to afford." Notably, "about 29 percent of large firms provided workers with retiree health coverage in 2009, down from 66 percent in 1988." Modern Healthcare (10/5, Vesely, subscription required) also covers the story.

States Receive $1 Million From HHS To Set Up Health Exchanges.

The AP (10/5) reports, "Federal officials say Nebraska and the Dakotas will each be getting $1 million to help the states establish a health insurance exchange. The exchanges, created by the federal Affordable Care Act, are meant to be one-stop shopping where people can purchase health insurance coverage," and "they're scheduled to be in place in 2014." Notably, HHS "is distributing nearly $49 million to help the states do the planning necessary to establish the exchanges and decide how they'll operate."

        States Watch As California Implements Health Benefits Exchange. The Sacramento Bee (10/5, 3A, Calvin) reports, "California's push to be the first in the nation to establish a health benefits exchange is being closely watched by other states as they act on implementing key elements of the national healthcare overhaul law." The Bee notes that Governor Schwarzenegger and the California Legislature will "soon begin considering appointments to the five-member oversight board that will be responsible for running the exchange -- and as the board begins its task of defining how the new exchange will operate."

Healthcare Providers, Insurers Concerned About Impact Of ACOs.

Kaiser Health News (10/5, Gold, Galewitz) reports, "Doctors and hospitals eager to pursue a new model of healthcare being promoted by the Obama administration are raising concerns that they could run afoul of antitrust and anti-fraud laws, while insurers are warning that the new arrangements could lead to higher prices for medical care." These "differences will be hashed out Tuesday," during a meeting "conducted by the Federal Trade Commission," CMS, and the HHS Office of the Inspector General. Notably, "a key part of the health overhaul law encourages the development of 'accountable care organizations' that would allow doctors to team up with each other and hospitals in new ways to provide medical services," but "healthcare providers want to make sure their ACOs won't be accused of stifling competition or trying to fix prices," and insurers "are expressing concern that providers could use the leverage of ACOs to demand higher prices."

NAIC Subpanel Approves Draft Regulations On MLR.

The Hill (10/5, Pecquet) reports in its Healthwatch blog, "A subpanel of the National Association of Insurance Commissioners voted Monday afternoon to adopt draft medical loss ratio regulations, teeing up final approval later this month." Notably, "the health reform law mandates that health plans spend a minimum percentage of premiums on care or pay rebates to their customers," and the "state insurance commissioners are tasked with defining the ratio." The Hill adds, "The model regulation was adopted with some edits, and it's expected to be open for comments through Oct. 11 once the changes are made."

Rockefeller Asks For Health Plan Data From McDonald's Insurer.

CQ Today (10/5, Ethridge, subscription required) reports, "Sen. John D. Rockefeller IV [D-WV] is seeking more information about the health insurance policies sold to nearly 30,000 employees of McDonald's restaurants after a report suggested the company might drop the coverage unless regulators waived a requirement in the healthcare law." The senator "asked BCS Financial Corporation, which provides insurance to hourly wage McDonald's employees, for details about its coverage plans by Oct. 15. He expressed concern the employees may be 'setting aside portions of their paychecks for an insurance product that may not be providing them a good value.'" Notably, the "letter follows a Wall Street Journal story that reported that McDonald's told the Obama administration that its insurer cannot meet a provision in the law (PL 111-148, PL 111-152) that goes into effect in 2011."

Memo Says HHS Missed Seven Deadlines For Health Reform Provisions.

The Hill (10/5, Pecquet) reports in its Healthwatch blog, "Six months after health reform's enactment, Health and Human Services Secretary Kathleen Sebelius has missed seven deadlines mandated by the new law, according to" a memo requested by Sens. Tom Coburn (R-OK), Orrin Hatch (R-UT) and John Cornyn (R-TX) from the Congressional Research Service. Coburn wrote on his website, "Future months are unlikely to see HHS improve its record of compliance," but "outside experts have praised the department's handling of high-profile mandates such as promulgating regulations for young adults to stay on their parents' insurance until the age of 26." Meanwhile, "HHS raised some issues with the report," and HHS spokeswoman Jessica Santillo said, "The Administration has met and beaten deadlines required by the Affordable Care Act."

Sebelius Says Medicare Advantage Plans Will Not Suffer Because Of Healthcare Law.

The Pittsburgh Post-Gazette (10/5, Malloy, Twedt) reports, "Medicare Advantage plans, exceedingly popular in Western Pennsylvania, will not wane under the new healthcare law, Secretary of Health and Human Services Kathleen Sebelius insisted Monday." During a "meeting with a handful of DC reporters...Ms. Sebelius said the decision by a large Massachusetts insurer to leave the Medicare Advantage market is not a harbinger of the program's decline." She stated, "My guess is companies will continue to cite this law from now on -- it's an easy mark. ... But frankly, any company that pulled out of the Medicare Advantage plan this year, my guess is that they had business plans to do that whether or not the president signed this law in March of 2010."

Health Reform May Be Inadvertently Hurting Fraud Prevention Investments.

The Hill (10/5, Pecquet) reports in its Healthwatch blog, "Healthcare reform regulations currently under debate could inadvertently 'discourage' fraud prevention investments, a national expert argued Monday." At "issue is the law's medical loss ratio provision, which mandates that health plans spend a minimum portion of premiums on medical care." National Health Care Anti-Fraud Association Executive Director Louis Saccoccio argues that fraud prevention efforts are "being undermined by the National Association of Insurance Commissioners' recent draft regulation on medical loss ratios, which treats private plans' spending on fraud detection and prevention as nonessential to quality healthcare."

Laws Improving Health-Insurance Coverage For Mental Illnesses, Substance Abuse.

The Washington Post /Kaiser Health News (10/5) reports, "Two federal laws that provide better insurance coverage for more people with mental health and substance abuse conditions are just beginning to take effect, and advocates describe the changes as a huge win for consumers that will greatly improve treatment." First, "under the Mental Health Parity and Addiction Equity Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments." Second, under the newly passed health reform law, "plans sold through the state-based insurance exchanges that will begin offering coverage in 2014 must include mental health and addiction benefits, and the benefits must be on a par with a plan's medical benefits."

HHS May Soon Announce Administrator To CLASS Act Program.

The Hill 's (10/4, Pecquet) "Healthwatch" blog reported the HHS "is expected to announce 'in the coming weeks and months' who will be heading the health reform law's long-term insurance program," according to Deputy Assistant Secretary for Policy and Evaluation Richard Frank. He said the agency "should shortly name an administrator and a location for the CLASS Act program." The "Centers for Medicare and Medicaid Services and the Administration on Aging are said to be in the running to host the program, which would also have repercussions on which congressional committees have jurisdiction," the blog added.

Hundreds Of Tennessee Residents Sign Up For TennCare Program.

The Tennessean (10/4) reported, "In just over an hour, 2,500 Tennessee residents in need registered today to get a waiver for the state's TennCare program." It "was the first round of applications for Standard Spend Down, a program to help people qualify for TennCare if they have high medical bills and are aged, blind, disabled or the caretaker relative of a Medicaid-eligible child." The state had "set up a toll-free hotline for residents wanting an application." The program "targets people with very low incomes or very high medical bills."

        Number Of Uninsured In Tennessee City Driving Up Hospital Costs. The Chattanooga Times Free Press (10/5) reports, "The number of uninsured hospital admissions in Hamilton County [TN] more than doubled between 2004 and 2008, leaving local hospitals with barely three in 10 patients who have private insurance to pay for their care, according to a new report on health in the Chattanooga region." The "loss of commercially insured patients...has contributed to hospitals' staggering losses to charity care." Hospitals are feeling "the pain of providing more and more uncompensated care, said Craig Becker, president of the Tennessee Hospital Association." But "employers and individual consumers are feeling it in the wallet, too." As "providers are forced to cost-shift their losses from uninsured patients to commercially insured patients, private insurers have raised their monthly rates to customers, contributing to more employers and individuals being unable to afford private insurance, Becker said."

Sebelius Discusses How Healthcare Law Can Help Government, Business Cut Costs.

CQ HealthBeat (10/5, Reichard, subscription required) reports, "It's what Health and Human Services Secretary Kathleen Sebelius calls 'the other health reform' -- the overshadowed elements of the healthcare law that are designed to help government and business get better value for the healthcare dollar." Notably, "Sebelius kicked off a day-long conference Monday, sponsored by her department and several lawmakers, by showcasing" several achievements by "employers, hospitals, insurers and other groups," and said that "she believes the [healthcare] law will help implement these successes more widely." In addition, Sebelius said that she "wants to have Medicare and Medicaid become better 'value purchasers,' and she asserted that the law will help accomplish that goal with" Peter Lee, director of delivery system reform in the HHS Office of Health Reform, "playing a major part."

BCBS Michigan Launches Plans For Small Business Customers.

The Detroit News (10/5, Burden) reports, "Blue Cross Blue Shield of Michigan today announced it has launched new and more affordable insurance plans for small business customers." The "nonprofit insurer, which has 4.4 million customers in Michigan, has launched Simply Blue, a plan that offers several deductible and co-payment options and also can be paired with a health reimbursement account or health savings account. The plan will be available Jan. 1."

Berwick Urges Providers To Overcome "Fear Of Variation" In Healthcare.

CQ HealthBeat (10/5, Norman, subscription required) reports, "Throughout the nation there are 'stunning examples' of healthcare providers who have 'leapt over the fear' of studying variations in healthcare quality and outcomes," CMS "Administrator Donald M. Berwick told a national summit on healthcare quality and value Monday." Berwick added that "there are going to be differences across the country in provider performance and in the value offered for the healthcare dollar, a hot topic." Overall, "healthcare in the United States can and should be improved with the 'triple aim' of better care, better health and lower costs," and "transparency is also needed, which takes courage, because 'we have to learn our way to a new future for healthcare,' he said."

Study Finds "Mixed" Results On Quality Of Care For Children In Medicaid, CHIP.

CQ HealthBeat (10/5, Adams, subscription required) reports, "The quality of healthcare services for children served by Medicaid and the Children's Health Insurance Program (CHIP) was mixed, according to a report by the Department of Health and Human Services." HHS investigators "used data from the National Committee on Quality Assurance to find that the quality of care for three of seven medical conditions was rated high, while four were rated low. The three maladies for which states were delivering relatively high-level care were asthma, upper respiratory infections and childhood immunizations." On the whole, "the Medicaid and CHIP children did have better access to medical treatments than those who were uninsured," although data show that they "need better access to...dental and mental health services."

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