Friday, November 18, 2011

Tuesday, June 22, 2010

Supreme Court to Review State Officials' Refusing to Provide Records When Someone Dies in State Mental Hospital Facilities: Remember Steven Sabock

Where's Bob Dylan when we need him. Remember Steven Sabock:

Steven Sabock

Steven Sabock, age 50 and not a happy man,
sat in his chair unfed for 22 hours at Cherry Hospital in Goldsboro, North Carolina,
choked on his medicationand died.
A few feet awaythe staff watched TV and played cards.
It was not reported what programs they watched
or who won at cards,but maybe that was not important,and neither was Mr. Sabock.

Tom Greening, PhD

see earlier Defarge:

"...High court to review mental health advocacy suit

Posted: Jun 21, 2010 10:10 AM EDTUpdated: Jun 21, 2010 10:30 AM EDT

WASHINGTON (AP) - The Supreme Court says it will decide whether Virginia's advocate for the mentally ill can force state officials to provide records relating to deaths and injuries at state mental health facilities.

The justices agreed Monday to review a federal appeals court ruling dismissing the state advocate's lawsuit against Virginia's mental health commissioner and two other officials.

Backing the appeal, the Obama administration said the ruling by the 4th U.S. Circuit Court of Appeals in Richmond "threatens to undermine the enforcement of federal laws that Congress designed to protect especially vulnerable individuals from the abusive and neglectful practices that can result in injury and death."

The Virginia advocate's office, like those in the other 49 states, was created under two federal laws that give states federal money for monitoring the treatment of the mentally ill in state facilities. The first law grew out of public reports in the 1970s of crowded, filthy conditions and abusive treatment of mentally retarded children at the Willowbrook State School in New York.

The issue for the court is whether the Eleventh Amendment prohibits a state agency from going to federal court to sue officials of the same state. The state itself could not be sued in the same circumstances...."
Bob Dylan writing about a man unjustly charged w/ murdering someone (while the evidence was undoubtedly shuffled under a bigger pile, where it would be hidden):

"All of Rubin's cards were marked in advance
The trial was a pig-circus, he never had a chance.
The judge made Rubin's witnesses drunkards from the slums
To the white folks who watched he was a revolutionary bum
And to the black folks he was just a crazy nigger.
No one doubted that he pulled the trigger.
And though they could not produce the gun,
The D.A. said he was the one who did the deed
And the all-white jury agreed."

Younger People Blamed for Making Private Insurance Market Prices Soar by Industry's Trade Group

Sorry, Mr. Robert Zierkelbach, you have no evidence that younger people are dropping their health insurance leaving the older beached, whales to be washed up on shore.

This simply looks like a good time to drag out that excuse so that the industry can continue to make its massive profits prior to 2014 when pre-existing conditions will no longer be admissable evidence for denial of insurance.

Costs soar for individual health coverage
Insurance premiums increase average of 20%, Kaiser Family Foundation report says
By Guy Boulton of the Journal Sentinel
Posted: June 22, 2010 (57) Comments

".....The market for individual insurance has long been considered the most problematic in the industry, and it is the target of many of the most sweeping health care reforms recently enacted by Congress....

"Many people see the individual market as the most broken part of the insurance market," Drew Altman, president and chief executive of the Kaiser Family Foundation, said in a teleconference....

America's Health Insurance Plans, the industry's trade group, tracks premiums in the individual market and does not have information on how the recent increases compare with those of past years.

But Robert Zirkelbach, a spokesman for association, said the premium increases stem from higher medical costs and from younger and healthier people dropping their health insurance during the economic downturn.

People who are young and healthy basically subsidize the cost of health insurance for people who are older and sicker.

But Kaiser's Altman noted that there is not good data on whether younger and healthier people have actually dropped their coverage or on what is behind the sharp increases in premiums in the individual market....."

Tuesday, April 27, 2010

NM BCBS Raises Rates on Consumers One Hour Before Public Meeting: 24% HIKE in Rates

NM Blue Cross Hikes Premiums Before Public HearingPosted:

April 27, 2010SANTA FE, N.M. --

Blue Cross and Blue Shield and the New Mexico insurance superintendent have signed off on a rate hike on insurance premiums, less than an hour before a state Public Regulation Commission hearing to hear opposition to the plan.Public Regulation Commissioner Jason Marks calls Monday's agreement a back room deal announced before the public had a chance to comment.

The hearing was called after a 24 percent increase in Blue Cross and Blue Shield premiums in December.

The revised rates allow the company to raise premiums by an average of 21 percent.A spokeswoman says that will affect 40,000 New Mexico customers.Read more:

Monday, April 26, 2010

NC 2010-2011: $500 MILLION Unanticipated Medicaid Growth: We Don't Need No Stinkin' Public Option

Amazing figures in the just published NC Justice Center, BTC Reports, Volume 16 No1 April 2010.

Naw: we don't need no Public Option when it comes to health insurance for $500,000,000 'unanticipated budget pressure' as associated with people going onto the Medicaid roster is surely no indication that people have health insurance that they can afford (or even obtain).

page 7 :

Projected FY 2010-11 General Fund Budget Gap

Anticipated Budget Pressures

Unanticipated Medicaid growth $500,000,000
Unanticipated Community College Enrollment growth $85,000,000

Also, as associated w/ Community Suport Services (Mental Health: NC DHHS) in NC, they had this to say:

".....Cuts to programs that fall under the Health and Human Services (HHS) portion of the budget have also impacted individuals and communities. The deepest outright cuts to HHS programs were to community support services for people with mental illness and substance abuse issues and to personal care services that help individuals with medical conditions to remain in their homes and out of institutional settings. The mental health association of North Carolina estimates that 10,000 to 15,000 individuals currently need community support services but are unable to access them to due to funding constraints. ..."
The Treasure of the Sierra Madre (film)

"....The bandits then reappear, pretending, very crudely, to be Federales, which leads to the now-iconic line about not needing to show any "stinking badges". After a gunfight, and the fourth American is killed, a real troop of Federales appear and drive the bandits away.,,,"

Wednesday, February 17, 2010

Top 5 Insurance Companies increase profits by 56% over 2008: We don't need no stinkin' public option

NAH: we don't need no stinkin' public option. I lost my BCBSNC insurance when the family premium hit $1000/ month for 3 healthy members. I just can't pay that kind of money out.

Friday, February 12, 2010 - Top insurers reap billions as health costs soar

By Noam N. Levey

Tribune Washington Bureau

WASHINGTON As the nation struggled last year with rising health-care costs and a recession, the five largest health-insurance companies racked up combined profits of $12.2 billion, up 56 percent over 2008, according to a new report.

Based on company financial reports for 2009 filed with the Securities and Exchange Commission, the report said insurers WellPoint, UnitedHealth Group, Cigna, Aetna and Humana covered 2.7 million fewer people than they did the previous year.

The report also said three of the five insurers cut the proportion of premiums they spent on customers' medical care, committing relatively more to salaries, administrative expenses and profits......

Industry analyst Sheryl Skolnick, a senior vice president at CRT Capital Group, said many of the insurance companies likely would benefit from more customers.

But they are driven to increase prices for their products to satisfy investors, which in turn drives away more and more customers.

"It is a terrible thing to run your business for Wall Street," Skolnick said. "It creates very bad incentives, and it ultimately prevents you from doing the thing that is in the best long-term interest of your business. ... There is no way that as long as these businesses are publicly traded, they can have the best interest of their customers at heart."

Federal Mental Health Parity Act Proposed by Obama Administration: (remember how BCBSNC got around parity in 2009)

People who think the Obama administration is 'doing nothing' are not paying attention. He could beat on his chest and create some fan-fare but all this will create is more tea-bagging. Comments are due by May 3, 2010.

Here are my comments:

"As a doctoral level psychologist whom treats people w/ Severe Persistent Mental Illnesses, the passage of federal mental health parity is an absolute necessity.

In North Carolina, in 2009, for instance, BCBSNC was allowed to OPT OUT of mental health parity by the NC State Legislature due to their undue influence on the NC STate Legislature. BCBSNC is the largest private insurer in the state of NC. BCBSNC is supposedly monitored by the NC State Legislature.

Thus, very obviously, until there is PARITY in terms of Utilization Review and what the insurance company can DO versus what they SAY----- little to no progress will be made as regarding mental health parity. Undue influence will continue to trump any efforts to obtain mental health parity.

Marsha V. Hammond, PhD: Clinical Health PsychologyNC Licensed Psychologist"
**********************************************************************Federal Mental Health Parity Act proposed. Comments can be stated here:

3 results for keyword "CMS-4140-IFC" Records Per Page: View By Relevance View By Docket Folder Title Document Type Agency ID Posted Date Actions Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Comments Due 05/03/10 11:59

PM ET RULES EBSA EBSA-2009-0010-0409 02/02/10 Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Comments Due 05/03/10 11:59 PM ET RULES

IRS IRS-2009-0008-0120 02/02/10 Interim Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Comments Due 05/03/10 11:59 PM ET RULES CMS CMS-2009-
0040-0048 02/02/10

"Today the Departments of Health and Human Services, Labor and the> Treasury today jointly issued the following news release:>> Date: 1/29/2010> Media Contact: HHS: (202) 690-6145> Telephone: 240-276-2130>> OBAMA ADMINISTRATION ISSUES RULES REQUIRING PARITY IN TREATMENT OF> MENTAL, SUBSTANCE USE DISORDERS> Paul Wellstone, Pete Domenici Parity Act Prohibits Discrimination>> The Departments of Health and Human Services, Labor and the Treasury> today jointly issued new rules providing parity for consumers enrolled> in group health plans who need treatment for mental health or substance> use disorders.>> "The rules we are issuing today will, for the first time, help assure> that those diagnosed with these debilitating and sometimes life-> threatening disorders will not suffer needless or arbitrary limits on> their care," said Secretary Sebelius.>> "I applaud the long-standing and bipartisan effort that made these> important new protections possible.">> "Today's rules will bring needed relief to families faced with meeting> the cost of obtaining mental health and substance abuse services," said> U.S. Secretary of Labor Hilda L. Solis.>> "The benefits will give these Americans access to greatly needed medical> treatment, which will better allow them to participate fully in society.> That's not just sound policy, it's the right thing to do.">> "Workers covered by group health plans who need mental health and> substance abuse care deserve fair treatment," said Deputy Treasury> Secretary Neal Wolin.>> "These rules expand on existing protections to ensure that people don't> face unnecessary barriers to the treatment they need.">> The new rules prohibit group health insurance plans--typically offered by> employers--from restricting access to care by limiting benefits and> requiring higher patient costs than those that apply to general medical> or surgical benefits.>> The rules implement the Paul Wellstone and Pete Domenici Mental Health> Parity and Addiction Equity Act of 2008 (MHPAEA).>> MHPAEA greatly expands on an earlier law, the Mental Health Parity Act> of 1996 which required parity only in aggregate lifetime and annual> dollar limits between the categories of benefits and did not extend to> substance use disorder benefits.>> The new law requires that any group health plan that includes mental> health and substance use disorder benefits along with standard medical> and surgical coverage must treat them equally in terms of out-of-pocket> costs, benefit limits and practices such as prior authorization and> utilization review.>> These practices must be based on the same level of scientific evidence> used by the insurer for medical and surgical benefits.>> For example, a plan may not apply separate deductibles for treatment> related to mental health or substance use disorders and medical or> surgical benefits--they must be calculated as one limit.>> MHPAEA applies to employers with 50 or more workers whose group health> plan chooses to offer mental health or substance use disorder benefits.>> The new rules are effective for plan years beginning on or after July 1,> 2010.>> The Wellstone-Domenici Act is named for two dominant figures in the> quest for equal treatment of benefits.>> The late Senator Paul Wellstone (D-MN), who was a vocal advocate for> parity throughout his Senate career, sponsored the ultimately successful> full parity act.>> He was joined by former Senator Pete Domenici (R-NM) who first> introduced legislation to require parity in 1992.>> Champions of the legislation also included the bipartisan team of> Representative Patrick Kennedy (D-RI) and former Representative Jim> Ramstad (R-MN).>> The issue of parity dates back over 40 years to President John F.> Kennedy, and was also supported by President Clinton and the late> Senator Edward Kennedy.>> The interim final rules released today were developed based on the> departments' review of more than 400 public comments on how the parity> rule should be written. Comments on the interim final rules are still> being solicited.>> Sections where further comments are being specifically sought include so-> called "non quantitative" treatment limits such as those that pertain to> the scope and duration of covered benefits, how covered drugs are> determined (formularies), and the coverage of step-therapies.>> Comments are also being specifically requested on the regulation's> section on "scope of benefits" or continuum of care.>> Comments on the interim final regulation are due 90 days after the> publication date. Comments may be emailed to the federal rulemaking> portal at: .>> Comments directed to HHS should include the file code CMS-4140-IFC.>> Comments to the Department of Labor should be identified by RIN 1210-> AB30. Comments to the Treasury's Internal Revenue Service should be> identified by REG-120692-09.>> Comments may be sent to any of the three departments and will be shared> with the other departments. Please do not submit duplicates.>> Contacts:>> HHS: 202-690-6145> DOL: 202-693-8666> Treasury: 202-622-2960>