Wednesday, February 4, 2009

Why Does the NC State Legislature keep shielding BCBSNC?? or JUST HOW MUCH $$ DOES BCBSNC GIVE THE STATE LEGISLATORS?

There's stink all over this company BCBSNC. So who knows just how much and who in the state legislature gets funding from BCBSNC?

So, as per the below, there's 660,000 people who have this 'State Plan' managed by BCBSNC.

There's 2.5 million + people who have BCBSNC Advanta plans, such as my family (to the tune of $750/ month w/ a $2500 deductible for anything other than doctor visits and prescriptions).

Not even mammograms or screening colonscopies are reimbursed.

And mental health parity was thrown overboard as re: the Advanta plan. It pays 50% for mental health services; mental health parity was to have created the same reimbursement/ rate schedule as for physical health services (commonly and usually 80%).

And so I asked the 'legislative liasons' (you know, the ones who help the NC STate Legislature and have BCBSNC as the suffix of their e mail addresses), about this mental health matter as I am a psychologist and inquiring minds want to know.

This is what Ken Wright's (BCBSNC legislative liason person) assistant said (in part):

Responding to your questions FROM: TO: SENT: Mon 02 Feb 2009 14:52:49 EST EXPIRES: Mon 09 Mar 2009 14:52:49 EDT

"....Many plans have customized requirements and/or the requirements aresubject to change....With regard to federalemployee plans, these services are determined by the Office of PersonnelManagement in Washington, DC. The FEP benefits are not subject to thenew federal mental health parity law......The new federal mental health parity law also does not apply to theNorth Carolina State Health Plan. State Health Plan benefits are set bythe North Carolina legislature..."

As per the post below from NC Justice Center as associated with a meeting associated w/ the NC State Legislature today:

"....State Sen. Ellie Kinnaird was brave enough to ask if our prescription drug manager Medco and Blue Cross have the best interests of the state at heart. Other than that, there was almost no mention of the insurance company....."

I guess we might conclude that State Senator Ellie Kinnaird doesn't get any money from the lobbying arm of BCBSNC.

Everyone else present just sat on their hands, apparently. So, I guess we might presume that everyone else present from the state legislature DOES get lobbying money from BCBSNC.

So, regardless of this fine 'mental health parity law' which passed in 2008, with main sponsor Martha Alexander, there's no mental health parity for:

BCBSNC Federal employee plans
BCBSNC Advanta Plans
BCBCNS 'State Plan'



update from 2.4.2009, NC Health Report/ NC Justice Center:

"The power of Blue Cross on full display during State Health Plan presentation

Today legislators heard a briefing on the State Health Plan from Mark Trogdon of the state's fiscal research division. Trogdon told legislators that the SHP will need $300 million before March 2009 to continue operations and $1.2 billion over the next two years. Trogdon said that the three options for the General Assembly to consider are reducing benefits, raising premiums, or both.

Once again, there was little time spent on how we got into this mess or creative ways to fill the SHP hole without hurting the more than 660,000 people insured by the state. It's not the fault of state employees and retirees that SHP projections went awry. It should not be up to state employees and retirees to make up for SHP lapses.

The elephant in the room during the presentation was the company that administers the SHP, Blue Cross and Blue Shield of North Carolina. One of the problems with the SHP is that administrative costs paid to the insurer are larger than expected. Another problem is that the savings projected by shifting all state employees and retirees to the Blue Cross network never materialized...."

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