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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.
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Friday, February 12, 2010 - Top insurers reap billions as health costs soar
By Noam N. Levey
http://seattletimes.nwsource.com/cgi-bin/PrintStory.pl?document_id=2011050573&zsection_id=2003905675&slug
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: http://www.regulations.gov/search/Regs/home.html#searchResults?Ne=11+8+8053+8098+8074+8066+8084+1&Ntt=CMS-4140-IFC&Ntk=All&Ntx=mode+matchall&N=8099+8061+8056+8057+8058
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: http://www.regulations.gov/ .>> 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>
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: http://www.regulations.gov/search/Regs/home.html#searchResults?Ne=11+8+8053+8098+8074+8066+8084+1&Ntt=CMS-4140-IFC&Ntk=All&Ntx=mode+matchall&N=8099+8061+8056+8057+8058
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: http://www.regulations.gov/ .>> 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>
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