INDIANAPOLIS, IN – On January 27, the nation’s second largest health insurance provider announced that it had launched an innovative reimbursement initiative, partnering with primary care physicians to improve quality and reduce medical costs. WellPoint Inc., which insures approximately 34 million Americans, will offer primary care doctors a fee increase as well as the possibility of additional payments
Beginning this summer, WellPoint Inc. will offer primary care physicians a fee increase, averaging 10%, with the possibility of additional payments that could increase what they receive for treating the patients it covers by as much as 50%. The tactic could infuse an additional $1 billion or more into primary care, which WellPoint is hopeful that it will pay off in the form of fewer emergency room visits and hospital stays.
“Primary care physicians who are committed to expanding access, to coordinating care for their patients and being accountable for the quality of care and the health outcomes of those patients, will get paid more than they do today, and we’re committed to helping them achieve these quality and cost goals,” said Dr. Harlan Levine, WellPoint executive vice president, Comprehensive Health Solutions. He added, “Primary care is the foundation of medicine, and it can and should be the foundation of our members’ health.”
To participate in the shared savings, practices must meet plan quality requirements, which include quality standards established by organizations such as the National Committee on Quality Assurance, the American Diabetes Association, the American Academy of Pediatrics and others. Those prima
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Couples may be inspired to invest in wedding insurance after hearing how one pair allegedly had their big day ruined by an event planner.
The New York Daily News reports how Hector Santana and Wendylee Perez have brought a lawsuit against celebrity wedding specialist David Tutera.
Despite paying $30,000 (£19,127) for their nuptials, the bride and groom claim the US reality TV star was absent from their nuptials and failed to secure several key features for the celebration.
The lawsuit stated: “Due to the defendants arrogant and heartless actions, plaintiffs have been harmed personally and financially.”
According to the couple, Tutera failed to provide the invitations, wedding cake, a DJ and flowers for the occasion.
Elton John and Jennifer Lopez are said to have been among the planners previous clients.
The former wed his long-term partner David Furnish in an elaborate ceremony, while Lopez tied the knot with her now estranged husband Marc Anthony.
The Obama Administration rejected Texas request that it be allowed to phase in federal health reforms medical loss ratio to prevent the states health insurance market from destabilizing.
The U.S. Department of Health and Human Services ruled that state officials failed to convince the agency of its argument that if insurers had to meet the new requirements the number of companies providing health insurance in the state through employers would drop.
A total of 17 states have sought waivers from the MLR provision. Six received them, nine were denied and two more are pending.
The Patient Protection and Affordable Care Act, passed in March 2010, requires health insurers to spend no more than 20% of individual and small-group premiums and 15% of large-group premiums on administrative costs, including agent commissions. The remainder must be used for medical costs, as President Barack Obama and the Democratic-controlled Congress sought to ensure that health insurance companies and their executives were not taking too much of premiums for profits.
Insurance companies who exceed the medical loss ratio must pay rebates to their customers, starting Aug. 1.
The Texas Department of Insurance had asked for the law to be phased in over four years to ensure that small carriers and those writing individual policies dont leave the states insurance market.
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London-based insurer Markel International has acquired an initial 50% stake in the Munich-based Anglo Underwriting.
As per the terms of the joint venture agreement, Markel has an option to acquire the remaining 50% by 2017.
Markel said Anglo Underwriting’s Munich office, it’s first in Germany, will add to its growing European network.
Markel International president and COO William Stovin said that with premiums of more than €180 billion a year, Germany is one of the largest and most attractive markets in Europe. The agreement is a first step in building a much stronger presence in Germany and is part of their overall plan for European expansion.
Anglo Underwriting was founded in 2005 and now works with 2,500 brokerage firms in Germany and Austria and has 8,000 individual clients.
Anglo’s business is split into six lines, which include industrial, commercial, private, errors and omissions, professional indemnity and specialties.
Markel has recently been expanding its presence in Europe and opened an office in Rotterdam in 2011.
An alarm was sounded after a New Zealand hospital revealed that hospital staff contracted TB or tuberculosis from a patient who later died from an unrelated TB condition. It emphasizes once more the need for all travelers to protect themselves with international travel health insurance. With overseas health insurance, a visitor to any foreign country can get proper medical treatment in a major hospital with excellent facilities and the best doctors.
The NZ hospital where the TB case occurred is admittedly a rare incident. The TB happened because he patient’s immune system was compromised by his condition. His inactive TB turned active and was unexpected.
The hospital has taken all necessary precautions to have everyone who was exposed to the patient tested for TB. This includes hospital staff, doctors, relatives and friends of the patient and others. Thus far, only 3 have been tested positive for latent TB.
Latent TB means that the condition is controllable and the infected person cannot contaminate anyone. Basically, they have bacteria in their lungs and this is treatable with drugs. According to medical experts, 90% of people with latent TB never get full-blown TB. Their immune system prevents it from becoming active. Symptoms include blood in the phlegm, coughing, chest pains, appetite loss, weight loss, and fatigue.
Anyone can get TB but usually the cases come from developing countries which mean the man probably traveled to a developing country. It also means that anyone traveling to a developing country should take the necessary precautions.
WASHINGTON, DC – On January 12, CVS Caremark agreed to pay $5 million to settle charges by the Federal Trade Commission (FTC) that the retail pharmacy and healthcare corporation had misrepresented the price of certain prescription drugs in one of its Medicare drug plans, causing many seniors to pay significantly higher prices than advertised. The settlement came more than two years of investigation by the FTC.
The settlement comes at a time of intensive government scrutiny of pharmacy benefit managers such as CVS Caremark, which manage prescription drug plans for employers and insurers. The FTC is also reviewing the proposed merger of the two main competitors to CVS Caremark: Express Scripts and Medco Health. In that case, the FTC is evaluating whether the combination would create an entity with too large of a market share.
In regard to CVS Caremark, FTC examined whether the merger of one of the largest drugstore chains with one of the largest pharmacy benefits managers had given the company an unfair market advantage in steering garnering customers as well as information about competing pharmacies. CVS Caremark works with a network of about 65,000 pharmacies, including more than 7,300 of its own drugstores.
The CVS lawsuit was prompted by concerns raised in 2009 by some legislators, labor unions, pharmacies and consumer groups regarding potentially anticompetitive and anticonsumer business practices by the company. Together with the January 12 settlement, the FTC dismissed the more serious allegations of anticompetitive behavior. The agency found only one violation: one of the company’s Medicare drug plans, then called RxAmerica, misled some consumers regarding pharmaceutical prices. I
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