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  03:30:34 pm, by MedBen5   , 112 words,  
Categories: News, Health Plan Management

No Health Care Reform in 2009?

The Wall Street Journal reports that the prospects of passing a health care form bill this year are fading. While House legislation could potentially come to a vote in the coming weeks, the Senate has yet to argue its plan – so getting a combined bill for President Obama to sign in the next two months becomes increasingly difficult. If the reform debate extends into 2010, the calendar becomes a greater factor, as mid-term elections near and senators become more wary of such far-reaching legislation.

Meanwhile, House Republicans are crafting their own scaled-back bill, which includes tort reform, wouldn’t require mandatory coverage and would allow insurance companies to sell policies across state lines.


  05:27:30 pm, by MedBen5   , 162 words,  
Categories: News, Health Plan Management

Friday Legislative Update: House Unveils Health Reform Bill

On Thursday, Speaker Nancy Pelosi unveiled the House health care reform bill, which would provide coverage to 36 million people currently without insurance. The New York Times reports that the legislation would cost $1.05 trillion over 10 years, but would reduce projected federal budget deficits by $104 billion over the same period. Provisions to increase Medicare payments to doctors, which would cost over $200 billion over 10 years, were placed on a separate bill introduced later in the day.

Among the features included in the House bill is a stipulation that public option care fees would be negotiated directly with providers, rather than using Medicare rates, as the Senate bill does. Also, the House bill would impose a surtax on high-income people – again unlike the Senate bill, which would impose an excise tax on high-premium employer plans. The Congressional Budget Office compared the two bills and concluded Friday that the Senate provisions would control federal spending more effectively over the next decade, according to The Washington Post.


  04:44:28 pm, by MedBen5   , 106 words,  
Categories: News, Health Plan Management

Employer Mandate Could Prove A Costly Proposition

Amidst all the tumult and debate over such issues as health insurance reforms and public options, the subject of employer mandates has received comparatively little mention. The Wall Street Journal notes that while the Senate Finance Bill only places modest fines on employers that don’t offer health insurance coverage, other Congressional legislation currently under review would substanially charge larger businesses that don’t cover a certain percentage of family premiums – up to an 8% payroll penalty in one House bill. So depending on which bill Congress ultimately chooses as its foundation, it could mean a huge difference in the amount an employer would potentially have to pay.


  04:46:14 pm, by MedBen5   , 130 words,  
Categories: News, Health Plan Management

Friday Legislative Update: Public Option Rising from the Ashes?

Is the public option, once thought to be on life support, poised for a comeback? ABC News reports that the final Senate reform bill will feature a government-run insurance program provision, if Majority Leader Harry Reid has his way. This is in spite of the fact that some moderate Senate Democrats continue to oppose the measure, and Reid needs their support to get the 60 votes required to pass the bill.

Earlier this week, Democrates in the Senate suffered a setback on another piece of health care legislation, according to The New York Times. A bill to increase Medicare payments to doctors was blocked by a vote of 53-47. A dozen Democrats and one independent sided with the Republicans in rejecting the unfunded bill, which would have cost $247 billion over 10 years.


  03:54:38 pm, by MedBen5   , 109 words,  
Categories: Health Plan Management

Planning Your 2010 Health Coverage

As 2009 is winding down – only ten weeks till Christmas, can you believe it? – it’s time to consider your health plan options for next year, particularly if have a flexible spending account (FSA) or health savings account (HSA). The Los Angeles Times offers several thoughtful strategies for maximizing coverage and reducing costs for your health insurance, FSAs and HSAs.

(By the way, the FSA/HSA article provides a link to a website with an FSA calculator to estimate your medical expenses and federal tax savings, but we’ll save you the trouble of searching for it. Just go straight to The MedBen website and feel free to use ours!)


  04:57:42 pm, by MedBen5   , 123 words,  
Categories: News, Health Plan Management

Friday Legislative Update: Senate Bill Friends and Foes

The Wall Street Journal Health Blog breaks down how certain groups feel about the Senate Finance Bill:

  • The pharmaceutical industry: Supports it.
  • The American Hospital Association: Supports it, but with reservations.
  • The American Medical Association: No official position indicated.
  • Insurers and the Chamber of Commerce: Oppose it.
  • Major unions: Depends on which one you ask, but several unions, including the AFL-CIO, oppose the lack of a public option and the tax on more expensive health plans.

If you’re looking for a useful synopsis of recent reform happenings in the House and Senate, take a look at this New York Times page. And The Washington Post has a neat interactive graphic to help you track the contents of the major bills currently under consideration.


  03:34:18 pm, by MedBen5   , 64 words,  
Categories: News, Health Plan Management

Health Reform Update: Senate Finance Committee Approves Bill

The Washington Post reports that the Senate Finance Committee has approved its health reform bill by a vote of 14 to 9. Senator Olympia J. Snowe of Maine was the sole Republican to vote in favor of the legislation, saying that the consequences of inaction outweighed any concerns she had regarding the measure. A vote in the full Senate may happen as early as next week.

  02:00:26 pm, by MedBen5   , 105 words,  
Categories: News

Study Ranks State Levels of Health Care Quality

Interested in knowing how your state ranks in the quality of health care it provides? A study by The Commonwealth Fund assessed states’ performance based on various benchmarks, including quality, costs and health outcomes. Vermont residents have the best care in the country, followed by Hawaii and Iowa, according to Commonwealth’s State Scorecard; Mississippi, Oklahoma and Louisiana rank the lowest. Better access to medical treatment and an emphasis on preventive care were among the factors common to the states that placed highest in the study.

You can access The Commonwealth Fund report here, or just use this interactive map to see each state’s 2009 and 2007 rankings.


  01:19:06 pm, by MedBen5   , 138 words,  
Categories: News, Health Plan Management

Legislative Update: CBO Delivers Good News to Senate

The Senate Finance Committee’s health reform proposal got a major boost this week from the Congressional Budget Office, The Washington Post reports. The cost of the measure is projected to be $829 billion over the next decade, but would produce over $100 billion in savings and revenue. The Wall Street Journal Blog highlights five key numbers from the CBO assessment – such as 94%, the percentage of legal U.S. residents under 65 who will have insurance in 2019, assuming the Senate bill is passed in its present form. The committee is expected to vote on the amended bill on October 13.

Meanwhile at the House of Representatives, Speaker Nancy Pelosi is preparing three bills to send to the CBO for analysis, according to the Los Angeles Times. All three versions will include a public option, which was voted down in the Senate bill.


  02:00:37 pm, by MedBen5   , 101 words,  
Categories: Prescription, Health Plan Management

Debit Cards Give A Boost to CDHPs

Debit cards have gradually overtaken checks as the payment method of choice, so it should come as no surprise that their acceptance is spurring the popularity of consumer-driven health plans. This article on the Employee Benefits News website sites an Evolution Benefits survey in which two-thirds of respondents indicated that the availability of a debit card influenced their decision to enroll in a CDHP, and three-quarters said that debit cards make account management easier

MedBen offers debit card technology for flexible spending account (FSA) participants with 100% auto substantiation of prescription claims. For more information, contact MedBen Sales and Marketing at (888) 627-8683.


  12:55:53 pm, by MedBen5   , 82 words,  
Categories: Announcements, News, Health Plan Management

MedBen Achieves $11 Million in Survelliance System Savings

Just one month after reaching the $10 million threshold in cumulative client savings from its claims survelliance system, MedBen has posted an additional $1 million in savings. Introduced in September 2007, our survelliance system performs a comprehensive review of customer claims, looking for potential saving opportunies. The $11 million clients have saved so far is in addition to provider discounts and other MedBen cost containment methods.

For more information about MedBen’s claims survelliance system, please contact the MedBen Sales and Marketing Department at


  04:59:05 pm, by MedBen5   , 102 words,  
Categories: News, Health Plan Management

Friday Legislative Update: Amendments Added to Senate Reform Bill

The Senate Finance Committee adopted several key amendments to its health reform legislation this week. Perhaps the most noteworthy addition is an amendment that reduces tax deductions for insurance executive salaries from $1 million to $500,000, according to The Wall Street Journal. Other amendments would create health insurance exchanges for individuals and small-business employees and offer tax credits or Medicaid benefits to people at or near the poverty level. The Hill reports. The Committee is expected to vote on the bill next week.

The Wall Street Journal also has provided a comparison of the various health care proposals currently under consideration, including President Obama’s.


  12:11:26 pm, by MedBen5   , 69 words,  
Categories: News, Health Plan Management

Health Reform Update: Senate Committee Rejects Public Option

The Washington Post reports that the Senate Finance Committee twice rejected amendments that would introduce a government-run public plan to compete with private health insurers. While this does not completely rule out the possibility that a public option will make it into the final bill, it does severely hinder efforts by Senate Democrats to (quoting the article) “expand the federal role in health coverage as a cornerstone of reform.”


  03:19:24 pm, by MedBen5   , 235 words,  
Categories: News, Health Plan Management

Pain Management Procedures Proving Costly

Dr. Ed Mendoza

The use of pain management procedures has increased 235% in just 10 years, according to a 2009 study by the American Society of Interventional Pain Physicians (ASIPP). At MedBen’s recent Hospital Roundtable, AWAC Consulting Physician Dr. Ed Mendoza addressed the growing use of pain management in the medical profession, and the spiraling costs associated with its application.

Dr. Mendoza noted that while many anesthesiologists, neurologists and other professionals are board certified in pain management, over 1/3 of such procedures are performed by practitioners with little or no formal training in the area, who see pain management as an easy way to make money.

Contributing greatly to pain management costs is the increased use of injections to reduce inflammation in facet joints. Dr. Mendoza observed that such injections can be administered as often as the physician deems necessary. Consequently, a 2008 study by the Department of Health and Human Services found that 63% of facet joint injections did not meet Medicare requirements in 2006, resulting in $96 million in improper payments.

MedBen is working with AWAC to reduce abuses in pain management procedures. Dr. Mendoza estimates that MedBen clients will realize nearly $480,000 in pain management savings in 2009.

MedBen has composed a white paper regarding pain management and the plan options we have come up with to address the issue. This document is available for download in the Plan Design area of this blog, which is password-protected and accessible only to MedBen clients and consultants.


  01:15:29 pm, by MedBen5   , 229 words,  
Categories: News, Health Plan Management

Health Reform Update: Over 500 Amendments Proposed for Senate Bill

Capitol Building
  • Nobody expected the Senate Finance Committee’s health care bill to make it through the legislative process without a few tweaks, and indeed, there have been a number of proposed amendments – 564, at last count. (You can see the official list of modifications here). Notable changes include lowering the penalty for those who don’t purchase coverage and increasing government subsidies to help people buy insurance. The idea of mandatory coverage has drew particularly harsh critism from Republican senators, as The Wall Street Journal reports.
  • Medicare is also being hotly debated in the Senate – specifically, Medicare Advantage, the private health insurance program that currently serves about one-quarter of Medicare beneficiaries. The Senate bill aims to cut $123 billion in payments to private insurers, a proposal opposed by Republican members of the Senate. The New York Times offers an overview of Medicare Advantage and the current battle surrounding it.
  • Flexible spending accounts (FSAs) could be negatively affected by reform efforts, according to USA Today. Under the proposed Senate bill, the maximum FSA contribution, currently set by the employer, would be capped at $2,000 per year beginning in 2013.
  • So what exactly are these “health insurance co-ops” we keep hearing about? Short answer: a nonprofit, consumer-owned, voluntary association formed for the express purpose of providing health insurance coverage. For a more detailed examination, check out this New York Times Q&A and this FAQ.


  12:39:02 pm, by MedBen5   , 61 words,  
Categories: Announcements

MedBen to Perform System Upgrades

MedBen will be performing system upgrades on Saturday, September 19th beginning at 7:30 a.m. We estimate the process will be completed within 12 hours.

During the upgrades, MedBen Access, e-mail and AS/400 will not be available at all times. Any correspondence that is received at MedBen during an outage will be queued up and distributed once the system is brought back up.


  11:47:40 am, by MedBen5   , 232 words,  
Categories: News, Wellness

Swine Flu Recommendations and Links


By now, you’ve undoubtedly heard numerous news reports warning of a second outbreak of the H1N1, or “swine", influenza. While some segments of the population are more susceptible to the swine flu than others, every individual – regardless of age or personal health – should be aware of the potential dangers of the virus and the best preventive measures to take against it.

MedBen’s prescription benefits consultant Pharmaceutical Horizons has produced a memo that offers a swine flu overview, likely vaccination candidates and treatment recommendations. You can download and print the document here.

One portion of the document, which we reproduce below, offers useful links to the Centers for Disease Control (CDC). We encourage you to review the information found on these pages.

“The CDC has posted on its website guidance for the public on how to deal with H1N1 issues including:

  1. What to do if one becomes sick with flu-like symptoms,;
  2. Taking care of a sick person at home,;
  3. The use of face masks and respirators to reduce the H1N1 transmission,”

We’ll add one additional link to the CDC site, this one a Q&A featuring prevention and treament tips:


  01:28:22 pm, by MedBen5   , 255 words,  
Categories: Announcements, Discounts, Health Plan Management

MedBen Claims Surveillance System Savings Exceed $10 Million

Woman Reviewing Folder

MedBen has just achieved an impressive benchmark. In its first two years of operation, its advanced claims surveillance system has saved clients 10.4 million dollars – savings over and above plan provisions, network discounts and medical management.

MedBen introduced the proprietary cost containment system in September of 2007, as a member of the AWAC® Alliance, a select network of third party administrators. The system goes beyond normal claims processing programs, in that it thoroughly analyzes a claim using over 80,000 financial and clinical algorithms to determine the potential for large loss, inappropriate billing or fraud, and cost reduction. This service is performed at no additional cost to the client.

When the surveillance system flags a claim, it is evaluated – with the consent of the client – by a medical panel to determine potential cost savings from both a clinical and cost perspective. On average, this physician-driven process saves clients 43% per selected claim.

MedBen President and CEO Doug Freeman said, “We saw the addition of the claims surveillance system as a real opportunity to provide our customers proven and measureable savings on top of our other cost controls. To reach $10 million in savings so quickly is a true testament to its effectiveness.”

Of the cumulative two-year total, $6 million was saved in the last 12 months alone. “Thanks to the work of the panel physicians, we’ve seen claims savings range from 20% to upwards of 80% during this past year,” Freeman added.

If you should have any questions regarding the MedBen claims surveillance system, please contact MedBen Marketing Services at (888) 627-8683 or


  03:31:59 pm, by MedBen5   , 213 words,  
Categories: Announcements

McClain Joins MedBen as Regional Sales VP

MedBen is pleased to announce the addition of a new associate to its Sales and Marketing team. Kelly McClain will serve as Regional Sales Vice President in Southern and Central Ohio and West Virginia, assisting his region’s broker network with the sales of all MedBen product lines.

A 13-year veteran of the managed health care industry, Kelly has extensive experience working with TPAs, PPO networks, brokers and consultants – knowledge that will serve him well in his new position. He is a graduate of Ohio University and currently resides in Dublin, Ohio with his wife Katrina and two sons. Please join us in welcoming Kelly to MedBen!

Throughout 2009, MedBen has been revamping the Sales and Marketing Department to ensure that our clients and brokers have the means necessary to help them provide comprehensive group health coverage while keeping costs as low as possible. Part of this overhaul includes our recent reassignment of sales regions. In addition to Kelly, Michael DeBois now oversees sales efforts in Northern Ohio, Northern Indiana and Michigan, while Blair Pickerill manages broker network activity in Southern Indiana, Kentucky and Tennessee.

If you have any questions regarding MedBen sales territories or the current Sales and Marketing team, please contact Brian Fargus, Vice President of Sales and Marketing, at (800) 423-3151, Ext. 388.


  02:20:44 pm, by MedBen5   , 230 words,  
Categories: News, Health Plan Management

Health Reform Update: How Will Kennedy's Passing Impact Reform?

  • The big question in the media today: What effect will the death of Senator Edward Kennedy have on health care reform? According to The New York Times, Democrats say they are even more determined to pass a bill in Kennedy’s name, while Republicans believe his ability to find common ground will be missed as the legislative debate continues. And this brief piece in The Wall Street Journal blog reviews the influence Senator Kennedy had on health care throughout his long career.
  • As Congress wraps up its summer vacation, the Los Angeles Times offers a refresher of President Obama’s key health reform goals – among them, universality, a public option and a deficit-neutral plan.
  • This CQ Politics website article examines the various claims made by health reform proponents and opponents, and judges whether they’re true, false or misleading.
  • With the dialogue at town hall meetings becoming so heated nowadays, it can be frustrating to those looking for informed conversation on health reform. This Washington Post Q&A offers some intelligent back-and-forth discussion on the subject. While the commentator makes it clear as to her wariness about reform, the generally civil discourse offers interesting arguments regardless of which side of the issue you’re on. And for a pro-reform viewpoint, click here.

Stay informed on the latest news and breaking stories on health care reform and other topics at MedBen’s Twitter page.

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