A reminder to MedBen FSA and HRA clients: For most groups, the week of March 25th is the last week to turn in expenses for the 2011 FSA and/or HRA plan year.
If you have any outstanding 2011 expenses that you would like to get reimbursed for from your Health FSA, Dependent Care and/or HRA plan, those expenses must be submitted on or before the close of business on Friday, March 30. FSA and HRA reimbursement forms are available at the MedBen website.
Please note that some FSA/HRA groups have different year-end deadlines to submit expenses. If you’re unsure as to your final submission date, please speak to your plan administrator or contact MedBen Customer Service at 800-297-1829.
On this, the second anniverary of the passage of the Affordable Care Act, it’s an appropriate time to to look at the impact of health care reform so far, as well as what’s coming down the road. Fortunately, Kaiser Health News has done the heavy lifting for us.
“A Consumer Guide To Health Reform Law” offers a wide-ranging FAQ about ACA provisions past, present and future. We’ll highlight a couple questions here pertaining to employer-based health plans, but check out the complete article for additional information about other aspects of the law.
I get my health coverage at work and I’d like to keep my current plan. Will I be able to do that? How will my plan be affected by the health law? If you get insurance through your job, it is likely to stay that way. But, just as before the law was passed, your employer is not obligated to keep the current plan and may change premiums, deductibles, co-pays and network coverage.
You may have seen some law-related changes already. For example, most plans now ban lifetime coverage limits and include a guarantee that an adult child up to age 26 who can’t get health insurance at a job can stay on her parents’ health plan.
I own a small business. Will I have to buy health insurance for my workers? No employer is required to provide insurance. But starting in 2014, businesses with 50 or more employees that don’t provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchange will have to pay a fee of up to $2,000 per full-time employee. The firm’s first 30 workers would be excluded from the fee.
However, if you have a firm with 50 or fewer people you won’t face any penalties.
In addition, if you own a small business, the health law offers a tax credit to help cover the cost. Employers with 25 or fewer full-time workers who earn an average yearly salary of $50,000 or less today can get tax credits of up 35 percent of the cost of premiums. The credit increases to 50 percent in 2014.
The Food and Drug Administration is currently conducting a two-day hearing to discuss the possibility of allowing more drugs to be purchased without a prescription, Bloomberg Businessweek reports.
At a meeting yesterday, the FDA discussed whether cholesterol, asthma, migraine and blood-pressure medications should be sold over-the-counter. By allowing this regulatory change, the agnecy hopes to lower costs and ease access to drugs for people with chronic conditions.
And today, the question of contraceptive care will enter the debate. Reproductive-rights advocates are urging that any expansion of nonprescription drugs include birth control. Last year, the Obama administration overrode the FDA’s support for selling “morning-after” pills over-the-counter to girls 16 and younger – a move that upset women’s health advocates.
Over-the-counter medicines save the U.S. health-care system $102 billion a year, according to the Consumer Healthcare Products Association, the nonprescription drugmakers’ lobbying group in Washington.
By a vote of 223 to 181, the House of Representatives yesterday approved a bill to abolish the Independent Payment Advisory Board created by the Affordable Care Act. The purpose of the 15-member board is to recommend Medicare spending cuts, which would automatically take effect unless Congress voted to block or change them.
According to the New York Times, the House vote fell largely along party lines. Seven Democrats voted for the bill, and 10 Republicans voted against it.
“The Independent Payment Advisory Board encompasses all that is wrong with the Affordable Care Act,” said Representative Michael C. Burgess, Republican of Texas. “It is not accountable to any constituency, and it exists only to cut provider payments to fit a mathematically created target.”
Democrats who also voted against the bill say they fear it will usurp the power of Congress to set Medicare policy. But most party members objected to the bill’s inclusion of tort reform proposals that could limit patients’ ability to recover damages for injuries suffered as a result of medical malpractice.
A simple test could predict whether a heart attack is looming, the Los Angeles Times reports. Using a blood sample, doctors may be able to determine circulating cells that have broken off damaged blood vessel walls – which in turn can form a blood clot that blocks flow to the heart, leading to an attack.
While physicians can easily determine if a heart attack is underway, anticipating one that’s still some time away is much more difficult. But new research offers hope that the test could potentially address “the greatest unmet need” facing cardiologists, said lead author Dr. Eric Topol, a cardiologist at the Scripps Translational Science Institute in San Diego.
“When someone is having the real deal, we know that,” Topol said. “The real question is, is something percolating in their artery? We’d like to prevent the heart attack from happening,” or mitigate its effects with drugs.
Of course, a better strategy than hoping this heart attack test works is to minimize your risk of developing heart disease in the first place. With MedBen Worksite Wellness, plan members with certain specific diseases or risk factors will be identified for intervention and management. Our Specialty Care Program provides individualized disease monitoring and nurse coaching for members with heart disease as well as diabetes, asthma, hypertension and high cholesterol.
For more information about MedBen Worksite Wellness, please call Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
The battle to visually upset smokers is getting as convoluted as the battle to strike down health care reform. Just weeks after a U.S. District Judge found the federal requirement to place graphic images on cigarette labels to be unconstitutional, a federal appeals court has ruled the law doesn’t violate the free speech rights of tobacco companies.
According to Reuters, Cincinnati-based U.S. Court of Appeals for the 6th Circuit upheld Food and Drug Administration regulations, which include a requirement that cigarette makers incorporate pictures depicting the hazards of smoking on their packaging. Tobacco companies argued that the rules violated their First Amendment right to communicate with adult tobacco consumers.
“There can be no doubt that the government has a significant interest in preventing juvenile smoking and in warning the general public about the harms associated with the use of tobacco products,” Judge Eric Clay wrote for the three-judge 6th Circuit panel.
The FDA has approved nine images to go on cigarette packs, including graphic pictures of dead bodies, diseased lungs and rotting teeth. Warning-label regulations, passed by Congress into 2009, specify that the labels must be in color, must cover the top 50% of a cigarette pack’s front and back panels, and must cover the top 20% of print advertisements.
Floyd Abrams, a lawyer for Lorillard Tobacco Company, predicted that the 6th Circuit case would likely end up in the U.S. Supreme Court.
The Internet can be a great source of medical knowledge. But knowing where to look, and who you can trust, is critical when trying to diagnose symptoms or learn more about a disease. Former law professor Toni Bernhard offers some tips for your online health information search (read her complete comments on theKevinMD.com blog):
We’re just a few days from the battle of the century – President Obama vs. 26 states challenging his Affordable Care Act, going mano a mano in the Supreme Court, with the future of healh care reform hanging in the balance.
The outcome of the three-day hearing likely won’t be known until summer, but that hasn’t stopped HealthDay News from asking legal experts to predict the outcome. And just about everyone is giving the President a win by technical knockout:
Gregory Magarian, professor at Washington University Law School: “The folks [26 states] who are challenging the act have somewhat of an uphill battle. It’s been some time since the court has struck down a major piece of federal legislation on the theory that it exceeds Congress’ constitutional authority.”
Neil Siegel, professor of law and political science at Duke University School of Law: “The court has held that in issues of economic activity, Congress can act as if we have an integrated national economy. Here you have economic conduct [health care] with massive interstate effects.”
Robert Field, professor of law at Drexel University’s School of Public Health: “I think it’s unlikely the court wants to create a major public or policy upheaval, which is what it would be doing if it overturned the law.”
Stephen Presser, professor of legal history at Northwestern University School of Law: “I think [Justices] Scalia, Thomas, Alito and Roberts will all have to view this as Congress going much too far and virtually ignoring the 10th Amendment. Justices Breyer and Ginsburg have always been strong voices for expanded Congressional power, and Justices Kagan and Sotomayor are not going to embarrass the man [Obama] who appointed them, so there are four sure votes to uphold the legislation as well. That leaves only Kennedy as the swing vote, as most commentators, I think, understand.” Presser believes Kennedy will vote with the conservative justices, which means the ACA will be ruled unconstitutional.
Sometimes, expensive health care is just that – expensive health care, no matter where you get it. And lower-cost caregivers can deliver high quality regardless of geography.
According to Medical Xpress, a new study conducted by physicians in San Francisco found no solid evidence to support the theory that regions of the United States that spend more on health care and have higher rates of health care use deliver more unnecessary care to patients. Conversely, low-cost areas don’t necessarily deliver more efficient care – they simply don’t charge as much for care that’s just as good.
MedBen’s own experience has demonstrated degrees of cost-effective care at hospitals of all sizes, in regions large, small and in-between. But one important lesson we’ve learned is that many smaller facilities do indeed offer care that’s of comparable quality to their larger colleagues, and frequently charge less for it.
Partners Community Health Plan, now available in multiple Southeast Ohio and Southwest Kentucky regions, rewards members who choose local hospitals and doctors. Under the plan – a partnership between MedBen and leading area providers – members can obtain lower-cost care from smaller regional hospitals, at the same outcome levels found at facilities in major metropolitan areas.
Partners plans are available to both fully-insured and self-funded groups. To learn more, visit the Partners website or contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
Not only is aspirin lauded for its ability to limit heart attack damage, it is believed that the painkiller can reduce the long-term risk of dying from cancer. Now, new research shows that there may be a short-term advantage as well.
Bloomberg reports that men and women who took a daily dose of aspirin had a 24% lower rate of developing cancer after three years and were 37% less likely to die from the disease after five years than those who didn’t, according to a study in The Lancet medical journal. Previous research had concluded that it took at least eight years to realize the benefits.
Based on the research findings, it’s also possible that the faster-acting qualities of aspirin may help to prevent tumors from spreading.
“We still need to do trials of aspirin in treatment of cancer to show that the benefit is definitely there if you start taking it after the cancer’s been diagnosed,” said Peter Rothwell, a professor at the University of Oxford who led the research. “But potentially it would be a highly cost-effective way of preventing the spread of cancers.”
As we noted on this blog last July, 2012 looks to be a big year for generic rollouts of popular brand name drugs. WebMD recently reported on two such introductions:
The Food and Drug Administration has ruled that three generic drugmakers may now sell their own versions of the drug Boniva, a once-a-month pill prescribed to prevent or to treat bone loss from osteoporosis.
Boniva, known by the generic name ibandronate, has been officially approved only for treatment of postmenopausal women, as the clinical studies that led to approval mostly involved women. However, doctors often prescribe the drug to men.
A reminder to MedBen plan members who get pharmacy benefits management services through Pharmacy Data Management (PDMI): You can get information about generic alternatives and compare prices through MedBen Access. By clicking on your name under “My Rx Claims” in the sidebar menu, you will be taken directly to the RxEOB service.
To access MedBen Access, simply go to MedBen.com, select “Online Client Services", and click on “MedBen Access".
The Affordable Care Act turns two years old on March 23, and to mark the occasion, Politico has compiled a list of five things to watch for in year three. Below we offer a “teaser” – you can find the complete answers at Politico website.
1) How many states won’t set up their own exchanges? So far[…] a lot of states are not moving ahead. The federal exchange could end up covering as many as 15 to 25 states[.]
2) What’s next on essential benefits? So far, [Health and Human Services] has put out a “bulletin” – less formal than an actual rule – that said states will be able to choose from a selection of benchmark plans. But who in the states, exactly, gets to make that call? And how can states fill in the gaps for benefits not typically offered by their insurers?
3) Who’s forming accountable care organizations? [July 1 is] the deadline for providers to apply to become accountable care organizations – the new networks of hospitals and physicians that will work together to deliver medical care more efficiently under new payment rules, incentives and quality measures. It’ll be too soon to tell whether these ACOs can actually save money without skimping on patients’ care, which is the point of the program. But the sign-up deadline will give everyone a better read on whether providers believe the model is viable in the long run.
4) Will there be more scares about the costs? Each study of how employers may react to the health care law invites potentially damaging answers that speak to people’s worst fears about employers dropping coverage. The studies get widely quoted, and new ones could make the public sour on the law even more.
5) Will there be a replacement plan? Congressional Republicans insist the Affordable Care Act is not the only way to fix the health care system — but they haven’t yet delivered the promised plan to “replace” the law with a more market-driven, state-centered alternative.
Only about 1 in 100 Americans meets seven heart-healthy targets recommended by the American Heart Association. according to WebMD.
The seven behaviors include:
A study conducted in 2005-2010 found that just 1.2% of Americans followed all the heart health habits, a drop from 2% in 1988-1994. Researchers noted that the number of people eating a healthy diet has declined, while the prevalence of obesity and abnormal fasting blood-glucose levels has risen.
There is some positive news, though. Smoking is down from from 28% to 23%, and more people met the ideal heart-healthy level of physical activity (45%, up from 41%). But the percentage of people classified as inactive doubled from 16% to 32%.
The study also demonstrated that heart disease and death risk decreases as more heart-healthy goals are met. People who met six of the seven goals had a 76% lower risk of heart-related death and a 51% lower risk of death from any cause, compared with those who met one or fewer.
More proof that we can learn a lot just by looking in someone’s eyes – especially if you look really close. WebMD reports people who have eye damage involving the blood vessels of the retina have a higher risk for memory decline, according to a new study.
Researchers say that retinopathy – damage to blood vessels in the eyes, caused by vascular disease – may indicate that blood vessels in the brain are likewise not operating properly. Retinopathy is also a common complication of diabetes and uncontrolled high blood pressure, which have also been linked to a higher risk for memory and thinking declines.
If the study is correct, it demonstrates how regular eye exams can identify problems that go well beyond impaired vision – in this case, potentially helping identify people at risk for dementia.
MedBen VisionPlus is a perfect match to your health care plan. Detecting eye disease and other potential ailments early reduces the risk of major medical costs down the road. To learn more about the benefits of group vision coverage, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
From John Goodman’s Health Policy Blog: In his new book American Health Economy Illustrated, Christopher Conover of the American Enterprise Institute debunks some widely-held health care myths.
Myth: Relative to other countries, the U.S. spends “too much” on health care.
Differences in income explain 85% of variations in health spending. The U.S. is spending what it should in GDP per capita, while France spends 1/5 too much, and Canada and the U.K. spend too little. Blue states are spending too much due to overregulation (Massachusetts, New York, New Jersey). After RomneyCare, Massachusetts has the highest level of health care spending.
Myth: The U.S. has an abysmal infant mortality rate.
It does rate 43rd, but there is no standard for reporting infant mortality. The U.S. is one of eight countries that count extremely premature infants as live births despite low chances of survival. If we categorize births by length of gestations the U.S. ranks 2nd, 3rd, or 4th (depending on type of rank) to European countries.
Myth: The U.S. lags behind its competitors in life expectancy.
The U.S. ranks 39th, but this is misleading. This distortion is due to a high rate of deaths resulting from violence. When adjusted for deaths related to violence and suicide the U.S. ranks first in OECD countries.
Myth: The U.S. has worse health outcomes than its peers.
Cancer is the second leading cause of death in the U.S., but cancer patients live longer in the U.S.; cancer survival rates are better. The U.S. has far higher screening rates.
Conclusion: The U.S. health system has many problems, but other countries do not offer a magic bullet.
In an effort to address the ongoing contraceptive coverage controversy, the Obama administration has announced how religious organizations than insure themselves can remain exempt from paying for birth control, yet still provide free coverage for female employees and students.
According to The New York Times, the administration said that in such cases, contraceptive coverage will be provided by “third party administrators” or by “some other independent entity.”
As to whom will provide the money to pay the claims for contraceptive drugs and devices, Health and Human Services Secretary Kathleen Sebelius suggested that pharmaceutical companies could provide drug rebates to help cover the cost. Alternatively, the federal government could encourage or require one or more private insurers to provide contraceptive coverage for people in a religious organization’s health plan.
Sebelius said these proposals would guarantee women access to contraceptives “while accommodating religious liberty interests.” Republican in Congress had a different take on it.
“It’s a Washington accounting gimmick,” Representative Jeff Fortenberry, Republican of Nebraska, said Friday in an interview. “The administration is twisting itself in all directions to expand the ‘accommodation’ for faith-based institutions. Why is it the government’s role to decide who gets an accommodation? The White House is creating an unnecessary political firestorm.”
The early onset of Spring weather has certainly been a pleasant surprise. But for allergy sufferers, dealing with sneezing and sniffling sooner than usual means the warm temperatures are a mixed blessing.
However, allergy sufferers need not just accept their plight, advises Dr. Myron Zitt, former president of the American College of Allergy, Asthma and Immunology. “People with spring allergies often don’t realize how many things can aggravate their allergy symptoms, so they just muddle along and hope for an early end to the season. But there’s no reason to suffer. A few simple adjustments in habits and treatment can make springtime much more enjoyable,” says Zitt in a college news release.
According to HealthDay, allergists recommend allergy-sufferers keep their house and car windows closed so pollen can’t drift in from outdoors. Using the proper air filter is also essential.
People with seasonal allergies to grass, birch trees or alder trees may also have cross-reactions to closely related fruits, vegetables and nuts. As a result, grass allergy sufferers may experience tingling, itching and swelling around the mouth when they eat tomatoes, potatoes or peaches. Likewise, those with tree allergies sometimes find celery, cherries or apples risky as well.
Allergists also encourage people to take their medicine even before their symptoms flare, and to see an allergist who can suggest the best course of treatment.
A recent Towers Watson survey of over 500 businesses reveals the wide range of difficulties employers face when trying to keep health care costs in check. As listed on the MedCity News website, the top ten challenges include:
At MedBen, we have the people and the technology to help employers face these challenges – and any other obstacles that may arise along the way. From innovative wellness programs that promote better health habits, to prescription plans that offer superior discount rates on brand name and generic drugs alike, we help businesses of all sizes save money.
Among the many resources we employ to control employer health care expenses is an advanced claims surveillance system. Going beyond traditional cost control measures, the system – working in conjunction with highly trained health care professionals – screens every claim, searching for that “small” claim that may very well have large claim potential. On average, this physician-driven process saves 45.1% per selected claim.
To learn more about MedBen’s array of cost containment tools, please contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
Could 20 million people lose their employer-sponsored insurance in 2019? Highly unlikely, says a new report from new report from the Congressional Budget Office – but not totally out of the question, either.
The 20 million number is a worst-case scenario based on a CBO analysis of the Affordable Care Act. More probable, the agency says, 3 million to 5 million fewer people between 2019 and 2022 will have health care coverage from their employer due to the health reform law. It’s even possible – and here we’re talking best-case outcome – that an increase of 3 million workers with employer insurance could happen.
According to Politico, whether the loss of employer coverage be 2 million people or 20 million, the federal government would subsidize coverage for many of these workers through the new health insurance exchanges or cover them through Medicaid. And CBO estimates that because their coverage would be more than offset by employer penalties and higher income taxes, it would actually reduce the law’s cost.
Regardless, CBO still thinks that “most employers will continue to have an economic incentive to offer health insurance to their employees.” The agency expects changes will stick close to its earliest estimate that 3 million people could lose their workplace coverage.
Cancer experts are advising that women get screened for cervical cancer less frequently than doctors currently recommend, NPR reports.
Guidelines released by the American Cancer Society and two other medical groups now recommend that women wait until they turn 21 to get their first Pap smear, and then only get tested every three years thereafter if everything looks okay. This goes against the long-standing recommendation that screening should begin either at age 21 or three years after the onset of sexual activity.
Debbie Saslow of the ACS says that cervical cancer is rare in young women, so there’s no reason to start earlier than age 21. And the cancer grows very slowly, so there’s no danger in waiting longer between tests. “If you compare the benefit of annual screening to screening every three years with the Pap test it’s almost nothing,” she said.
Also factoring into the recommendation is that Pap tests often produce false alarms, so more frequent testing can result in unnecessary procedures to ensure there’s no cancer, Saslow added.
The new guidelines also advise women to cease Pap smears at age 65, provided there’s no evidence of cervical cancer risk in earlier screenings.