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Archive for the ‘News’ Category

Here is the full story from USA Today.  The health system whose data was compromised was Community Health Systems based in Franklin, TN.  The information stolen included names, addresses, dates of birth, phone numbers and social security numbers.  The hackers were believed to be from China.  The breach apparently occurred in April and June.  The company confirmed that the hackers were able to successfully copy the patient data outside their system.  Those affected are those that had received services from physicians affiliated with the system over the past 5 years.

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Here is an interesting article on how Walmart is looking to move into the Primary Care space from the New York Times.  They currently have 6 locations in South Carolina and Texas and plan on opening up 6 more locations in 2015.  Walmart had opened some critical care clinics in the past, with limited success.  Their new strategy is more focused on Primary care versus urgent or critical care and is using one managing partner versus several.

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Here is a brief overview from Richard Hammer’s post on Linked in.  Key points on the study were that a much higher percentage of Medicare age in’s are now individual purchasers as opposed to having coverage through a group or retiree plan.  Also, purchasers are more likely to consider higher deductibles as opposed to first dollar coverage.  This correlates to the tendency for those aging into Medicare to select Medicare advantage over traditional Medicare and a supplement (at least at a higher rate than the overall Medicare population).

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Most Medicare beneficiaries believe that AEP ends on December 31st, followed by December 1st.  About 22% of Medicare beneficiaries answered correctly that AEP ends on December 7th.

Here is a link to the poll that was taken by HealthPocket:

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The following email came from the State of California Department of Insurance.

NOTICE

TO:  All Admitted Insurers, Insurance Producers, Bail Agents, Independent and Public Adjusters and Other Interested Parties

SUBJECT:  Reporting of Administrative Actions and Criminal Convictions

DATE:  August 16, 2013

Background
On January 1, 2005, Section 1729.2 was added to the California Insurance Code. This section requires all licensees and applicants for licenses issued by the California Department of Insurance’s (CDI) Producer Licensing Bureau to report any administrative actions or criminal convictions to CDI within 30 days of the final disposition of the matter. This requirement applies to both California resident and non-resident licensees and applicants.

Purpose
Several licensees have told CDI that they are not aware of the reporting requirement. Therefore, the purpose of this notice is to remind all affected parties of the requirement and to provide instructions for how to report the information.

What needs to be reported?
Background information that must be reported includes any of the following:

• A misdemeanor or felony conviction

• A filing of felony criminal charges in state or federal court

• An administrative action regarding a professional or occupational license

• A licensee’s discharge or attempt to discharge in a personal or organizational bankruptcy proceeding an obligation regarding any insurance premiums or fiduciary funds owed to any company, including a premium finance company, or managing general agent

• Any admission, or judicial finding or determination, of fraud, misappropriation or conversion of funds, misrepresentation, or breach of fiduciary duty

How to report
To report information to CDI in writing, you may use the background change disclosure form available on our website at http://www.insurance.ca.gov by selecting “Producer Background Information” under “Agents & Brokers”. Additional information regarding this requirement, and the form, can be found by following the link here or by typing “background change” in the search box on CDI’s homepage.

All Admitted Insurers, Insurance Producers, Bail Agents, Independent and Public Adjusters and Other Interested Parties Reporting of Administrative Actions and Criminal Convictions

You may also submit background changes electronically to the National Insurance Producer Registry (NIPR) Attachment Warehouse Reporting of Actions (ROA) at http://www.nipr.com/ by selecting “Reporting of Actions” under “Attachments Warehouse”. The documents submitted through the ROA service fully satisfy the Background Reporting requirements of Section 1729.2 of the California Insurance Code.

What documents to provide?
Please include supporting documents such as a statement regarding the background change; certified court documents; administrative or disciplinary documents; or any other information relative to the change.

Specific Requirements for Employees of Organizational Licenses
If any of the changes in the background information involves an applicant or licensee who is listed as an endorsee on a business entity license, the licensee or applicant must also provide the notice of background change to any officer, director, or partner listed on that business entity license or application pursuant to Section 1729.2(a) of the California Insurance Code.

You may contact the Licensing Background Bureau at (916) 492-3650 if you have further questions about these background reporting requirements.

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Whether or not you agree with Dr. Carson’s political views, I think his speech is worth a listen.  Dr. Carson is an amazing inspiration to me personally having read his book (Gifted Hands) and watched the movie based on his life (same title).  He pioneered many revolutionary techniques in pediatric neurosurgery (and neurosurgery, generally) and was hired as the Directory of pediatric neurosurgery at John’s Hopkins at the age of 33.  By revolutionizing techniques in neurosurgery, he’s saved countless lives and improved the quality of life for countless more.  Dr. Carson was raised in abject poverty by a single mom in Detroit.  Her passion for raising her kids with a love of learning and expectations of excellence was instrumental in his amazing life story.

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Sequestration Cuts to Medicare Looming

It seems like the possibility that sequestration cuts will occur (due March 1st) is growing recently.  Nancy Pelosi appeared on Fox News Sunday today and argued for higher taxes on Gas and Oil and reductions in “loopholes” for high income earners as the way to replace sequestration.  Ms. Pelosi argued that there were plenty of spending cuts in the budget control act and that the Federal Government doesn’t have a spending problem, but a growth problem.

The $85 Billion in sequestration cuts were postponed to March 1st with the “Fiscal Cliff” deal (last time I want to use that term) in order to give time for the Senate time to pass a budget.  It appears that the Senate (and the Administration) prefer tax increases and do not want to see the sequestration cuts occur.  Republicans don’t particularly care for sequestration, however, this may be their only opportunity to government spending.

If sequestration cuts DO occur, it would mean a 2% cut to Medicare providers.

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