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December 30, 2009
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It’s tough being a most-favored nation. Anthem Blue Cross and Blue Shield of Connecticut, a subsidiary of Indianapolis-based WellPoint Inc., got a tongue lashing from that state’s attorney general for the “most-favored nation” clauses it inserts in its contacts with hospitals. The clauses insist the hospitals give no other insurance plan a discount larger than that given to Anthem. The clauses are preventing some of Connecticut’s hospitals from signing up for a new state-run insurance plan for the uninsured, called Charter Oak. It pays rates lower than those negotiated by Anthem, and many hospitals have refused to join for fear Anthem would insist that the hospitals allow Anthem to lower its payment rates to equal those of Charter Oak. Connecticut Attorney general Richard Blumenthal wrote a letter this month to Anthem asking it to promise not to insist on receiving discounts equal to Charter Oak. “I call on Anthem to break its death grip on hospitals and encourage them to join in this critical health insurance program,” Blumenthal said in a statement. Most-favored nation clauses were banned in Indiana by the General Assembly in 2007.

Even though Wall Street likes the Senate health reform bill, that doesn’t mean rank-and-file insurance professionals do. But in the Christmas spirit, Susan Rider,  president-elect of the Indianapolis Association of Health Underwriters found some positives in the latest version of health reform. She likes that there will be no government-run health plan or an expansion of the Medicare program—although she still does not like the proposed expansion of Medicaid. She likes that a cap on flexible-spending accounts of $2,500 will now rise in line with inflation. She likes that the federal Department of Health and Human Services will not set broker commissions in the newly created insurance exchanges. But she does not like much of the meat of the bill. She thinks the requirement for insurance plans to spend at least 85 percent of premiums on care (80 percent for individual policies) needs to be reduced, likewise the $6.7 billion in annual taxes assessed on for-profit health insurers and the 40-percent tax assessed on insurance policies costing $23,000 or more. Rider said the fines used to enforce the mandate that all individuals buy health insurance will be “completely ineffective” because they will allow Americans to pop in and out of insurance pools only when they need health care services.

This can’t be good for business—especially for a human resources business. Indianapolis-based consultant HR Solutions Inc. was sued in federal court last month for allegedly failing to pay commissions earned by a saleswoman and then firing her the day after she got out of the hospital after a pancreatitis attack. The saleswoman, Candi Marsch of Evansville, wants HR Solutions to shell out back pay, punitive damages and legal fees.

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  1. By Mr. Lee's own admission, he basically ran pro-bono ads on the billboard. Paying advertisers didn't want ads on a controversial, ugly billboard that turned off customers. At least one of Mr. Lee's free advertisers dropped out early because they found that Mr. Lee's advertising was having negative impact. So Mr. Lee is disingenous to say the city now owes him for lost revenue. Mr. Lee quickly realized his monstrosity had a dim future and is trying to get the city to bail him out. And that's why the billboard came down so quickly.

  2. Merchants Square is back. The small strip center to the south of 116th is 100% leased, McAlister’s is doing well in the outlot building. The former O’Charleys is leased but is going through permitting with the State and the town of Carmel. Mac Grill is closing all of their Indy locations (not just Merchants) and this will allow for a new restaurant concept to backfill both of their locations. As for the north side of 116th a new dinner movie theater and brewery is under construction to fill most of the vacancy left by Hobby Lobby and Old Navy.

  3. Yes it does have an ethics commission which enforce the law which prohibits 12 specific items. google it

  4. Thanks for reading and replying. If you want to see the differentiation for research, speaking and consulting, check out the spreadsheet I linked to at the bottom of the post; it is broken out exactly that way. I can only include so much detail in a blog post before it becomes something other than a blog post.

  5. 1. There is no allegation of corruption, Marty, to imply otherwise if false. 2. Is the "State Rule" a law? I suspect not. 3. Is Mr. Woodruff obligated via an employment agreement (contractual obligation) to not work with the engineering firm? 4. In many states a right to earn a living will trump non-competes and other contractual obligations, does Mr. Woodruff's personal right to earn a living trump any contractual obligations that might or might not be out there. 5. Lawyers in state government routinely go work for law firms they were formally working with in their regulatory actions. You can see a steady stream to firms like B&D from state government. It would be interesting for IBJ to do a review of current lawyers and find out how their past decisions affected the law firms clients. Since there is a buffer between regulated company and the regulator working for a law firm technically is not in violation of ethics but you have to wonder if decisions were made in favor of certain firms and quid pro quo jobs resulted. Start with the DOI in this review. Very interesting.

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