Legislation set to come out of Washington will not change the most fundamental problems of the health
care system, leaving it up to states, cities and companies to figure out what to do about it.
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.
Congress is on the cusp of transforming health insurance—if it can pass a health reform bill that was losing popularity
late in the year.
Group presidents tell Indiana senators that the reform bill would expand dysfunctions of current health care systems.
Mathematica Policy Research, which last studied Indiana in 2004, will now examine Healthy Indiana Plan.
Indiana government has lost more than 1,500 workers in the past year, and that’s a good thing, Gov. Mitch Daniels says.
House and Senate versions of health care reform could halt the trend toward physician-owned hospitals.
Indianapolis-based Eli Lilly and Co. has won a bid to dismiss part of a negligence lawsuit brought by Mississippi that alleges
improper marketing of antipsychotic drug Zyprexa for unapproved uses.
After the U.S. House of Representatives narrowly passed a sweeping health care overhaul, leaders of Indiana’s two
largest health care entities turned their hopes to the U.S. Senate to give them a bill more to their liking.
Drugmaker and health insurer bemoan aspects of House health reform bill and hope Senate crafts more industry-friendly bill.
Indiana Gov. Mitch Daniels on Friday announced a series of spending cuts and other steps designed to offset a continuing multimillion-dollar
decline in state revenues. If the trend continues without spending cuts, he said, Indiana’s reserves would be wiped out by
next August.
In letter to Indiana congressmen, the governor says the reform bill would kill jobs with ‘enormous’ new taxes.
President Barack Obama’s federal stimulus package has steered about $848 million to Indiana so far and created or retained
nearly 18,900 jobs, the White House said. But an analysis found the report is still full of errors.
The health care overhaul bill produced by House Democrats would impose an array of new taxes, fees and government mandates
on major players in the health industry, including drug companies and big medical-device makers headquartered in Indiana.
Indianapolis-based WellPoint Inc.’s Anthem Blue Cross and Blue Shield subsidiary claimed 42.5 percent of central Indiana residents
covered by private health insurance
this year, up from 35-percent last year, according to a market research firm.
A federal judge has ordered Indiana’s partially privatized welfare intake system to speed up decisions on food-stamp applications,
but the state has a year to meet its first target.
Indiana human services chief Anne Murphy is expected to reveal more details on how the state will handle welfare intake after
its contract with IBM Corp. runs out.
Lawmakers said Tuesday that Indiana welfare subcontractor Affiliated Computer Services Inc. will come under closer
scrutiny now that Gov. Mitch Daniels has fired IBM Corp. from the project.
Indiana has received nearly $2.4 billion in federal stimulus money and has spent nearly $780 million so far, according to
preliminary data released Thursday.
As health care legislation
continues to wend its way through Congress, Indianapolis-area industry leaders still harbor strong
opinions about the issue. Five industry insiders discussed how to improve the health care system during
IBJ’s Power Breakfast Sept. 25 at the Westin Indianapolis.
