10.11.09

[Guidance Overview] Balance Billing Practices May Constitute Breach of Contract

Posted in Uncategorized at 5:33 am by heaven

Excerpt: "This district court opinion holds interest for health care providers and benefit fiduciaries alike. As against a motion to dismiss, the district court holds that the plaintiffs have stated a cause of action against the health care provider for balance billing, i.e., billing the balance 'owed' after their health plan paid the PPO discounted rate." (Attorney Roy F Harmon III in the Health Plan Law blog)

Private Health Insurance: Research on Competition in the Insurance Industry (PDF)

Posted in Uncategorized at 5:33 am by heaven

13 pages. Excerpt: "Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. . . . Despite [the] challenges, researchers have used the data available to study competition in health insurance markets, typically using one of two measures of competition: (1) HMO market concentration or (2) the number of HMOs in a market." (U.S. Government Accountability Office)

New York Laws Increase State COBRA Period and Age for Dependent Health Insurance Coverage (PDF)

Posted in Uncategorized at 5:33 am by heaven

3 pages. Excerpt: "On July 29, 2009, New York Governor David Paterson (D) signed into law three health reform bills -- one extending the period for state health coverage continuation rights from 18 to 36 months, one requiring insurers to offer continued coverage for unmarried adults through age 29 under their parent's individual or group health insurance policies, and one instituting a series of managed care reforms." (Buck Consultants)

09.23.09

Free treatment to weaker sections in hospitals on govt land

Posted in Uncategorized at 2:02 pm by heaven

NEW DELHI: Delhi Government will soon set up a mechanism to ensure that private hospitals built on subsidised government land provide free treatment to economically weaker sections of the society in the city.

The move came a day after Delhi High Court directed Indraprastha Apollo hospital to reserve at least 200 beds for free treatment to poor patients and imposed a fine of Rs two lakh on it for not complying with the land lease agreement.

"We will set up a monitoring mechanism to check compliance of the land lease agreement with the private hospitals. The hospitals must offer free treatment to the needy patients," Delhi Health Minister Kiran Walia said.

Welcoming the High Court ruling, Walia said action will be initiated against the hospitals which do not provide free beds to 33 per cent poor patients in indoor patient department and 40 per cent poor patients in OPD as per the land lease agreement with the government.

Over 20 hospitals had taken land from the government at subsidised rates promising that it will offer free treatment to the poor section of the society in the national capital.

A division bench of Delhi High Court directed the Apollo hospital to comply with the agreement to provide free treatment to poor patients.

The Court directed the Delhi government to set up a special committee to monitor whether the hospital is implementing its direction or not.

09.22.09

Hygiene product makers cash in on swine flu outbreak

Posted in Uncategorized at 8:34 pm by heaven

PUNE: The recent swine flu scare has translated into brisk business for health and hygiene sectors. While branded products like Dettol saw a rise in their sales, even local ayurvedic drug manufacturers are marketing their products as protection against the H1N1 virus.

After the flu outbreak, products like eucalyptus oil, homeopathy medicines and disinfectants like Dettol, liquid hand wash and soaps were in great demand. As a senior official from Reckitt Benckiser, global FMCG company and maker of Dettol, puts it: "Demand for our products in this category has risen 40-45% in the past two months in Maharashtra."

After the first few swine flu fatalities, there was a sudden rush to buy personal hygiene products. Kavita Yogesh Kode, owner of a local medical store, said: "Earlier, people did not know much about hand sanitisers. I used to sell one bottle a month. Now, sales are up and I sell about 20 bottles a day." While some local companies have launched new brands of hand sanitisers, others have re-launched their old brands.

Swine flu panic also helped in pushing up sales of several ayurvedic products. After some ayurveda practitioners emphasised that extracts of certain herbs like tulsi, bel ahwagandha etc and burning of camphor may help against the spread of H1N1 virus, demand for these herbs also went up.

Sachin Vetankar, another medical store owner, said: "We have seen a five to six fold increase in the sale of eucalyptus oil. Against a weekly sale of about 3-4 bottles before the outbreak of swine flu, I sold about 50 bottles every day when the scare was at its peak. Now, I sell at least 10 bottles everyday."

In Pune, which saw the highest number of swine flu deaths, the protective N95 and N90 masks were being sold at exorbitant rates in the black market. "Currently, we are selling the N95 mask for Rs 100. But, after the first swine flu death in Pune, these masks were sold at Rs 300-Rs 400 per piece," said a medical store owner.

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