Wednesday, October 07, 2015

Promise: Broken

Not to sound like a broken record, but remember when President Obama swore that "if you like your insurance, you can keep your insurance?"

Just got email from Humana that the following letter is going out to at least one of my clients:
Re:    Policy Number:
Your current Humana plan will no longer be available in your area for 2016
You will need to select a new health plan between November 1 – December 15,2015

Dear :

Unfortunately, your current Humana plan will no longer be available in your area beginning January, 2016; however, it will remain the same as it is today until December 31, 2015, as long as you continue to make your monthly payment. We know how important it is to select the health plan that best fits your needs, so we would like to help you understand your options and what to do next.
The entire letter is available here.

Color me shocked.

Urgent for our NJ readers

New Jersey health officials say nurse reused syringes while giving flu shots; testing urged.

Unintended Consequences #2,584

Back in 2013, we posted on the travails of an Old Line State same-sex couple trying to untangle their health insurance:

"I got a call today from a woman who needed to find new coverage. She had been covered by her same sex partner as a domestic partner, but since Maryland passed gay marriage, she's now been told that she can no longer stay on the policy unless they get married."

Fast forward two years, and the post-Obergefell era is claiming another scalp:

"The Obama administration reversed a policy Monday that had allowed unmarried federal employees and retirees in same-sex domestic partnerships to obtain insurance coverage for children of their partners"

That is, until now, same-sex couples could cover their children on their gummint-issue health insurance even if they weren't married. Back in Aught 14, "the Office of Personnel Management broadened eligibility ... It made children of an employee or retiree’s same-sex domestic partner — although not the partner himself or herself — eligible." That is, they could add their "step-children" (but not their Significant Other) to their healthinsurance plan.

As a result of the SCOTUS Obergefell ruling, that's no longer the case, and these folks will now have to join us great unwashed in seacrhing for affordable health insurance.

Be careful what you wish for.

[Hat Tip: HotAir]

Tuesday, October 06, 2015

An embarrassment of linkage:

In no particular order:

■ Up to 3 million ObamaTax victims enrollees stand to forfeit their subsidies next year because they're behind on filing their taxes:

"Fully 40% of taxpayers who received ObamaCare subsidies last year haven't filed their taxes yet and are at risk of losing their subsidies for next year"

This, in addition to looming rate increases - Yikes!

■ Fear of going to the dentist is a major issue for a lot of folks; in fact, it affects 75% of us to some extent. But that may become a thing of the past with new Scottish tech (no, not that Scottish tech):

"Remineralization is a natural process ... Reminova's prototype device can speed up this process to the same amount of time it would take to have a filling -- but painlessly, without injections and drilling.'"

Sign me up!

■ LifeHealthPro's Allison Bell alerts us to something that's generally been under the radar:

"[I]nsurers that participated in Gen Re's latest critical illness issuer survey reported a total of $380 million in 2014 critical illness premium revenue, up 15 percent from the 2013 total."

It seems that the Critical Illness (CI) market is exploding, and it's not difficult to understand why: these plans pay actual cash dollars to their insureds who suffer a listed condition (such cancer or stroke).

Something to consider if you have one of the new high out-of-pocket ObamaPlans.

Monday, October 05, 2015

Training Day Update 1

First, the good news: I received email this morning from the training "Help" Desk in reply to my pleas for assistance.

The bad news is what it said:

"After you have completed all registration requirements for the Individual and/or SHOP Marketplace, you may print your completion certificate specific to the Marketplace(s) for which you completed registration.

Note: your certificate will be marked Incomplete if you have completed training but you have not completed identity proofing. After you have completed training and identity proofing, your registration completion certificate will be marked Complete

Here's the problem:

[click to embiggen]

I've obviously completed step 1 and, as noted previously, completed all the training (as confirmed by the site itself).

So I replied that I had, in fact, completed both the identity proofing (?) and the training, but am still unable to print the certificates.

Wait and see, I suppose.

Sunday, October 04, 2015

ICD-10 Arrives

Co-blogger (and Medical Office Manager) Kelley B is working on an interesting ICD-10 post, but I couldn't resist blogging on some of the more ... esoteric ... examples:
■ Other Contact With Pig (W55.49X)

■ Problems in Relationship With In-Laws (Z63.1)
[Methinks this one will become a Top 10]

■ Sucked Into Jet Engine (V97.33X)
[That's gonna leave a mark!]

■ Prolonged Stay in Weightless Environment (X52.XXX)
[Really? How prevalent is this?]

■ Struck By Turkey (W61.42XA)
[Paging Les Nesman!]
Welcome to the brave new world of health care.

[Hat Tip: Ace of Spades]

Friday, October 02, 2015

Runnin' on empty

As we've long noted (here, for instance) the ObamaTax 'risk corridor' (essentially a slush fund to cover excess claims) was always unsustainable. But hope springs eternal (at least in DC).

Until, of course, Mrs Thatcher's observation kicks in.

Frustrating Government Tricks

So, it's that time of year again: Federal Marketplace training for Open Enrollment v3.0.

So, as I've done for the past few years, I set aside a day to get it all done, logged in and started learning. This year, there are 10 "modules," including 2 exams that must be passed (minimum of 70% correct answers). About halfway through, get this delightful message:


So, pick it back up an hour or so later, and complete the training (acing both exams, by the way). So far, so good.

Click over to print my certificates of completion, and am told that, despite the fact that I've completed all the modules (and the site confirms this) my training is "Incomplete," so no certs for me.

Are you kidding me?

So I futzed around on the site for another half hour or so, then decided enough for one day, will come back and pick it up - fresh - in the morning.

Which I do, to no avail. However, I find an online form to use to report a problem and an email address to accomplish same. Being a belt-and-suspenders kinda guy, I did both (keeping copies, of course). That's Wednesday (two days ago).

Wednesday comes and goes, no response from either inquiry, so repeat.

Thursday comes and goes, still no joy.

So this morning, I repeated (again), and then poked around a bit more until I find an actual phone number to call to report and/or discuss training issues. So I call the number, and a very nice young man named Jeremy explained that there is nothing he or anyone else at the "Help" Center can do, I'll just have to wait to hear from the folks at the online "Help" Desk. And no, he can't tell me how long that might be.

So here I sit in training limbo: yes, Open Enrollment doesn't start for a month, but I'd really like to put this behind me, and I can't do that. And I am completely powerless here: no one to threaten with bad ink (well, pixels), or to take my business elsewhere (only game in town).

Just call me Indy.

Private Fitbit Reporting for Duty

As we noted this past summer, the privacy challenges posed by folks using their FitBits (or similar exercise tracking devices) remain murky. One problem is that one doesn't necessarily know where the data will actually land, and whether or not that end-vendor (for lack of a better term) is a "HIPAA covered entity." The sticking point is defining just who (or what) is a "HIPAA covered entity."

The good news is that the situation recently became a bit less murky, at least for some folks:

"Fitbit announced it will enter into HIPAA business associate agreements with covered entity health plans and self-insured employers that will offer Fitbit’s wellness platform to employees and insured individuals."

So what does this mean in practice?

Basically, that FitBit will need to "implement the security controls required by the HIPAA Security Rule, but only with respect to data it is receiving from or collecting on behalf of covered entity health plans or healthcare providers."

So if your health plan includes FitBit-style tracking, then your info is likely  a bit more private than it has been. Of course, this applies only to FitBit users: if you're using some other similar device, you may want to do a little research on how your ostensibly private info is being treated.

Thursday, October 01, 2015

Medicaid HIX Credits SNAFU

Co-blogger Bob alerts us to this little glitch:

"The CMS has sent letters to Medicaid consumers who received tax credits to purchase insurance through the Affordable Care Act marketplace."

The first problem is that subsidies are supposed to be available only to folks in a narrow swath of income; those that fall below the minimum and are thus Medicaid-eligible aren't eligible for tax credits (subsidies). But in some states using the Federal Exchange system, "a small number" of Medicaid-eligible folks received these credits by mistake.

Never fear, though:

"The agency says these people will have to ... pay back the amount of the credit they've received."

Which gets to the second problem: um, good luck squeezing blood from that particular turnip:

"Many people will not understand what they need to do. Low income families tend to move often, so many addresses may be inaccurate.”

Not to mention that they're Medicaid-eligible for a reason.

Top. Men.

From the Mailbag: Wellness & Privacy revisited

Wednesday, September 30, 2015

Cancer Walk 2015

Time's running out on this year's Making Strides Against Breast Cancer campaign: the walk is is just a couple weeks away, and you can participate without even taking a step:

Just click here to make your donation, secure in the knowledge that you're helping to bring a cure one step closer.

Thank you!

NCQA-BBQ: It is to laugh

So, got this in email the other day:

"A new ratings system created by the National Committee for Quality Assurance (NCQA) provides consumers with a more accurate picture of how health insurance plans perform in key quality areas."

That's (mildly) interesting, but what were those "key" areas?


"[C]linical quality, member satisfaction and NCQA Accreditation Survey" [emphasis added]

Are you kidding? One third of the metric is itself?

How does that work?

More importantly, though, is the self-delusion that consumers actually care about these kinds of things:

"Oh sure, Anthem has a terrific rate, $100 a month cheaper than Humana, but Humana ranks 3 spots higher on NCQA, so I'll go with them."

Said no one, ever.

It's similar to the experts who claim that folks inadvertently "leave money on the table" by not choosing a health insurance plan that offers cost-sharing in addition to premium subsidies. There's a reason, and it's not ignorance of the program.

It's human nature.