Today's News from BenefitsLink

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The BenefitsLink Newsletter -
Welfare Plans Edition

June 29 - July 2, 2001

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Patients' Rights Bill Approved in Senate Despite Veto Threat
Excerpt: "Nine Republicans joined all 50 Democrats -- including California Sens. Dianne Feinstein and Barbara Boxer -- to pass the bill. Written by Sens. Edward Kennedy, D-Mass, John McCain, R-Arizona, and John Edward, D-North Carolina, it passed after a GOP alternative failed by an identical margin." (San Francisco Chronicle)

Senate's Health Care Benefits Lag Behind Those Provided Already by Some HMOs
Excerpt: "But during the feverish oratory leading up to the Senate vote, no one mentioned that the nation's largest health insurers have already begun to give their patients much of the care that a federal law would guarantee. Four summers ago, the nation's largest managed-care company, Aetna U.S. Healthcare Inc., began paying for emergency room visits whenever patients believed they needed to go." (Washington Post)

Opinion: New Trials, Old Tactics
Excerpt: "As Sen. John Edwards stood last week at the center of the U.S. Senate's debate over HMO reform, his career as a trial lawyer appeared both his greatest strength and his greatest liability. Democratic leaders tapped the North Carolina Democrat to help lead the fight ... largely because of his intimate knowledge of the legal process.... At the same time, Edwards' background gave ammunition to opponents of the bill who claim that it likely will help lawyers far more than consumers." (The News and Observer)

Opinion: For GOP, the Healthcare Fight Becomes Riskier
Excerpt: "The political pincers are beginning to close on President Bush and the Republicans on the patients' bill of rights issue. They may still find a way to shape the outcome into a White House signing ceremony, but GOP leaders concede that -- with Senate approval of the measure -- the political and policy risks they face are formidable." (David S. Broder in the Washington Post)

Opinion: Unheard Voices in the Healthcare Debate
Excerpt: "The problem with health care is that we still haven't resolved the tension among three essential goals. We want the care to be excellent. We want the costs contained. And we -- or at least most of us -- think all Americans should have access to adequate coverage." (E. J. Dionne Jr. in the Washington Post)

Commentary: a Changing World Is Forcing Changes on Managed Care
Excerpt: "The backlash against managed health care that pushed a patients' bill of rights to the top of the political agenda in Washington has already forced important changes in medical care for millions of Americans.... managed care is evolving under pressure from doctors, patients, consumer advocates and employers." (New York Times; free registration required)

Patients' Rights Fight Shifts to House
Excerpt: "House Republican leaders insisted Sunday that patients' rights protections they have endorsed stand a better chance of becoming law than a Senate bill passed last week that is opposed by President Bush." (New York Times; free registration required)

Bill Establishing Patients' Rights Passes in Senate
Excerpt: "The vote was 59 to 36. Nine Republicans joined 50 Democrats in voting for the legislation. Thirty-five Republicans and the one independent, James M. Jeffords of Vermont, voted against it." (New York Times; free registration required)

Supreme Court to Look at HMO External Review Statute
Excerpt: "Section 4-10 of the Illinois Health Maintenance Organization Act requires independent review when a patient's primary care doctor considers a proposed procedure to be medically necessary, but an HMO disagrees and denies coverage. The patient may have the HMO's decision reviewed by an outside physician, and under law the HMO must abide by that physician's decision." (United Press International)

Justices to Hear Case on HMOs: Court Will Rule on State Laws Requiring Medical Reviews
Excerpt: "The case pits recent state laws regulating insurance against a 1974 federal law governing employee benefit plans. The court will hear the case in its next term, which starts in October. By taking the case, the court may nudge Congress to set national standards for independent medical reviews as part of a patients' bill of rights." (Sacramento Bee)

Supreme Court to Hear Preemption Case on State Patients' Rights Laws
Excerpt: "The question in the case, Rush Prudential H.M.O. v. Moran ... is whether states may enforce laws providing for binding independent review of a decision by a health maintenance organization to reject a proposed procedure as medically unnecessary. Illinois, where the case is from, is one of 37 states to have enacted such laws ... The lower federal courts have disagreed on whether, for employer-sponsored health plans, these laws are barred by [ERISA]." (New York Times; free registration required)

Managing Time Off: 2000/2001
Summary of survey results. Full report available for fee. Excerpt: "Among the 69% of companies who track sick day use, exempt employees took an average of 3.7 sick days in 1999; nonexempt took an average of 4.7 sick days." (Hewitt Associates)

Delaware Patients' Rights Bill Moves to Governor
Excerpt: "The Delaware House on June 26 unanimously approved legislation already passed by the state Senate that would allow private insurance patients to sue health plans and insurers for denial of care after exhausting an independent review process, the Associated Press reports." (KaiserNetwork.org)

After Patients' Rights, Vast Needs and Higher Hurdles
Excerpt: "Ahead lies the more complicated -- and more costly -- challenge of providing prescription drug benefits to the 39 million elderly and disabled people in the Medicare program. And there is the even more fundamental issue of the 43 million Americans who have no health insurance." (New York Times; free registration required)

State Legislatures Target Direct-to-Consumer Drug Ads as Link to Higher Drug Costs
Excerpt: "A handful of states have introduced bills this year to force pharmaceutical manufacturers to disclose what they spend on advertising and promoting their products to consumers." (Reuters via Medscape; free registration required)

Provider Network Instability: Implications for Consumers
Excerpt: "Many health care issues of greatest concern to consumers-- including provider choice, costs and continuity of care-- depend on health plans' ability to maintain adequate networks of hospitals, physicians and other caregivers. When providers drop out of plan networks, consumers may suddenly face the choice of changing caregivers or paying more for out-of-network care." (Center for Studying Health System Change)

Showdowns Between HMOs and Healthcare Providers On the Rise
Excerpt: "During the past two years, increasing numbers of contract disputes between health plans and hospitals and physicians have erupted in local markets, according to recent Center for Studying Health System Change (HSC) visits to 12 nationally representative communities. Many providers are taking a hard line in negotiations ..." (Center for Studying Health System Change)

(Following items also appear in Retirement Plans Edition)

11th Circuit Upholds Tax Court Finding that Winn-Dixie COLI-Loan Program Lacked Economic Substance
Excerpt: "Winn-Dixie Stores, Inc. appeals the tax court's judgment resting on the conclusion that Winn-Dixie was not entitled to deduct interest and fees incurred in borrowing against insurance policies that it owned on the lives of more than 36,000 Winn- Dixie employees. We affirm." (11th Circuit, U.S. Court of Appeals via FindLaw.com)

Why Employers Should Sound the Alarm on Expiring Options
Excerpt: "How interested are employers in alerting employees that their in-the-money stock options will soon expire? Listen to Tim Clancey and you might get the idea that employers simply aren't that concerned." (CFO.com)

Newly Posted or Renewed Job Openings ( Post Yours! )

Plan Administrator

for Benefit Resources, Inc.
in CA

Administrator/Employee Benefit Plans

for Benefits Division of Orlando, Florida CPA Firm
in FL

Employee Communications Consultant

for CitiStreet - A State Street and Citigroup company
in MA

Manager of Compliance

for The Park Group & Associates, Inc.
in MD

Employee Benefits Division Chief

for County of San Bernardino
in CA

Benefits Paralegal

for Ogletree, Deakins, Nash, Smoak & Stewart, P.C.
in GA

Product Administrator

for U.S. Trust Company
in OR

Underwriting Analyst

for Stone & Associates
in CA

Qualified Plan Administrator

for Hayashi & Wayland Retirement Plan Services
in CA

Newly Posted Conferences ( Post Yours! )