A personal tale that accentuates the importance of Long Term Care
During my nearly 30 years working as an employee benefits consulting professional, I’ve helped popularize many benefit-related insurance products, despite sometimes harboring a lack of personal affinity with the primary intended audience. Long Term Care Insurance (LTC) emerged many years ago as just such a product – a concept pitch by the insurance industry seeking a new channel to tap into the buying power of baby boomers approaching retirement age.
The LTC insurance product was conceived to afford a layer of asset protection in the event of high cost care in settings where retiree health plans and Medicare don’t afford much cover – nursing homes, assisted living facilities, home health care, and the like. Varying coverage levels for reimbursement of qualifying expenses could be purchased; Read more…
Data breach lawsuit against Pentagon highlights vendor management risks
Another example is unfolding of why almost every company’s data security risk management practices should include a hefty dose of vendor management. And below the surface, there lurks questions that may lead others to investigate their own practices and insurance coverage.
The Department of Defense runs a health insurance program, called TRICARE, for military personnel, retirees and their families. Last September a contractor for TRICARE disclosed that up to 4.9M of its health records may have been breached. The records were contained on computer backup tapes stolen from a parking garage. The information on the tapes was not encrypted, but the contractor – Science Applications International Corporation (SAIC) – asserted that there is little risk to patients because reading the tapes would require knowledge of and access to specific Read more…
What’s behind the Massachusetts proposed 19.3% Workers’ Compensation rate increase?
The Worker’s Compensation Rating and Inspection Bureau of Massachusetts (WCRIB) recently proposed a 19.3% increase in average rates for all new and renewal policies effective September 1st. There has been continued pressure on Workers’ Compensation insurance underwriters coming from an increase in losses coupled with interest rates being held down to nearly zero percent through 2014.
In a phone conversation with the WCRIB last week, the bureau was quick to point out that no decision had been made and that it plans to continue the rate review process for some time. The current belief is that any rate increase will be significantly lower than 19.3%, especially given the filing history of Massachusetts Workers’ Compensation rate filings proposed versus approved. Rate increases have been very small to a slight negative, even more so amid a struggling economy, when the state is likely to view an increase as a Read more…
GAO reports on the Medicare Advantage bonus program
The non-partisan Government Accountability Office (GAO) released their findings on the interim Medicare Advantage (MA) bonus program last week. This interim bonus program was put into place to help quell the uproar from the initial Medicare Advantage cuts that were initiated with PPACA and is set to run from 2012 to 2014. It was found that the estimated $8.35B program will not improve quality for MA programs due to the distribution of bonuses to plans rated with 3 or 3.5 stars (out of 5). While this program does reward plans rated with 4 and 5 stars, it does not incent lower rated plans to improve their quality. It is estimated that the majority of spend with the MA Quality Bonus Payment Demonstration will be paid to these plans that are rated with 3 and 3.5 stars. Under the PPACA plan roughly 30% of all MA plan sponsors would be eligible for bonus in 2012 and 2013. With the Read more…
Zurich conference on cyber risks
Zurich Insurance hosted a panel discussion of cyber security risks for corporations at its annual conference in New Orleans over the past weekend. Headlining the panel was former CIA and National Security Agency director, General Michael Hayden. Hayden outlined global threats of cyber risk for business including disruptions of ecommerce business and theft of intellectual property.
Hayden spoke plainly about the US government activities in cyber security built around protecting national military security. He distinguished US activities from those in other countries, particularly China, that continuously commit economic espionage over the internet. He also cited direct and indirect government sources in Russia and Eastern Europe as sources of electronic espionage, frequently for hire rather than Read more…
Disclose, apologize and offer: Massachusetts hospitals launch new initiative
The cost of defensive medicine has been widely believed to be among the top contributors towards soaring health care costs. This week, three major hospitals in the Boston area announced a new program called “Disclosure, Apology and Offer.” The program targets defensive medicine which has been defined to include often unnecessary or excessive medical tests and procedures ordered by doctors who are wary of litigious patients.
The program was announced Tuesday by the Massachusetts Medical Society, is intended to promote a less confrontational dynamic between patients and medical professionals when medical mistakes occur and help haste the speed of disputes. Read more…
Generic drug makers may soon face tougher standards
Current legislation that protects generic drug manufacturers from liability lawsuits associated with the medications they sell, could soon be reversed. Though generic medications are supposed to be functionally equivalent to their brand-name counterparts, last year’s Supreme Court ruling stated that manufacturers of generic drugs would not be held liable for failing to warn about dangerous side effects, even when they are aware that patients have not been given adequate information about the risk.
Federal law requires only that generic drugs provide an exact duplicate of the label warnings of the name-brand mediation they are copying. However, Senator Patrick Leahy (D-VT) introduced a new bill to Congress on Wednesday that would hold generic drug manufacturers responsible Read more…
Looking ahead: Change in the American healthcare industry
The recent US Supreme Court hearings regarding the constitutionality of the Patient Protection and Affordable Care Act has put this landmark legislation back on the front page of nearly every news publication in America. Regardless of whether this law is deemed constitutional or not, the landscape for American healthcare has forever changed. The idea of denying newborn children medical insurance due to “pre-existing” conditions would seem to be an idea that will not be allowed by the collective public conscience. The same may happen for “lifetime maximums” for Americans with chronic and life-long illnesses. But at its core, the business of healthcare in America will likely never be quite the same. I for one, think this is a good thing. Read more…
Top 10 areas for kidnap and ransom incidents
Kidnap for ransom was once a crime synonymous only with countries like Columbia and the surrounding Latin American region, but kidnap for ransom and extortion has become a worldwide threat plaguing countries around the globe from Iraq and Afghanistan to Yemen, China and India. While inconclusive reports and varying incident classifications make official statistics difficult to obtain, there is no question that kidnap and ransom crimes are on the rise. Reports of kidnapping, hostage-taking, piracy and extortion are turning up more frequently than ever before, affecting victims from both poor and wealthy backgrounds. According to Red24, a leading global security company providing global risk management to employees and companies, there were an estimated 30,000 incidents in 2011. Read more…
Can Healthcare Reform survive without the Individual Mandate?
The SJC heard three days of oral arguments about the individual mandate last week. The arguments were many: Do prior laws prevent us from even discussing it? Is it constitutional? Is it severable from the rest of the law? First I want to take a step back and say that I feel very fortunate to live in a country with the kind of government that thinks very carefully about our civil liberties, especially after seeing the governing body in The Hunger Games (!). I’ll also say that the Supreme Court Justices could easily rule on the individual mandate either way and back it up with a beautifully written opinion. There were compelling arguments on both sides. The truth is the Justices have already made their decision. We just have to wait until June to find out what it is.
If the individual mandate is to stand, then we move forward with the PPACA we know, in its totality, barring any other changes. Luckily, we have had two years to come to terms with PPACA and its requirements. I think most people know what to expect at this point. 2014 will be a pivotal year Read more…
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