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As of Thursday, insurers are no longer able to impose annual limits or lifetime caps on benefits, and they will face a higher standard before they can drop anyone’s coverage. Children will be guaranteed access to insurance no matter what their health condition. Additionally, parents can keep their adult children on their plans up to age 26. Also, insurers can’t charge copays or deductibles for preventive services like breast cancer screening and cholesterol tests. And the last notable change is that insurance companies can’t require you to make additional payments if you visit an emergency room that’s out-of-network for a medical emergency. Of course there are caveats to the aforementioned. To read a more comprehensive breakdown of the recent changes, click here.

Obama Gives $130 Million to Shore Up Healthcare Workforce

Last Friday the Department of Health and Human Services (HHS) allocated $130.8 million to shore up America’s healthcare workforce. The funds will be distributed to six key areas, including oral health workforce training ($23.9 million), primary care workforce training ($42.1 million), health career opportunity programs for disadvantaged students ($2.1 million), patient navigator outreach ($3.8 million), equipment to enhance training across the health professions ($50.5 million), and chronic disease prevention in health disparity populations ($8.3 million).

House Bans Bad Executives from Medicare

On Wednesday, the House of Representatives passed a bill that provides HHS with the authority to ban corporate executives whose companies (past and present) were convicted of fraud. The bill was sparked by the case of Rick Scott, a Republican candidate for Florida governor, who continued to work in the Medicare industry despite the fact that a previous company he helmed pleaded guilty of massive Medicare fraud. The bill now moves to the Senate where it is expected to be made law.

Medicare Advantage Rates Fall, Membership Rises

On Tuesday the Centers for Medicare & Medicaid Services (CMS) announced that Medicare Advantage plans will see an average price decrease of one percent in 2011 and that membership will grow by five percent. Last year, Medicare Advantage rates rose 15%. CMS representatives said that seniors should find little to no changes in their benefits in 2011. The cost decrease this year is attributed to the new Affordable Care Act that empowered CMS to better negotiate with health plan providers. CMS also is encouraging seniors to begin reviewing their options as open enrollment starts November 15. You and your clients may be interested in CMS’ official online Open Enrollment Center that can be accessed here

Sources: The Hill, NPR, CMS, KHN

On Thursday, the Census Bureau reported that 50.7 million Americans had no health insurance last year. Never before have so many Americans gone without health insurance since tracking began in 1987. The Midwest and South experienced the largest increases in uninsured. According to KHN both Democrats and Republicans are starting to use the report as fodder for their rhetoric. Democrats are saying the report is evidence of the need for the health care reform law passed this year, while Republicans will say that the report is proof that Democrats are failing to improve the economy.

The report also stated that roughly a third of Americans (estimated at 93 million) are now covered by government insurance, such as Medicare and Medicaid. In addition to insured data, the report also revealed that 43.6 million people lived in poverty in 2009, marking three straight years of an increase in poverty among Americans. Jonathan Oberlander, a professor of social medicine and health policy at the University of North Carolina – Chapel Hill described the report as “devastating.”

Health Care Reform Law FAQ Released

KHN released a very informative FAQ (frequently asked questions) guide for consumers explaining several key provision of the health care law that have taken shape over the past six months. One question is dedicated to Medicare, asking if benefits will change. The answer explains that Medicare benefits will expand, while Medicare Advantage plans will lose some extra benefits. It also states that next year beneficiaries will receive a 50% discount on brand name drugs and a 7% discount on generic drugs while in the doughnut hole. Also, beneficiaries won’t have to pay co-payments or deductibles on many preventative care services. To read the full FAQ, click here.

Medicare Saves $33 Billion through Generic Drugs

According to a Congressional Budget Office report, generic drugs saved both the government and beneficiaries roughly $33 billion in 2007. Businessweek reports the trade group Pharmaceutical Care Management Association expects an additional $14 billion in savings over the next few years due to new generics entering the market through 2012.

Medicare and FDA Testing Concurrent Product Reviews

For years companies and Medicare beneficiaries have complained about the time it takes for products to come to market. Not only does a new product have to go through the Food and Drug Administration (FDA), but it must then also go through the Centers for Medicare and Medicaid Services (CMS). Now the both organizations are starting a pilot project that would see new product reviews take place concurrently by both organizations. This new process is expected to significantly reduce the lag to market and provide much faster access to the latest medical technology.

Jobless Straining Social Security

Yet another government life line is in danger. Though it has long predicted that Social Security would go bankrupt at some point in the future, the Great Recession has accelerated that pace. According to a Washington Post article, the Congressional Budget Office projects that the Social Security Disability Insurance Trust Fund will be exhausted by 2018. According to the article, applications to the program increased 21% in one year alone to 2.8 million.

Social Security officials cite the high unemployment rate as the main reason for the sudden spike in applications and enrollments. One official stated that many of the applicants are older workers who got laid off and can’t find a job. They are too far away from being eligible from the retirement fund, so they do all they can to get on disability. The average age of new recipients is 49, with less than 1% returning to work.

Lawmakers may decide to transfer money from the retirement fund to extend the life of the disability fund, but this decision won’t be an easy one as baby boomers are going to swell the number on the retirement fund. The retirement fund is going to need every penny to handle the influx of retirees, so it will be interesting to see how Social Security resources will be distributed.

Medicare Advantage Quality Ratings Study Released

The Henry J. Kaiser Family Foundation released a new report entitled “Quality Ratings of Medicare Advantage Plans.” The report explains how quality ratings for Medicare Advantage plans are currently calculate, the effects of key changes in the 2010 health care reform law, the share of enrollees in high and low star plans, and more. If you are selling Medicare Advantage, it makes for a good read. Get it here.

Sources: AP, Businessweek, KHN, Reuters, Washington Post

Kaiser Health News in collaboration with The Washington Post published a very interesting article focusing on how more and more Medicare beneficiaries are finding they are not being classified as “admitted - inpatient” when staying at a hospital. Instead, they are being classified as “under observation.” Though the level of care doesn’t vary between either classification, the latter means Medicare beneficiaries will have to pay significantly more out-of-pocket for their total care.

One example given in the article is about Ed Timmins (88) who spent four days in the hospital for extreme back pain and other issues. The whole time he was never admitted, so Medicare isn’t going to cover his $23,864 nursing home bill. The hospital where he received treatment would not discuss his case, but implied that he did not meet Medicare’s “medical necessity” requirement to be in an inpatient status.

According to the Centers for Medicare and Medicaid Services, claims from hospitals for observation care have increased over the last several years. Observation care claims rose from 828,000 in 2006 to more than 1.1 million in 2009. Additionally, observation care claims regarding stays more than two days tripled to 83,183. The article states several reasons for the increase, but focuses on the fact that Medicare is being more aggressive in their audits in order to reduce costs. Click here to read the full article. Also, you may want to forward this useful link to your clients that explains what to do if they are classified as “under observation.”

Selling More with Jeffrey Gitomer

This month’s issue of InsuranceNewsNet has an in-depth interview with Jeffrey Gitomer who wrote The Sales Bible. Here is a list what he believes insurance agents should and should not do to increase their sales.

• Do communicate with your existing customers once a week, once every two weeks, or at the very least once a month. E-blasts are an excellent way to accomplish this and build trust.
• Do learn how to take rejection
• Do give a referral before asking for one
• Don’t spend too much time cold-calling – Mr. Gitomer believes it’s on “life support”
• Do speak publically as often as possible, or at least meet people in your target market as often as possible
• Do write articles and publish them in as many places as possible – Mr. Gitomer says every penny he has made since 1992 started from one of his articles
• Do join your local Toastmasters organization to hone your presentation skills
• Do develop a website and brand it with your name, not your company name
• Do weekly e-blasts
• Do maintain a blog
• Do maintain a Facebook fan page
• Do take your most important clients to networking functions, and network at least 4 to 6 hours a week, and have a 1-year networking plan each year
• Sales formula: 1/3 product knowledge, 1/3 presentation skills, 1/3 personal development

Google Implements New “Instant” Feature

Since many of you are beginning to utilize search engine optimization as a method of attracting more customers to your business, you will want to know that on Wednesday, Google implemented a new feature they call “Google Instant.” This feature automatically attempts to complete your search terms as you type them. As you are typing Google starts to stream results. These results change dynamically as you further refine your search term. Google says this new feature will reduce search times by two to five seconds. The change will also have a significant impact on SEO strategy. Now you will want to start optimizing for search terms that Google automatically generates. Also, this feature appears to only be available on the most recent browsers, so if you are still using older browsers such as IE 6 or 7, you’ll need to upgrade to use this new feature.

Sources: KHN, Washington Post, InsuranceNewsNet, ComputerWorld