INDEPENDENCE BLUE CROSS

Medicare/Medicaid

Issues pertaining to Medicare Advantage.

TargetedSENATE · HOUSE OF REPRESENTATIVES

Health Issues

See HCR addendum page. -Successful Insurance Industry Implementation of Health Reforms: good faith compliance standard, reasonable effective dates for compliance with PL 111-148 -State Oversight of Premium Increases: S 3078 and HR4757 Health Insurance Rate Authority Act of 2010; federal rate review; HR 4700 Transparency in All Health Care Pricing Act of 2010; existing state regulatory functions; federal exchanges; state exchanges; -Grandfathering Rules: Interim final rule of June 14th; Flexibility to modify items that are not specifically prohibited Medical Loss Ratios: Quality improvement definition; Consistent reporting requirements for all insurers; Transition for smaller states and Plans; include benefits for individuals as well as populations -Dependent Health Insurance Coverage: IRS Guidelines on dependent coverage; BCBS commitment to cover individuals up to age 26 on their parents health insurance; HR5200 "FEHBP Dependent Coverage Extension Act" -Pre-Existing Condition Exclusions: Pre-existing condition for children; guaranteed issue for children under the age of 19 -Lifetime and Annual Limits: lifetime and annual dollar limits on "essential health benefits" -Rescissions and Patient Protections: Open enrollment period; adverse selection implications -Affordable Private Health Care: Insurer Fees; Realistic Minimum Benefit Values; Effective Individual Mandate; Health Care Delivery System Reforms; Small Employer Tax Credits -Health Care Quality; Patient-centered Primary Care/Medical Home; Health Disparities; Wellness; Chronic Care Management; Comparative Effectiveness Research; Improved Delivery of Health Care; Evidence Based Care; Health Care Delivery System Reforms -Health Information Technology Standards; Health Information Privacy; Electronic Health Records; Administrative Simplification; ICD10 Real time claims adjudication -Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Small Business Health Care; Guaranteed Issue; Community Rating; Health Status Rating; Health Savings Accounts/Medical Savings Accounts; Individual Mandate; MEWAs -HR 2517, "Domestic Partnership Benefits and Obligations Act of 2009", regarding all provisions.