Wednesday, May 11, 2011

HHS offers new tools to help states lower Medicaid costs, provide better care

The U.S. Department of Health and Human Services (HHS) today announced a series of initiatives to work with states to save money and better coordinate care for the 9 million Americans enrolled in both Medicare and Medicaid. The new initiatives include better access to Medicare data and better coordination of health care between Medicare and Medicaid. The initiatives will be led by the new Federal Coordinated Health Care Office (the Medicare-Medicaid Coordination Office), which was created by the Affordable Care Act to help make the two programs work together more effectively to improve patient care and lower costs.

“Medicaid costs are largely driven by the complex medical needs of low-income seniors and people with disabilities who are eligible for both Medicare and Medicaid. We know that by working together, we can provide better, more coordinated care while lowering health care costs and saving money for states,” said Centers for Medicare & Medicaid Services (CMS) Administrator Donald M. Berwick, M.D. “Medicare and Medicaid spends $300 billion each year to care for people enrolled in both programs. Better coordinated care for this vulnerable population could yield savings and improve care and coverage in Medicaid.”

Currently, 60-percent of Medicare-Medicaid enrollees, “dual eligibles,” have multiple chronic conditions and 43-percent have at least one mental or cognitive impairment. While only 15-percent of Medicaid enrollees are also Medicare beneficiaries, Medicare-Medicaid enrollees represented 39-percent of Medicaid spending in 2007. Medicaid spent about $120 billion on this group – about twice as much as Medicaid spent on the 29 million children it covered. The Medicaid spending per Medicare-Medicaid enrollee was $15,459 in 2007, over six times higher than the comparable cost of a non-disabled adult Medicaid-only enrollee ($2,541).

The Medicare-Medicaid Coordination Office today launched the Alignment Initiative, an effort to more effectively integrate benefits under the two programs. Currently, low-income seniors and people with disabilities must navigate two separate programs: Medicare for coverage of basic acute health care services and drugs, and Medicaid for coverage of supplemental benefits such as long-term care supports and services. Medicaid also provides help with Medicare premiums and cost-sharing for those who need additional assistance.

A lack of alignment between the programs can lead to fragmented or episodic care for people with both Medicare and Medicaid coverage, which can reduce quality and raise costs. For example, Medicaid and Medicare have different coverage standards for those accessing durable medical equipment in the community. This can lead to fragmented care and coverage gaps that could result in patients losing access to the treatments and equipment that help them live at home or in the community. Even temporary coverage gaps can be disruptive if patients no longer have coverage for wheelchairs or other expensive medical care. The Medicare-Medicaid Coordination Office is seeking input and ideas about how to align in six areas: care coordination, fee-for-service benefits, prescription drugs, cost sharing, enrollment, and appeals. Better alignment in these areas can reduce costs by improving health outcomes and making care coordination more efficient.

Today, HHS also announced a new process that provides faster state access to Medicare data to support care coordination. Access to Medicare data is an essential tool for states seeking to coordinate care, improve quality, and control costs for their highest cost beneficiaries. For example, a state that wants to expand its long term care and behavioral health care management program to serve low income seniors and people with disabilities needs data on their Medicare-covered hospital, physician, and prescription drug use. With Medicare data, states can identify high risk and high cost individuals, determine their primary health risks, and provide comprehensive individual client profiles to its care management contractor to tailor interventions.

“Navigating the two programs can be both complicated and burdensome for beneficiaries and their families and caregivers,” said Medicare-Medicaid Coordination Office Director Melanie Bella. “We are facilitating a national conversation on how to make these programs better serve the people that depend on them every day. We are working with states toward new levels of seamlessness so as to smooth the care journeys for these individuals.”

The first step in the Alignment Initiative is a notice for public comment that will be displayed in the Federal Register. The notice requests public input on priorities and key goals. Individuals wishing to submit comments have until July 11, 2011 to do so. For more information on the Alignment Initiative notice for comment, visit: The Medicare-Medicaid Coordination Office will continue to engage with local stakeholders around the country on the Alignment Initiative through regional listening sessions.

The announcement of the new policy on state Medicare data for enrollees in Medicare and Medicaid will be published in a Center for Medicaid, CHIP and Survey & Certification (CMCS) Informational Bulletin today. The Bulletin is available at:


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Tuesday, May 10, 2011

Most uninsured unable to pay hospital bills according to new HHS report

A new report released today by the U.S. Department of Health and Human Services (HHS) shows that few families without health insurance have the financial assets to pay potential hospital bills. On average, uninsured families can only afford to pay in full for approximately 12-percent of hospital stays they may experience – and even higher income uninsured families are unable to pay for most potential hospital stays. Hospital stays for which the uninsured cannot pay in full account for 95-percent of the total amount hospitals bill the uninsured. Other studies have estimated that the bills for all types of health care that the uninsured cannot pay – the uncompensated cost of care – is up to $73 billion a year, a significant portion of which is shifted into higher costs for Americans with insurance and their employers.

“One of the most enduring myths in American health care is that people without health insurance can get care with little or no problem. Nothing could be farther from the truth,” said HHS Secretary Kathleen Sebelius. “The result is families going without care – or facing health care bills they can’t hope to pay. When the uninsured cannot afford the care they receive, that cost must be absorbed by other payers. This is why expanding access to affordable health insurance under the Affordable Care Act is so important.”

Approximately 50 million Americans are uninsured. The report found that most uninsured people have virtually no savings. In fact, the median financial assets for all uninsured families are just $20. Even among higher income families, assets are low. Half of families with income at 400-percent of the Federal Poverty Level (FPL), or $89,400 a year for a family of four in 2011, have financial assets below $4,100.

Every year, nearly 2 million uninsured Americans are hospitalized. With 58-percent of these hospital stays resulting in bills of more than $10,000, most uninsured people are unable to afford potential hospital bills. Even the top 10-percent of uninsured families with the most assets are estimated to be able to pay the full bill for only half of potential hospital stays. Uninsured families can, on average, afford to pay the full bills for only about 12-percent of the hospital stays they might experience, bills that account for just 5-percent of the total amount hospitals bill them.

“Health insurance is critical in helping protect families from unexpected hospital costs,” said Sherry Glied, HHS assistant secretary for planning and evaluation. “This report shows that even higher income uninsured families are struggling to meet the high costs of health care. No family should bear the burden of being one illness or accident away from bankruptcy.”

The high cost of hospitalization means that lacking health insurance poses a greater risk of financial catastrophe than lacking car insurance or homeowner’s insurance. Although people are 50-percent more likely to have car accident than to be hospitalized in a given year, the average bill for a hospital visit is over two and a half times higher than the average loss for a car accident. And, while the bill for a single hospitalization is about the same as the average loss from a house fire, a person is ten times more likely to be hospitalized than to experience a house fire.


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Assisted Living Costs Rising Faster Nationally Than in Georgia, Finds Genworth's Annual Cost of Care Survey

/PRNewswire/ -- According to Genworth's 2011 Cost of Care Survey, assisted living cost inflation in Georgia is being outpaced by national cost increases. Overall, the cost of long term care services in Georgia is well below national levels.

The median hourly rate to receive care in the home, Americans' preferred long term care setting, is $17.50 an hour in Georgia for home health aide services and $19 per hour nationally. The cost for this type of care has increased 1.5 percent a year over the past six years in Georgia, and 1.4 percent nationally during this same period.

The cost for a private nursing home room in Georgia has risen 4.4 percent annually over the past six years, and in line with the national rate. The median annual rate in Georgia for a private nursing home room is $63,875 per year, less than the national rate of $77,745 per year.

Nationally, the median annual cost of long term care in an assisted living facility is $39,135, an increase of 6.0 percent annually over the past six years. In Georgia, the annual cost of assisted living care is $28,800 and costs have risen 0.7 percent per year over the same time period.

Click here for an interactive map of long term care costs in 15 regions across Georgia, as well as nationally.

Knowing Local Care Costs for Productive LTC Discussions

"Understanding local caregiving expenses is an essential first step for families faced with rising care costs," said Buck Stinson, president, U.S. Life Insurance Products at Genworth. "Genworth's Cost of Care Survey arms consumers with the knowledge to have informed conversations, whether they are speaking with a family member, a care provider or financial professional, about how they might realistically pay for care."

Now in its 8th year, Genworth's Cost of Care Survey not only provides Georgia residents with national and local long term care cost data, but also information on cost inflation over time. Armed with this information, consumers and their advisors can:

* Develop a comprehensive financial plan to cover anticipated future long term care costs
* Conduct an informed discussion with family members to address future long term care needs and preferences
* Negotiate more effectively with providers of long term care services

Negotiating With Care Providers: It Never Hurts to Ask

Some consumers may be surprised to learn that they have the power to negotiate with care providers to help contain costs. Care providers, particularly assisted living facilities and home care agencies, often face stiff competition in their local markets. Consumers should feel comfortable addressing the issue of costs, and the opportunity to lower them, when discussing care options with a provider of long term care services. Genworth's Cost of Care Survey provides localized cost data that empowers families to confidently discuss care costs and options with service providers.

Know What to Ask: Tips for Reducing Caregiving Costs

While nursing homes generally do not discount their rates because they are strongly influenced by the effect of Medicare/Medicaid on their overall business plans, assisted living facilities and home care providers are more apt to do so. Tips on where to start when negotiating with a long term care provider include:

* Know Local Costs: Genworth's Cost of Care Map provides the median cost of long term care across the U.S., including 15 regions in Georgia, to help consumers plan for the potential costs associated with the various types of long term care available in their preferred location and setting.

* Fee Waivers: Assisted living facilities often charge a one-time fee when a client first moves in. If the facility is in a competitive market, or has a surplus of vacant units, they may discount or waive this fee (or offer other discounts such as free rent for a period of time).

* Special Rates : Facilities will sometimes have a special rate if residents move in at the first of the month or during a time that is known to have higher vacancy rates.

* Vacancy Rates : Facilities may allow a resident to choose a more expensive room, at a lower price, if vacancies are currently high.

* Lower Hourly Rates: Home care agencies may lower their hourly rate if the services needed are easy to staff and long term, such as a weekday schedule that is predicted to last several months.

* Shop Around: If a home care agency's fees are at the high end of the local range, they may lower rates if they know the client is interviewing several agencies and cost is an important factor. Let care providers know if a lower rate has been quoted elsewhere for the same services.

* Premium Waivers: Agencies usually charge a premium for weekend services. For a client that also engages services for a significant amount of weekday hours, the agency may waive this premium.

* Ask for an Upgrade: Nursing homes generally do not discount their rates, however, certain extra amenities, or a private room upgrade, may be available under certain circumstances.

It is important to note that most of these price concessions are based on the availability of staff, or residential units, which is a factor that fluctuates often for some businesses. Contacting several providers before making a final decision offers the best chance of securing safe, appropriate services at a reasonable rate.

"While consumers should seek out quality and value when shopping for long term care, it is crucial that they have a financial plan in place to pay for long term care," said Stinson. "The cost of long term care remains one of the biggest risks to one's retirement security, especially with ever-increasing healthcare costs."

For consumers interested in learning more about the cost of care in their local market, Genworth offers an interactive map of long term care costs in 437 regions across all 50 states, including 15 regions in Georgia, at The site offers a range of educational tools that help consumers compare costs across geographies, project future costs and share comparisons and calculations with family, friends or a financial professional.

Additional Resources:

* Genworth's "Let's Talk" campaign was developed to help families initiate conversations about long term care preferences, options, and strategies.
* Genworth Celebrates Caregivers Facebook Page: Caregivers can have their questions about caregiving challenges answered by a professional care advocate.
* An interactive Cost of Care press release containing downloadable content is available at:

About Genworth's 2011 Cost of Care Survey

Genworth's Cost of Care Survey, is the most comprehensive study of its kind, covering nearly 15,500 long term care providers nationwide. The survey includes 437 regions which cover all Metropolitan Statistical Areas defined for the 2010 U.S. census. Genworth annually surveys the cost of long term care across the U.S. to help Americans plan for the potential costs associated with the various types of care available in their preferred location and setting. CareScout®, part of the Genworth Financial family of companies, has conducted the survey since 2004. Located in Waltham, Massachusetts, CareScout has specialized in helping families find long term care providers nationwide since 1997. Genworth's 2011 Cost of Care Survey was conducted during January, February and March 2011.


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Thursday, May 05, 2011

Blue Cross and Blue Shield of Georgia Extends Grace Period on Premium Payments for Members Affected by Tornados

/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGa) today announced it is extending the grace period on premium payments to help members directly impacted by Georgia tornados on April 27 and 28. Extensive property damage, injuries and death are attributed to these storms.

A Governor's State of Emergency remains in effect, and a Presidential Disaster Declaration has been made for Bartow, Catoosa, Coweta, Dade, Floyd, Greene, Lamar, Meriwether, Monroe, Morgan, Pickens, Polk, Rabun, Spalding, Troup and Walker Counties. Additionally, the damage caused by the tornados and storms have had a significant impact on transportation throughout the state, including disruptions in mail service.

Mail delivery disruptions may have caused delays in BCBSGa receiving premium payments, and as a result, BCBSGa has extended the grace period on premium payments for Georgia members for payments due in April and May. Members impacted by the tornados that may receive a delinquency notice or cancellation notice need to contact BCBSGa to have the delinquency notice waived. Policies will not be cancelled for this timeframe if premium payments were delayed due to disruptions in mail service.

"This is a very tragic time for many Georgians and it is of the utmost importance that our members not experience additional hardships," said Morgan Kendrick, President, BCBSGa. "We are taking every precaution possible, including extending grace periods and shifting staff roles to assist in the processing of any premium payment backlogs."

If members have questions about their premium payment status due to mail disruptions caused by recent inclement weather conditions, they should call the customer service number on the back of their Member ID card, and if they do not have their card, they should call 1-866-417-7107.


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Wednesday, March 16, 2011

Newly Released Study Shows Insurance Barriers Blocking Access to Healthcare

/PRNewswire/ -- Significant barriers to patient care implemented by the health insurance industry are difficult to navigate, have a negative impact on patient care and drive up the administrative costs of healthcare, according to a statewide survey of Georgia physician assistants. The survey, which was released today by the Georgia Association of Physician Assistants (GAPA), also indicated that most physician assistants (PAs) are proactively taking steps to help address the problems that plague the system, and feel there is a legislative role that can contribute to a solution.

According to the survey, a nearly universal 99 percent of PAs stated they have had to change the way they treat a patient as a result of restrictions imposed by an insurance company. An overwhelming majority, 94 percent, feels that health plans frequently or occasionally delay or deny diagnostic testing or prescription medications for their patients.

Not surprisingly, 93 percent of those surveyed stated they felt insurance requirements such as prior authorizations, pre-certifications, and step therapy protocols had some degree of a negative effect on their ability to treat patients.

"The lessons learned from this report are resounding, in that nearly all the physician assistants that responded to the survey cited major insurance hurdles they had to jump over before being able to provide the care they deemed appropriate for their patients," said Mary Vacala, ATC, PA-C, MSPAS, DFAAPA, and 2010-11 president of the Georgia Association of Physician Assistants. "Some cited several phone calls taking 45 minutes with an insurance company. Others noted that patients are forced to go without medication until the insurance company would approve the treatment already prescribed by the healthcare professional."

One-in-five respondents stated they or their staffs are required to interact with an insurance provider to obtain approval for a prescribed course of treatment or to determine the insurer criteria for prior authorization or step therapy protocols an alarming 150 times or more per month. Approximately one-in-five said the number was 61-100 and more than one-in-four stated the number of interactions as 21-60.

Understanding that each hour a provider spends on administrative tasks is an hour not spent evaluating patients, PAs are proactively taking steps such as utilizing newer technology to streamline the process. Currently, 64 percent of respondents have implemented Electronic Medical Records and 45 percent are using an e-prescription process on some level. At the same time, 90 percent of those surveyed agree that there should be enforceable legislation addressing restrictions that insurance companies place on health care providers.

"There are more than 2,000 physician assistants across the state of Georgia, and so many are using technology such as electronic medical records and e-prescribing, to promote better, more coordinated care," concluded Vacala. "As these technologies continue to be developed, the Georgia General Assembly should take steps requiring that patient formulary information be more transparent and that there be a uniform electronic process for obtaining medication approval. By taking simple steps, we will save significant time and resources while also having a healthier patient population in Georgia."

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Tuesday, March 01, 2011

States Urged to Pass and Defend Patient Protection Laws Requiring Insurers to Cover Costs of Colon Cancer Screening

/PRNewswire/ -- Passage of laws requiring insurance providers to cover the costs of colon cancer screenings has stalled over the past two years and advocates are bracing to protect existing legislation in states that currently guarantee access to these lifesaving tests, a coalition of public health associations and medical professional societies reported today. The progress made in passing state-mandated coverage of colon cancer screening tests according to accepted medical guidelines has come to a near halt as state legislatures reconsider their role in the wake of the passage of the federal Affordable Care Act.

Only one state, Hawaii, passed coverage legislation in 2010. Combined with Vermont's legislation passed in 2009, only two states have improved their grade in the past two years as reported by the annual Colorectal Cancer Legislation Report Card – the slowest improvement since the report card launched seven years ago.

"The facts are clear – in states with laws mandating coverage of colon cancer screening, more people get screened and more lives are saved," said Lisa Paulsen, CEO of the Entertainment Industry Foundation, the 501(c)(3) non-profit organization of which the National Colorectal Cancer Research Alliance is a part. "State legislatures need to move to ensure that everyone who needs colorectal cancer screening has access to it. We know that the prevention or early detection that can result from screening saves lives, and will save health care dollars for the states in the long run."

With the addition of Hawaii in 2010, 23 states and the District of Columbia now require insurance coverage of colonoscopies and other procedures that follow accepted medical guidelines, earning them the grade of "A." Ten other states require varying degrees of coverage, with scores of B, C or D, while 17 states score an "F" for failing to mandate any coverage of the cost of colon cancer screening.

As of September 23, 2010, all new health plans are required to cover colorectal screening tests as part of the Patient's Bill of Rights in the federal Affordable Care Act (ACA). The coverage rules follow guidelines established by the U.S. Preventive Services Task Force, which require that insurance companies cover some colorectal cancer screening tests for those ages 50-75. However, those guidelines still leave high-risk populations under 50 without coverage options. In addition, grandfathered plans (those existing health plans in which a person was enrolled on the date of enactment of ACA), are not required to cover the tests.

Starting in 2014, as part of the ACA, all plans participating in state exchange programs will be required to provide coverage based on a federally mandated "essential benefits" package. It is expected that the package will also follow the U.S. Preventive Services Task Force guidelines – potentially leaving high risk populations that fall outside the guidelines without coverage options.

In the 17 states that currently do not guarantee screening coverage, many people will continue to fall through the cracks unless patient protections are established. In addition, many of the states that currently have guaranteed coverage have benefits that go above and beyond the U.S. Preventive Services Task Force guidelines and advocates do not want to see any of those guarantees rolled back.

"We have made tremendous strides in moving states to take action to protect the health and lives of their citizens by ensuring that colorectal cancer screenings are covered for all who need them," said John R. Seffrin, PhD, CEO, American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society. "While the essential benefits package in the Affordable Care Act will go a long way in 2014 to guarantee coverage, the best way to ensure that everyone who needs screening tests have access to them is for states to continue to enact patient protections and maintain the strong laws they already have in place."

Colorectal cancer (also known as colon cancer) is the second-leading cause of cancer deaths for men and women combined in the United States. However, the disease can often be prevented entirely through the early identification and removal of pre-cancerous polyps. When colorectal cancer is diagnosed at an early stage, the five year survival rate is 90 percent. However, when it is not diagnosed until it has spread to distant organs, the five year survival rate is only 11 percent. In 2010, the American Cancer Society reported that the colorectal cancer death rate has continued to decline. Down approximately 3.9 percent per year in men from 2002 to 2006 and 3.4 percent per year in women from 2001 to 2006, colorectal cancers saw one of the largest declines in death rates of all leading cancers.

Research has shown that regular screening is crucial for all those over 50, as well as those under 50 at increased risk.

Despite widespread awareness about the importance of colon cancer screenings, insurance coverage is still a barrier to screening according to a 2009 survey undertaken by Harris Interactive on behalf of ACS CAN and the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance (EIF's NCCRA).

In fact, 70 percent of all survey respondents, including two-in-three (62 percent) of those 50 and older, said that if they knew that their insurance covered the entire cost of colonoscopy, they would be somewhat to much more likely to have the procedure at age 50, or earlier if their doctor recommended.

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Thursday, February 10, 2011

New Rule Ensures Students Get Health Insurance Protections of the Affordable Care Act

A new proposed regulation announced today by the Department of Health and Human Services (HHS) would ensure students enrolled in health insurance coverage through their college or university benefit from critical consumer protections created by the Affordable Care Act. Students enrolled in college plans would have the freedom from worrying about losing their insurance, or having it capped unexpectedly if they are in an accident or become sick.

"Thanks to the Affordable Care Act, college students will have more control over their health care," said Secretary Sebelius. "This rule would ensure that these plans remain a viable, affordable option for students while guaranteeing that they are regulated consistently and offer transparent benefits to students."

Student health plans are often purchased when family coverage is not available, or is unaffordable. Approximately 1,500-2,000 institutions of higher education across the country offer some type of health coverage; however, what benefits are covered by these plans, as well as how they're regulated vary widely. The proposed regulation would ensure students enrolled in these plans benefit from important consumer protections created by the Affordable Care Act by clarifying that these plans will be defined as "individual health insurance coverage." Under the proposed rules, some of the new health insurance protections include:
* No Lifetime Limits on Coverage: Insurance companies would no longer be able to impose lifetime dollar limits on the amount they spend on health benefits in student health plans.
* No Arbitrary Rescissions of Insurance Coverage: Insurance companies can no longer drop coverage when student health plan enrollees get sick because of an unintentional mistake on an application.
* No Pre-Existing Condition Exclusions for Students Under Age 19: Insurance companies cannot deny or exclude coverage for students under age 19 because of a pre-existing condition.

Today, some student health plans, only offer limited benefits with low annual dollar limits on health care, or have limited networks of doctors, and other health care providers. For many students, these health plans are their only health insurance option.

The Affordable Care Act allows HHS to take steps to preserve market stability while ensuring student health plans remain affordable until all Americans have new coverage options through the state-based Exchanges that will be established in 2014. Under the proposed rule announced today, student health insurance plans would be allowed to have annual dollar limits on essential health benefits of no less than $100,000 for policy years beginning before September 23, 2012. Student health plans with policy years beginning after that date must fully comply with the Affordable Care Act's annual limit restrictions.

The proposed rules would also require insurance companies to clearly tell students enrolled in student health plans whether or not their plan meets the new requirements laid out under the Affordable Care Act-bringing transparency to this marketplace and enabling students to understand the value and quality of the coverage they have.

As a part of the new proposed rule, HHS also is requesting comments on how other Affordable Care Act protections might apply to student health plans, including the choice of medical provider and application of the new medical loss ratio rules.

To find the new proposed rule, visit For a fact sheet on the new proposed rule, visit . For more information about the new patient protections created under the Affordable Care Act, visit

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Georgia Seniors Get Very Low-Cost Medicare Supplement Insurance Policy

(BUSINESS WIRE)--A new low-cost Medicare Supplement insurance policy is now approved for sale to seniors in Georgia. The Georgia Office of Insurance and Safety Fire Commission has approved a very low-cost Medicare Supplement insurance plan for seniors and Georgia is among the first states in the nation to allow this supplemental insurance plan to be offered to its citizens. The availability of this low-cost supplemental plan for Georgia seniors was announced today by State Mutual Insurance Company of Rome, GA.

“We have eliminated a substantial cost element in this process”

State Mutual President and CEO, Dee Yancey III, said that Georgia residents of Medicare age now have access to one of the lowest cost Medicare supplement insurance plans available anywhere in the nation. Yancey said that State Mutual Insurance Company will allow Medicare-age consumers to apply for the supplemental Medicare insurance policy online, without having to talk with an insurance agent. “They can go online ( to fill out a confidential application and only buy the coverage they determine for themselves that best supplements their Medicare,” he said. “They can go forward secure in the knowledge that no one is going to try to sell them anything,” he said.

State Mutual was founded in 1936 and is licensed in 41 states and the District of Columbia. Yancey said that by using the Internet and allowing consumers to fill out their own applications online, the company has been able to substantially reduce its costs and the price it charges to consumers. “Consumers can also call the company for assistance in filling out applications,” he said.

A quick random comparison of Medicare supplement policies available in a number of states shows that the State Mutual policy is generally the lowest cost in most categories, and in some cases, costing less than half the price of the most expensive policies for the same coverage.

The online program allows an interested customer to review and select a policy, see a price quote, submit an application, receive confirmation of coverage and receive his or her policy in a few minutes of online time. Most policies will be issued within a working day, rather than the customary one- to two-month wait for underwriting review and processing. The customer can also download his or her policy and store it for review at any time. Consumers who wish to speak to a customer service representative, either to obtain information or to apply for a policy, can do so by calling 1-855-764-4000.

Yancey said that the low-cost of the State Mutual Insurance Company policy is achieved by empowering the customer to go online for most, if not all, of the information and application phase of obtaining Medicare supplement insurance. “We have eliminated a substantial cost element in this process,” he said. “This benefits the consumer who can obtain a superior insurance policy from an established company very quickly and inexpensively,” he said.

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Friday, February 04, 2011

Two Year Anniversary of Children's Health Insurance Law Sees Millions of Newly Insured Children, Families

Two years after President Obama signed the Children's Health Insurance Program Reauthorization Act (CHIPRA), HHS Secretary Kathleen Sebelius today announced that more than two million more children were served by Medicaid or the Children's Health Insurance Program (CHIP) at some point over the past year.

Together, the two programs serve more than 42 million children who would otherwise not have access to regular medical care. CHIPRA was signed into law on February 4, 2009.

"The increase in the number of children served by these two vital programs is especially significant in the face of the recent economic downturn states are experiencing," said Secretary Sebelius. "Even in times of hardship states have demonstrated their commitment to the health of children by continuing efforts to identify and enroll them in coverage."

To continue to advance coverage for children, Secretary Sebelius today also announced $40 million in new grants to states, community-based organizations, school systems and others to support their outreach and enrollment activities. The grants will help states further modernize and streamline their administrative systems, as well as create and implement school-based outreach strategies and approaches for identifying children who have historically been hard to reach.

Today's grant announcement builds on $206 million in enrollment bonuses earned by 15 states last year that increased enrollment above specific target levels. The bonus funds help states cover the cost of enrolling additional children in Medicaid.

"As we mark the second anniversary of one of President Obama's first actions as President, we can be confident that CHIPRA has proven to be a tremendous success," said Sebelius. "Now we must build on our accomplishments. Today, I am again calling on leaders across the country - from federal, state and local officials to private sector leaders - to join our effort to insure more children. We all have a stake in America's children and together, we will ensure millions more children get the care they need."

States were able to increase enrollment in the two programs in part because of boosts in federal support provided by the American Recovery and Reinvestment Act (ARRA). ARRA temporarily increased federal matching funds for state Medicaid programs during the recession.

While Medicaid and CHIP have helped bring the rate of uninsured children to the lowest level in more than two decades, an estimated five million uninsured children are thought to be eligible for one of these programs, yet not covered.

The Secretary's Challenge: Connecting Kids to Coverage, launched last year, will continue support efforts to reach more children by providing leaders with critical information and support as they work to insure more children in their communities and by closely monitoring progress.

"States' continued progress toward enrolling all eligible children in coverage is a significant step in cushioning the recession's impact on access to health insurance," said Cindy Mann, director of the Center for Medicaid CHIP, and Survey & Certification within the Centers for Medicare & Medicaid Services (CMS). "As families lose employment or have their hours cut back they may lose the health coverage benefit that came with that job. If not for these two programs, millions more children would go without critical health care services."

In its second annual report on CHIP and Medicaid enrollment, CMS notes that:

. More than 2 million children gained Medicaid or CHIP coverage during federal fiscal year 2010 (October 1, 2009 - September 30, 2010). In total, Medicaid and CHIP served more than 42 million children last year. This steady increase in enrollment is evidence of the important role that Medicaid and CHIP play for children, especially during economic downturns. The uninsured rate for children continues to decline at a time with the rate for adults is climbing. The increase in children's enrollment demonstrates that Medicaid and CHIP are serving the purpose for which they were created - providing high quality health coverage for lower-income families.

. Thirteen states implemented eligibility expansions in 2010 and many others simplified their enrollment and renewal procedures. Forty-six states and the District of Columbia now cover children with incomes up to 200 percent of the federal poverty level (FPL) in Medicaid and CHIP; with 24 of those states and the District of Columbia covering children with incomes up to 250 percent of the FPL. Twenty-one states now offer coverage to lawfully residing immigrant children and/or pregnant women, enabling states to receive federal funding for this coverage.

. CHIPRA Performance Bonuses have encouraged states to adopt and augment simplification measures in Medicaid and CHIP. Fifteen states qualified for a total of $206 million in performance bonuses for FY 2010; this is a significant increase over 2009 where 10 states received bonuses totaling $75 million. These bonuses provide additional federal financial support each year to states that successfully boost enrollment above target levels among previously eligible but uninsured children in Medicaid. To qualify, a state not only has to enroll more children, but must also have implemented program features that are designed to promote enrollment of eligible children.

. States are increasing their use of technology to facilitate children's enrollment and retention. Nearly two-thirds of states (32) have an on-line application that can be submitted electronically; 29 states allow electronic signatures on those applications. Six states have received approval to enroll children through the "Express Lane Eligibility" option created by CHIPRA. Express lane eligibility allows states to use data gathered for other programs such as housing assistance or food stamps to determine Medicaid or CHIP eligibility. And 33 states are utilizing the CHIPRA data matching process provided by the Social Security Administration to confirm U.S. citizenship for children.

. Outreach and enrollment grants have advanced coverage and led to public-private partnerships throughout the country to enroll more children. Sixty-eight grantees across 41 States and the District of Columbia are working diligently to facilitate children's enrollment in health coverage.

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