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PubMed1985

Medicare program; revision of explanation of Medicare benefit notice and review procedures for beneficiaries; supplementary medical insurance (Part B); court order--HCFA. Notice with comment period.

This notice complies with a U.S. District Court Order (Civil Action Case No. 77-488, Gray Panthers, et al. v. Heckler) issued on November 4, 1985. The order requires us to give notice to class members of the agreement (stipulation) reached by the Gray Panthers and the Department regarding notice and review procedures for Medicare beneficiaries dissatisfied with a carrier's denial of all or part of a claim for services under Part B (Supplementary Medical Insurance) where the amount in controversy is less than $100. The agreement is part of a resolution of constitutional due process issues relating to certain notice and review aspects of the Medicare program identified in a remand order of the U.S. Court of Appeals for the District of Columbia Circuit in the case of Gray Panthers v. Schweiker (Gray Panthers II), 716 F.2d 23 (D.C. Cir., 1983).

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

[Health economic analysis of the effects of including complementary medicine in the benefit package of health insurance].

A randomized experiment was set up in which 7,500 policyholders of Switzerland's largest health insurance fund, Helvetia, were offered free supplementary insurance for complementary medicine for 3 years. This was meant to simulate a situation in which the experimental group had access to the full range of complementary medical treatments under their health insurance policies. The remaining policyholders in the scheme (670,000 people) formed the control group. A third group of policyholders who had taken out additional insurance for complementary medical services at their own expense is mentioned only in passing. The health insurer's cost and benefit data were analyzed to evaluate the effect of the offered free supplementary insurance for complementary medicine. In addition, a survey was carried out among random samples of subjects from the experimental group and from the control group using the 36-Item Short-Form Health Survey (SF-36) to examine the effects of including complementary medicine on people's subjective state of health. The analysis of the cost data showed that subjects in the experimental group used complementary medicine in addition to mainstream medical services. It became also clear that alternative medical treatments were given in combination with orthodox medicine; less than 1% of the experimental group used exclusively alternative medical services. However, as only a very small percentage of the experimental subjects (6.6%) took advantage of complementary medicine, no significant impact on overall health cost could be inferred. On the other hand, multiple regressions showed that the use of complementary medicine had a greater effect on the treatment costs than sex, age or language region. Neither at the beginning nor the end of the experiment were any significant differences noted in the scales of the SF-36 between the experimental and the control group; nor did multiple regressions reveal any effects on subjects' state of health due to the inclusion of complementary medicine in the basic insurance cover. This study was presented in the media and at a public hearing of the Swiss National Science Foundation. It triggered numerous valuable discussions. The study design and the conclusions were not left uncontested.

Adult↗
PubMed1992

The effect of the Americans With Disabilities Act upon medical insurance and employee benefits.

The Americans With Disabilities Act will have a significant impact upon plan sponsors and the administration of an employee benefit plan. Prior to the July 26, 1992 effective date, a plan sponsor or trustee should meet with the plan's attorney, provider and other insurance advisers and review the effect ADA will have upon the plan. The EEOC will be issuing additional interpretive rules before the effective date of ADA, and there will be numerous court challenges after the effective date. Plan sponsors and trustees should keep abreast of the developments as they occur. Before a benefit change or premium adjustment is made, it should be reviewed with legal counsel to assure that it conforms to ADA's insurance exemption. Plan sponsors and trustees should have legal counsel, the provider and the plan's insurance advisers develop the documentation that will enable the plan to establish ADA's insurance exemption to defend any legal challenge.

Civil Rights↗
PubMed2005

The effect of premiums on the decision to participate in health insurance and other fringe benefits offered by the employer: evidence from a real-world experiment.

In this paper, we investigate the effect of the out-of-pocket premium on the decision to enroll in employer health insurance and other benefits plans including dental insurance, vision care, long-term care insurance, and wellness benefits. Previous estimates of the effects of premium on takeup of health insurance could be biased toward zero due to a correlation between premium and unobservable demand or plan quality. We solve this problem using data representing hypothetical choices by employees under three different price regimes, providing price variation uncorrelated with either individual-specific or plan-specific unobservables. We find that workers are insensitive to price in health insurance takeup. Workers show much greater price sensitivity to decisions about dental insurance, vision plans, long-term care insurance, and wellness benefits. We conclude that premium subsidies are unlikely to have a substantial impact on increasing insurance rates of workers already offered employer insurance.

Decision Making↗
PubMed1979

Insurance plan raises benefits, lowers costs.

The Direct Service Contract encourages hospital employees to use their own hospital for medical services. The plan benefits the hospital, cuts costs, and raises employee morale.

Deductibles and Coinsurance↗
PubMed2000

Commentary on Sommer et al. 'A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance.

The study by Sommer et al. recently reported in Complementary Therapies in Medicine has been heavily criticised in Switzerland since its original publication. Its major problems are an inadequate reflection of real practice, an inadequate study design relative to the central research objective, questionable value of the applied instrument and procedure for health assessment, methodological and statistical problems, and failure to consider literature relevant to the topic. For these reasons, this experimental study does not allow an answer to its central questions as to costs and effectiveness of complementary medicine made available within Switzerland's mandatory basic health insurance provisions. We propose more practice-related, non-experimental prospective study designs to realistically answer these questions.

Complementary Therapies↗
PubMed1979

A hospital self-insurance program: employee medical benefits.

Many hospitals have explored self-insurance to help keep insurance costs down for medical malpractice and workmen's compensation. Before leaping to adopt this new approach, however, a hospital must analyze its its advantages and disadvantages, variables affecting program costs and ways to quantify the risks.

Costs and Cost Analysis↗