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Federal Due to several snowstorms in Washington, Congress began the day President’s recess for a whole week early and has conducted no official business last week. However, there was a legal drama Senate Majority Leader Harry Reid pulled the rug from under Finance Committee Chairman Max Baucus by the demolition of Bill jobs Baucus (without warning), which contains numerous articles of medical insurance, and replace it with a bare, narrow jobs bill. If health items Baucus originally inserted with the help of the Republicans are going to return to the table remains unclear. Among the items of health have been discontinued are: the extension of COBRA eligibility (to May 31), fix Äúdoc AT (to October, 2010) rates of Medicare reimbursement and office management support CMS to calculate 2011 Medicare Advantage Rates “as if” the doc fix in place. STATESCALIFORNIA Insurance Office of Patient Advocacy released a report on the state, aos HMO last week. Aetna has received 3 out of 4 stars. The newsletter’s purpose is to allow consumers to compare how health plans use the medical staff and help address conditions such as asthma, arthritis and diabetes. Colorado: Governor Bill Ritter held a press conference to announce what he calls “the next round of reforms that are common sense.” The legislative package includes bills to prevent insurance companies from charging different rates depending on the sex of a person, ensure that women have access to screening for breast cancer, providing a simple language is used in insurance forms, standardize applications and insurance explain the benefits and encourage greater use of online tools to include people in government programs. In addition to the proposals of the Governor, a bill that would establish a public option was also introduced. Connecticut: At d ‘ a short legislative session only three months, insurance and real estate committee wasted no time in putting forward a program that includes many design projects legislation reiterate previous sessions. It is including copayments prohibiting health insurance for preventive care, reducing co-payments for prescription drugs, by prohibiting the payment of compensation Social Security disability, and exempt municipal employees health insurance tax premiums on premiums in small groups. In addition, the Committee has reintroduced legislation that includes nearly a dozen new mandates for health benefits. The Council for Affordable Health Insurance, an independent think-tank, argues that Warrants could increase insurance premiums in Connecticut more than 50 per cent overall. Georgia, a bill was proposed last week that would impose significant restrictions on the ability of insurers to cancel insurance policies health. Aetna, through the Association of Health plans Georgia and AHIP, met the legislator sponsoring the bill to express their concerns with the bill. INDIANA: The legislative session is half-time, and l ‘agenda Insurance is now limited. Most bills insurance issue is officially dead, including a bill that would prohibit the provision of health plan requiring a contracted provider to accept more than one number patient coverage for dialysis treatment regardless of whether the facility is under contract or not, and without restrictions to certain benefits and a bill that would have allowed outside the assignment of network benefits. However, Aetna expects a bill requiring insurers and HMO’s annual report the composition of reasonable prices, including administrative costs, may be resurrected. A bill restricting dental insurers and HMOs to establish fee schedules for services not covered by the Senate adopted, with our amendment to accommodate most of the major concerns expressed by opponents of the bill. As the bill, dental plan in May to impose tariffs of fees for services covered, regardless of whether the plan pays for services actually rendered. Kansas: An amended version of SB 389 relating to dental services approved by the Senate Financial Institutions and Insurance Committee on February 11. The amended bill prohibits any contract between the insurer of the health plan that provides health benefits and a dentist to contain a provision that requires the dentist to accept a fee schedule for services unless the service is a service covered. Amendments to the committee added to the definition of a, Äúhealth benefit plan, the AU as follows: any agreement of warrants issued by a corporation, nonprofit dental services and any insurance policy Health purchased by individuals, children State aos insurance plan health medical assistance under the state Medicaid program. We will keep you informed as this bill progresses and expectancy make positive changes as the bill in the House. MASSACHUSETTS: Governor Deval Patrick filed a bill 40-page which proposes giving the Insurance Commissioner the power to hold public hearings on rate adjustments and most of the cap increases health care prices. The rate increases for individuals will be at the rate of inflation of medical costs, those sold to employers with 50 or fewer workers could not exceed one and half the rate of medical inflation. The legislation would also impose a two-year moratorium on any new health benefit mandates. Legislative Leaders welcomed the intention of the Governor, aos plan, but refused to pledge support. A strong opposition is expected from the medical provider groups. The governor has announced simultaneous emergency provisions take effect immediately, will require health insurers to submit proposed increases to low levels of business for consideration by the state 30 days before to take effect. Several other proposals include the requirement that insurers offer at least a coverage plan with a limited network of providers of health care that cost at least 10 percent less than health plans with the access to more doctors. The Massachusetts Association of Health Plans is lobbying for a bill introduced by Senate Insurance Chairman Richard Moore, who would create a cheaper insurance products health for small employers, capping payments to vendors only 10 percent higher rates of health insurance. The Massachusetts Medical Society is against this proposal. MISSOURI: A bill autism coverage mandate has been amended and Äúperfected, the AU by the Senate and then sent to government accountability and Financial Oversight Committee that he must leave before returning to the Senate floor. In more than two terms related amendments, a third amendment to the bill allowing the sale of limited cross-border Cross health insurance has also adopted. In its present form, the bill contains a supply of business coverage in the individual market. The coverage is limited to treatments prescribed by a doctor or a psychologist whose treatment plan the carrier is entitled to review every six months. coverage for applied behavioral analysis (ABA) is limited to $ 52,000 per year (down from 72, $ 000 as presented) for Persons under 21 years. Meanwhile in the House bill contains important language on accreditation of service providers of autism also increased. The bill also contains a mandate to offer coverage in the individual market and group under 25 years. Groups of 25 to 50 would be entitled to an exemption from the mandate if they could demonstrate an increased premium on the warrant. The bill limits the annual coverage of ‘ABA (36,000 $ for kids ages 3-9, $ 20,000 for children aged 9-21). Aetna will continue to monitor the status of these mandates, but it seems pretty clear then that something will pass on the issue of autism. NEW JERSEY: Last week, Governor Chris Christie has declared a state of financial emergency calls a special session of the Legislature to outline a plan to address State, aos current $ 2. 2 billion budget shortfall. His plan provides for major reductions or eliminations through 375 programs and state withholding 500 million dollars in state education aid. It should noted on the program side is $ 12. 6 million reduction in funding charity care in hospitals, which pays for care for uninsured residents. In legislative action, the Assembly Financial Institutions and Insurance held a hearing for three hours on public out-of-network reimbursement. Much of the hearing relates to billing practices significantly higher ambulatory surgery centers and a non-hospital para. Aetna presented evidence concerning experience with non-par hospital, citing disparate increased their year on year in expenses compared to others in the same situation of hospitals. Schaer Chairman said the committee will work over the coming months to develop a solution. NEW YORK: With Sen. Hiram Monserrate officially expelled from the Senate, the Democratic majority (31-30) face an uphill battle now get the 32 votes needed to pass legislation. However, the Senate and the Assembly has moved from the before a public hearing on the proposed Executive Budget for health, including the section mandating prior approval for rate adjustments. Health Plan Association testified on behalf of the industry. If passed, the Governor Paterson proposed a ratio of 85 percent medical loss and an approval process before the hearing for all rate adjustments would essentially amount to government control of health insurance, which undermines the private market health insurance in New York. The price control would weaken the solvency of health plans, providers injury and virtually eliminate the innovation and efficiency. At the same time, the proposal ignores the underlying cause of the rising cost of health insurance – an increase in actual costs of services of health care. Oklahoma: The second session of the Legislature convened in Oklahoma 52nd in Oklahoma City on February 1. Legislators quickly turned to the State aos $ 1. 3 billion budget deficit described by Governor Brad Henry (D) in his eighth and final State of the State address and exercise 2011 Executive Budget. During his speech, the Governor highlighted his plans for solving the $ 1. 3 billion budget deficit through cuts precise. His only reference to health insurance was to encourage the expansion of Insure Oklahoma, a program developed by the state in partnership with small employers to provide health coverage affordable. The legislature is scheduled to adjourn May 28, but only after sending a series of laws , several bills of interest to Aetna. SOUTH DAKOTA: A bill Dental Fee Schedule (SB 108) passed unanimously in the Senate Commerce Committee and should be considered by the full Senate early week. Bill prohibits any contract between the insurer of the health plan that provides health benefits and a dentist to contain a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Aetna will continue to monitor the progress of the Bill as it progresses. TENNESSEE: Several bills have been proposed which would bring changes to the law of external review of the state. Aetna and other industry representatives to meet with the Ministry of Commerce of Tennessee and insurance on the proposed amendments to the law of external review. The bill proposed by the IDD more closely mirrors the model legislation proposed by the National Association of Commissions Insurance. UTAH: The Speaker presented a draft reform of health from information technology to health, individual and small-market reforms and transparency group. The main theme of reform is micro-management rates and rating factors, and an enlargement of Insurance Commissioner’s authority. The provisions on transparency applies the design plans and descriptions of the advantages offered by carriers, and requiring suppliers to make available, upon request, price list for services both on an inpatient and outpatient.

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