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Health law gives consumers new rights to appeal insurer decisions

The Obama administration issued regulations yesterday addressing a top consumer gripe with health insurers: The rejected claim. "Rejection notices are often unclear, as are the procedures for challenging them." The new regulations are "designed to simplify the process and expand consumers' rights, as required by the recently enacted healthcare law." Current appeals rules differ by insurer. The regulations will standardize the process, allowing consumers to first take their complaints to the insurer, and then to an independent review panel (Levey, 7/22).

23 Jul 2010

Insurers, advocates fight over upcoming spending rules

Insurance companies are banding together to weaken a key health law rule that requires them to spend as much as 85 percent of their revenues on medical care, according to the advocacy group Health Care for America Now. At issue is the definition of 'medical loss ratio,' a figure used on Wall Street to show an insurer's profitability.

23 Jul 2010

Prevalence of HD substantially underestimated in the UK

The prevalence of Huntington's disease is substantially underestimated in the UK, with significant implications for those affected, the healthcare system, and research. New estimates of prevalence, and their implications, are discussed in a comment published in an upcoming Lancet, written by Professor Sir Michael Rawlins, who is the Chairman of the UK National Institute for Health and Clinical Excellence, but writes in his capacity as an Honorary Professor of the London School of Hygiene and Tropical Medicine, UK.

23 Jul 2010

Securing universal access to HIV prevention, care, treatment and support

The biennial meeting of the global AIDS community concluded today with clear evidence of tangible progress in HIV research and programme scale up, yet facing an urgent need for increased resources, the protection of human rights, and broader use of scientifically sound prevention strategies. Delegates and organizers depart Vienna - where the conference opened 18 July under the theme of Rights Here, Right Now -- with a renewed commitment to push for securing universal access to HIV prevention, care, treatment and support.

23 Jul 2010

Today's OpEds: Varying points on the nation's doctor shortage, benefits of negative studies, and what about universal health care?

In the long list of problems affecting the American health care system, the shortage of general practitioners and overabundance of specialists is usually ranked near the top. There is truth to this: only 32 percent of physicians practice primary care medicine. As a result, patients have to wait longer to see their doctors and are more likely to be seen by nurse practitioners and physician assistants instead. However, pediatrics has the opposite problem: a growing shortage of pediatric subspecialists (Dennis Rosen, 7/22).

23 Jul 2010

Researchers investigate regional variation in Medicare spending

In the latest Health Policy Outlook from the American Enterprise Institute and the Schaeffer Center for Health Policy and Economics at USC, Schaeffer Center researchers investigated whether geographic variations in utilization of health services and spending differed between Medicare and the private sector.

23 Jul 2010

NYC hospitals agree to pilot program to cut medical-malpractice costs

To cut medical-malpractice costs, five New York City hospitals have agreed to a pilot program to divulge medical mistakes early, offer settlements quickly and use special state 'health courts,' where judges will help negotiate agreements before cases go to trial. The program, funded for three years with $3 million from the federal government, aims to cut the $1.4 billion spent annually in New York State on medical-malpractice premiums, hospital and state officials say.

23 Jul 2010

HPM recognizes 19 Michigan health care providers for outstanding quality, service

The 19 Michigan health care providers were identified as the top primary care offices through a rigorous selection process that was based on Health Plan of Michigan's 2009 quality incentive plan. "We wanted to show our gratitude to our highest ranking health care providers for their excellence in quality and service," said Raymond D. Pitera, Vice President of Provider Service for Health Plan of Michigan. "We truly appreciate the access to quality services they provide to our Medicaid Members."

23 Jul 2010

GOP questions math of HHS' premium hike estimates; Abortion issue defining implementation

Senate Republican leaders are questioning an estimate by the Department of Health and Human Services that the effect of the new health law on insurance premiums will likely be less than 1 percent, The Hill reports.

23 Jul 2010

States still hoping for extra Medicaid money but also developing contingency plans

Kaiser Health News reports that states and hospital groups continue to lobby for a six-month extension of enhanced Medicaid money despite funding concerns and the lack of a way forward for such an extension.

23 Jul 2010

Most Americans with disabilities still struggle with lifestyle, economic issues: Survey

On the 20th anniversary of the signing of the Americans with Disabilities Act, a new survey sponsored by Kessler Foundation and National Organization on Disability finds that most Americans with disabilities are still struggling with many of the same lifestyle and economic issues they confronted in 1990 when the ADA became federal law.

23 Jul 2010

MAXIMUS operates health care appeal programs for state regulatory agencies

The United States Departments of Health and Human Services, Labor and the Treasury announced yesterday a new internal claims and appeals and external review process for group health plans under the Patient Protection and Affordable Care Act.

23 Jul 2010

New data on health insurance to be included in AHRQ's 2009 State Snapshots

The Agency for Healthcare Research and Quality's annual release of state-by-state quality data has been expanded to include new data on health insurance, including data on health care quality categorized by source of payment, including private insurance, Medicare, Medicaid and those without insurance.

23 Jul 2010

New appeal regulations empower consumers to better control their health care decisions

Today, the Obama Administration is announcing both new regulations to empower consumers to appeal decisions made by their health plans or insurance companies and the availability of resources that will be used to help give consumers more control of their health care decisions. These provisions of the Affordable Care Act will help support and protect consumers and help end some of the worst insurance company abuses.

23 Jul 2010

Senior Smart introduces online tool for seniors looking for quality assisted living facilities

In response to the "graying of America" phenomena, Senior Smart announced today the inception of http://www.assisted-living-info.org, an online tool that provides the perfect match between families and seniors actively looking for assisted living and quality assisted living facilities nationwide.

23 Jul 2010

Emotional barriers, structural barriers can prevent PLWHA from seeking care, treatment: Survey

Bristol-Myers Squibb Company today presented results from a national survey which found that emotional barriers, such as stigma, fear, denial and shame, and structural barriers, such as lack of knowledge, transportation, and insurance coverage, can prevent people living with HIV/AIDS from seeking care and treatment.

23 Jul 2010

New rules Thursday on appealing insurance claims, states take lead in health reform implementation

Kaiser Health News /The Washington Post obtained a summary of new rules to be released Thursday by the Obama administration that will make it easier for consumers to appeal the denials of their health insurance claims as the White House tries to "boost political support" for the new health law.

23 Jul 2010

Choice between late-term abortion or keeping an unhealthy foetus

Most pregnant women whose foetus is proven to have a genetic abnormality choose to have an abortion, but reaching that decision is a painful, exhausting process for most of them. "The women's doubt, pain and sorrow make abortion more moral - in the eyes of society as well as her own," says Sølvi Marie Risøy, a researcher at the Stein Rokkan Centre for Social Studies, University of Bergen.

23 Jul 2010

Premier awards Press Ganey contract to measure, improve patient satisfaction across member organizations

Press Ganey Associates, Inc. announced today that it has been awarded contracts by Premier Purchasing Partners, L.P., Inc., the group purchasing unit of Premier, Inc., to help measure and improve satisfaction and engagement among patients, employees, and physicians at its member organizations.

23 Jul 2010

New model for scaling up treatment, prevention of HIV amongst IDUs

Against the backdrop of some of the globe's fastest growing HIV epidemics in Eastern Europe and Central Asia, a report launched today at the XVIII International AIDS conference in Vienna makes the case for a new model for scaling up treatment and prevention of HIV amongst Injecting Drug Users.

23 Jul 2010

Health Care News and Research

Health law gives consumers new rights to appeal insurer decisions

Insurers, advocates fight over upcoming spending rules

Prevalence of HD substantially underestimated in the UK

Securing universal access to HIV prevention, care, treatment and support

Today's OpEds: Varying points on the nation's doctor shortage, benefits of negative studies, and what about universal health care?

Researchers investigate regional variation in Medicare spending

NYC hospitals agree to pilot program to cut medical-malpractice costs

HPM recognizes 19 Michigan health care providers for outstanding quality, service

GOP questions math of HHS' premium hike estimates; Abortion issue defining implementation

States still hoping for extra Medicaid money but also developing contingency plans

Most Americans with disabilities still struggle with lifestyle, economic issues: Survey

MAXIMUS operates health care appeal programs for state regulatory agencies

New data on health insurance to be included in AHRQ's 2009 State Snapshots

New appeal regulations empower consumers to better control their health care decisions

Senior Smart introduces online tool for seniors looking for quality assisted living facilities

Emotional barriers, structural barriers can prevent PLWHA from seeking care, treatment: Survey

New rules Thursday on appealing insurance claims, states take lead in health reform implementation

Choice between late-term abortion or keeping an unhealthy foetus

Premier awards Press Ganey contract to measure, improve patient satisfaction across member organizations

New model for scaling up treatment, prevention of HIV amongst IDUs

Discover how SciY empowers scientists

Why use light scattering to analyze proteins and viral vectors?

Changing the landscape of R&D to build clinical success from the ground up

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