CMS Launches New Website! www.Medicaid.gov

Next week CMS will launch a new website, "www.Medicaid.gov". The site was
created as a resource to help relevant stakeholders understand the program.

The website will contain information on the Medicaid program state by
state.It will have information on the state plan amendments, eligibility
requirements, and covered populations currently in place. The site will follow
the program as it evolves to 2014.

Individual Louisiana Blue Cross Members to Get One-Time Credit

Individual Blue Cross Members to Get One-time Credit

Our efforts to affect healthcare costs, as well as those of
our members in this block of business, have paid off. As a result, we are giving
a one-time premium credit for each individual Blue Max, BlueSaver, Blue Value, Blue
Select and conversion policy contract.

HMO Louisiana, VIP and CSD policies will not receive this credit. The credit amount is $100 on each single contract and $145 on each multi-person or family contract. It will be reflected on the member’s next bill, unless the monthly premium is less than the credit amount. In that case, the member will not receive another bill until an amount is due.

Those who pay by bank draft will simply see a reduced amount drafted from their accounts. Some members are already seeing this reduced bank draft amount today. Those who pay quarterly or further in advance will see the credit on their next invoice.

This particular block of business is performing better than expected thanks to our members’ efforts to take charge of their healthcare and improve their health. They are buying generic drugs, getting flu shots and other preventive screenings and making sure they go to network doctors. These steps toward health and wellness have helped to stretch our members’ premium dollars even farther.

Blue Cross and Blue Shield of Louisiana did our part by streamlining administrative costs, negotiating the best possible contracts with doctors, hospitals and other healthcare providers, and fighting fraud and abuse.

As a private, mutually held company, Blue Cross has always made decisions based on the best interests of our customers. We know the money we manage is theirs, and we take that responsibility very seriously.

Supreme Court to Rule on PPACA!

Nov 14, 2011

At 10 a.m. today, the Supreme Court issued its orders for the upcoming 2012 term, which includes the details of how the oral arguments related to the health law will shape up.

CNN: "The U.S. Supreme Court will hear a challenge to
President Barack Obama's sweeping health care reform law, the court announced
Monday" (11/14).

Bloomberg: "The justices today said they will consider whether
Congress exceeded its authority by requiring all Americans to either acquire
insurance by 2014 or pay a penalty. The court will wield unprecedented influence
over the presidential election campaign, with a decision in the case likely in
late June, months before the election" (Stohr, 11/14).

The Washington Post: "The Supreme Court said Monday it will
hear a challenge to the health-care overhaul act passed in 2010, with a decision
on President Obama’s most controversial domestic achievement likely to come in
the summer of his reelection campaign. Opponents have called the massive new
law, with its central mandate that almost all Americans have health insurance by
2014 or pay a penalty, an unprecedented expansion of the national government.
The administration says it is confident the act will be upheld as a valid
exercise of federal power, just as Social Security and the Civil Rights Act were
found to be constitutional" (Barnes, 11/14).

The New York Times: "The court’s decision to step in had been
expected, but Monday’s order answered many questions about just how the case
would proceed. Indeed, it offered a roadmap toward a ruling that will help
define the legacy of the Supreme Court under Chief Justice John G. Roberts Jr."
(Liptak, 11/14).

The Associated Press: "The justices announced they will hear
more than five hours of arguments from lawyers on the constitutionality of a
provision at the heart of the law, the requirement that individuals buy health
insurance starting in 2014 or pay a penalty, and other related questions about
the act. The White House said 'we are pleased that the court has agreed to hear
this case'" (Holland, 11/14).

The Wall Street Journal: "The case raises several issues, but
chief among them is this: Did Congress exceed its constitutional powers when it
required most individuals to carry health insurance or pay a penalty? The court
is expected to hear oral arguments in March, with a decision expected by the end
of June. That timeline means the court will rule on President Barack Obama's
signature legislative achievement during the thick of the 2012 presidential
campaign" (Kendall, 11/14).

Los Angeles Times: "The justices said they would rule on the
constitutional challenge to the entire law brought by top Republican officials
from 26 states who contend the Democratic-controlled Congress overstepped its
authority in passing the measure. ... In agreeing to hear the cases, the court
said it will decide four questions that have arisen: Is it constitutional for
Congress to require all persons to have health insurance by 2014? If this
provision is struck down, can it be 'severed' from the law or must the entire
statute fall? Is it unfair to the states to force them to pay the extra cost of
expanding the Medicaid program? Finally, should a decision be put off until 2015
when the first taxpayers pay a penalty?" (Savage, 11/14).

The Hill: "The justices also will determine whether a separate
federal law bars them from reaching a decision on the mandate before it takes
effect. People can’t challenge a tax before they have to pay it, and the Obama
administration has defended the mandate by invoking Congress's taxing power. But
it has also said the court should bypass procedural issues and rule directly on
the mandate. Two federal courts of appeals have said the mandate is
constitutional under Congress’s authority to regulate interstate commerce. One
has ruled the law unconstitutional, and one said it could not reach a decision
on the mandate because of the aforementioned tax law" (Baker, 11/14).
Earlier today, news outlets reported on some of the key issues and moving
parts that will be in play if and when the high court hears pending health
law appeals.

Los Angeles Times: A Buoyed Health Care Law Reaches Supreme
CourtAfter a year and a half of legal skirmishing, President Obama's
embattled health care law has arrived at the Supreme Court riding a surprising
winning streak and carrying a constitutional stamp of approval from prominent
conservative judges. … The Supreme Court is expected to announce as soon as
Monday that it will hear the Florida case, the largest and broadest challenge to
the Patient Protection and Affordable Care Act (Savage and Levey, 11/13).

The New York Times: Supreme Court Memo: Health Law Puts Focus
On Limits Of Federal PowerIf the federal government can require people to
purchase health insurance, what else can it force them to do? More to the point,
what can't the government compel citizens to do? Those questions have been the
toughest ones for the Obama administration's lawyers to answer in court
appearances around the country over the past six months. And they are likely to
emerge again if, as expected, the Supreme Court, as early as Monday, agrees to
be the final arbiter of the challenge to President Obama's signature health care
initiative (Liptak, 11/13).

The Washington Post: The High Court: What Does Supreme Court
Decision On Social Security Mean For Health Care Act? Today, there are
unmistakable comparisons to the court's action on the Social Security Act of
1935 as the current justices consider whether to accept a constitutional
challenge of the 2010 Affordable Care Act. A decision could come as early as
Monday morning (Barnes, 11/13).

HHS application process for exchange to take 211 hours!

States and territories seeking to establish a health insurance exchange, funded under the Affordable Care Act, will be required to submit an application for approval during the fall of 2012, the Department of Health and Human Services has announced.

In a notice available now and being published Nov. 10, HHS estimates the application will take an average of 211 hours to complete. States and territories must demonstrate operational readiness through virtual and on-site reviews.

"Given the innovative nature of exchanges and the statutorily-prescribed relationship between the HHS Secretary and states in their development and operation, it is critical that the Secretary work closely with states to provide necessary guidance and technical assistance to ensure that states can meet the prescribed timelines, federal requirements and goals of the statute," according to the notice.

In implementing health reform, governors are turning to unilateral action

In implementing health reform, governors are turning to
unilateral action

By Sarah Kliff,

Published: November 1

A few parts of the health reform law require states to amend their Joles, David AP Gov. Mark Dayton (D) used an executive order to implement the health reform law in Minnesota. existing laws to reform their insurance markets. For instance, most states need to pass new laws to
participate in the health exchanges that will launch in 2014.

Usually, this requires the legislature. But those efforts have often run into political opposition. In 2011, more than a dozen state-level, exchange bills failed. That’s why governors are increasingly taking unilateral action: Earlier this week, Minnesota Gov. Mark Dayton, a Democrat, issued an
executive order to allow his state to continue planning for putting the health reform law into action. Republicans in the state legislature had blocked an exchange bill, leaving it to die in committee.

Minnesota Commerce Commissioner Mike Rothman told the state's public radio station that the executive order would allow the state to "develop and plan an exchange.”

By my count, governors in five states -- Alabama, Georgia, Indiana, Rhode Island and now Minnesota-- have used executive orders to move forward on the law. And when you count states
that have pursued grant money through their executive branch, that number rises to 15, according to the National Conference of State Legislatures. That includes all the medium-blue states on this map (click through for an interactive version):

Dayton is actually a bit of an anomaly: It’s mostly Republican governors who have used executive action to move forward on implementing the law. Republican legislatures that oppose the health reform law have stymied some states’ efforts toward implementation. That leaves governors with an uneasy choice: Implement a law they don’t like or watch the federal government come in and do the job itself. Georgia’s Nathan Deal and Indiana’s Mitch Daniels have landed on the latter option, issuing executive orders to allow their states to avoid federal intervention. These executive orders likely don’t allow for full implementation of the law. Most of those states will eventually need new legislative authority to continue planning. But, in the meantime, the executive orders serve an important role:

They give the states liberty to plan and pursue funding for a health exchange. If the Supreme Court rules the reform law constitutional, more are likely to take a second look at implementing the law themselves. At that point, all the groundwork being laid now via executive order could prove crucial in such a decision.

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