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Fact Sheets Home Health Care

guzen — Mon, 19 Apr 2010 09:03:32 +0000

Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.

At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.

How Do I Make Sure That Home Health Care Is Quality Care?
As with any important purchase, it is always a good idea to talk with friends, neighbors, and your local area agency on aging to learn more about the home health care agencies in your community.
In looking for a home health care agency, the following 20 questions can be used to help guide your search:

How long has the agency been serving this community?
Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one.
Is the agency an approved Medicare provider?
Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations?
Does the agency have a current license to practice (if required in the state where you live)?
Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary?
Does the care plan outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver?
How closely do supervisors oversee care to ensure quality?
Will agency caregivers keep family members informed about the kind of care their loved one is getting?
Are agency staff members available around the clock, seven days a week, if necessary?
Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
How does the agency ensure patient confidentiality?
How are agency caregivers hired and trained?
What is the procedure for resolving problems when they occur, and who can I call with questions or complaints?
How does the agency handle billing?
Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services?
Will the agency provide a list of references for its caregivers?
Who does the agency call if the home health care worker cannot come when scheduled?
What type of employee screening is done?

When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This should include an interview with the home health caregiver to make sure that he or she is qualified for the job. You should request references. Also, prepare for the interview by making a list if any special needs the senior might have. For example, you would want to note whether the elderly patient needs help getting into or out of a wheelchair. Clearly, if this is the case, the home health caregiver must be able to provide that assistance. The screening process will go easier if you have a better idea of what you are looking for first.

Another thing to remember is that it always helps to look ahead, anticipate changing needs, and have a backup plan for special situations. Since every employee occasionally needs time off (or a vacation), it is unrealistic to assume that one home health care worker will always be around to provide care. Seniors or family members who hire home health workers directly may want to consider interviewing a second part-time or on-call person who can be available when the primary caregiver cannot be. Calling an agency for temporary respite care also may help to solve this problem (see the Respite Care fact sheet for more information about these services).

In any event, whether you arrange for home health care through an agency or hire an independent home health care aide on an individual basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine. If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior:

Illnesses/injuries, and signs of an emergency medical situation
Likes and dislikes
Medications, and how and when they should be taken
Need for dentures, eyeglasses, canes, walkers, etc.
Possible behavior problems and how best to deal with them
Problems getting around (in or out of a wheelchair, for example, or trouble walking)
Special diets or nutritional needs
Therapeutic exercises.

In addition, you should give the home health care provider more information about:

Clothing the senior may need (if/when it gets too hot or too cold)
How you can be contacted (and who else should be contacted in an emergency)
How to find and use medical supplies and medications
When to lock up the apartment/house and where to find the keys
Where to find food, cooking utensils, and serving items
Where to find cleaning supplies
Where to find light bulbs and flash lights, and where the fuse box is located (in case of a power failure)
Where to find the washer, dryer, and other household appliances (as well as instructions for how to use them).

A WORD OF CAUTION . . .
Although most states require that home health care agencies perform criminal background checks on their workers and carefully screen job applicants for these positions, the actual regulations will vary depending on where you live. Therefore, before contacting a home health care agency, you may want to call your local area agency on aging or department of public health to learn what laws apply in your state.

HOW CAN I PAY FOR HOME HEALTH CARE?
The cost of home health care varies across states and within states. In addition, costs will fluctuate depending on the type of health care professional required. Home care services can be paid for directly by the patient and his or her family members, or through a variety of public and private sources. Sources for home health care funding include Medicare, Medicaid, the Older Americans Act, the Veterans’ Administration, and private insurance.

Medicare is the largest single payer of home care services. The Medicare program will pay for home health care if all of the following conditions are met:

The patient must be homebound and under a doctor’s care;
The patient must need skilled nursing care, or occupational, physical, or speech therapy, on at least an intermittent basis (that is, regularly but not continuously)
The services provided must be under a doctor’s supervision and performed as part of a home health care plan written specifically for that patient
The patient must be eligible for the Medicare program and the services ordered must be “medically reasonable and necessary”
The home health care agency providing the services must be certified by the Medicare program.

To get help with your Medicare questions, call 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048 for the speech and hearing impaired) or look on the Internet at http://www.medicare.gov.

WHERE CAN I LEARN MORE ABOUT HOME HEALTH CARE?
There are several national organizations that can provide additional consumer information about home health care services. These include the following:

The National Association for Home Care, which can be reached at 202-547-7424 or by visiting its website at www.nahc.org. The postal address is: 228 7th St., SE; Washington, DC 20003.
The Visiting Nurse Associations of America, which can be reached at 617-737-3200 or by visiting its website at http://www.vnaa.org. The postal addresses are: 99 Summer St., Suite 1700; Boston, MA 02110.

To find out more about home health care programs where you live, you will want to contact your local aging information and assistance provider or area agency on aging (AAA). The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116 or http://www.eldercare.gov can help connect you to these agencies.

Case Study

WHEN IS HOME HEALTH CARE APPROPRIATE?
Because it is not always clear to the average person when an ailing senior needs home health care and when he or she needs nursing home care, it is usually best to consult a medical professional for advice. The following case study describes one situation in which home health care proved to be the right choice.
Francis is 84 years old and recently had a stroke. She was hospitalized briefly and then discharged to continue recovering at home. To enable her to return home, her doctor called a home health care agency, and the agency gave Francis a complete home health care plan for six weeks. Since the doctor ordered the home care for Francis, Medicare paid for it.

For the first week after Francis went home, a nurse visited her every day. The nurse met with Francis’s family to discuss her special dietary needs and to arrange for exercise therapy to help Francis regain her strength. Once that was done, the nurse visited Francis twice a week to check on how well she was recovering. The home health care agency also sent a homemaker, a personal care attendant, and a physical therapist to visit Francis several times during the week. The homemaker would do the shopping and cook light meals. The personal care attendant would help Francis bathe, get dressed, and walk. The physical therapist would keep Francis moving and see to it that she got some exercise to aid in her recovery.

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Be My Friend – www.myspace.com Nutrition by Natalie Nutrition and Your Mental Health What does nutrition have to do with mental health? You might be surprised to find out the truth behind what happens when a person has a nutritional deficiency. Nutritional deficiencies can cause all sorts of psychiatric symptoms including apathy, low energy, irritability, insomnia, low energy, agitation, fatigue, concentration problems, aches and pains, weight changes, including weight loss or weight gain. Sound a lot like the symptoms of depression? The truth is the average American diet of fast food is low in vital nutrition that you need for your body to function correctly. This isn’t to say that all depression is caused by bad nutrition but it’s certainly a contributing factor in many cases and poor nutrition will always make depression worse. Antidepressant drugs also do not correct nutritional problems. So if your depressed because of nutritional problems an antidepressant will only partially cover up the problem and you body still won’t function correctly. Please visit Natalie’s website at www.nutritionbynatalie.com To find out more about orthomolecular psychiatry visit, http This video was produced by Psychetruth www.myspace.com www.youtube.com www.livevideo.com ©Copyright 2007 Zoe Sofia. All Rights Reserved. This video maybe displayed in public, copied and redistributed for any strictly non-commercial use in its entire unedited form. Alteration or commercial use is strictly …

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Health Care Reform March 15 2010

guzen — Sun, 18 Apr 2010 09:03:35 +0000

Week of March 15, 2010

The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie.

Federal

With a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill — requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess.

The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March.) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March.) Aetna urged Congress to apply the “doc fix” to next year’s reimbursement as well, since insurers’ Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond.

States

ARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the $700 million deficit this year and reduce the anticipated $2.6 billion deficit in 2011. Righting the state’s fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language.

CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers’ agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem.

COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees.

CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature’s Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance.

GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks.

KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial – a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on “most favored nation” clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of “eligible employee” to include part-time workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital’s highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers.

KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber.

SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor’s signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U.S. Senate and House.

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Each year, hazards in the home cause millions of illnesses and injuries across the nation. Many can be prevented by keeping your home clean and well-maintained. Recognizing problems and correcting them can protect you and your family. In HEALTH BEGINS AT HOME, several common problems and simple solutions are discussed. Comments on this video are allowed in accordance with our comment policy: www.cdc.gov This video can also be viewed at www.cdc.gov

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Health Insurance Reform From Easytoinsureme Health Insurance Quotes

guzen — Thu, 25 Mar 2010 08:56:26 +0000

Federal

Owing to multiple blizzards in Washington, Congress started its President’s Day recess a full week early and conducted no official business last week. However, there was some legislative drama as Senate Majority Leader Harry Reid pulled the rug out from under Finance Committee Chairman Max Baucus by scrapping the Baucus jobs bill (without warning), which contained many health insurance items, and replacing it with a stripped down, narrow jobs bill. Whether the health items Baucus originally inserted with Republican help will make it back to the table remains fuzzy. Among the health items that have been dropped are: the COBRA eligibility extension (to May 31); the “doc fix” (to October, 2010) of Medicare reimbursement rates; and the favorable statutory direction to CMS to calculate the 2011 Medicare Advantage rates “as if” the doc fix were in place.

States

California health insurance The Office of Patient Advocacy released a report card on the state’s HMOs last week. Aetna received 3 out of 4 stars. The goal of the report card is to allow consumers to compare how well health plans use personal medical records 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 represent common sense.” His legislative package includes bills to preclude insurance companies from charging different rates due to a person’s gender, ensure that women have access to breast cancer screening, assure plain language is used in insurance forms, standardize insurance applications and explanations of benefits, and encourage greater use of online tools to enroll people in public programs. Apart from the Governor’s proposals, a bill that would establish a public option was also introduced.

CONNECTICUT: In a short legislative session of only three months, the Insurance & Real Estate Committee wasted no time in putting forth an agenda that includes many concept drafts for repeat legislation from previous sessions. These include prohibiting health insurance copayments for preventive care, limiting prescription drug copayments, prohibiting Social Security disability payment offsets, and exempting the Municipal Employees Health Insurance Plans from the premium tax on small group premiums. In addition, the committee reintroduced legislation that includes nearly a dozen new health benefit mandates. The Council for Affordable Health Insurance, an independent think-tank, says that health insurance mandates could increase premiums in Connecticut by more than 50 percent overall.

GEORGIA: A bill was proposed last week that would impose significant restrictions on insurers’ ability to rescind health insurance policies. Aetna, through the Georgia Association of Health Plans and AHIP, met with the legislator sponsoring the bill to express concerns with the bill.

INDIANA: The legislative session is at halftime, and the insurance agenda is now limited. Most insurance issue bills are officially dead, including a bill that would have prohibited health plan provisions requiring a contracted provider to accept more than a certain number of patients; coverage for dialysis treatment regardless of whether the facility is contracted or not and without certain benefit restrictions; and a bill that would have allowed out-of-network assignment of benefits. However, Aetna is expecting that a bill requiring insurer and HMO annual reporting of premium cost composition, including administrative costs, may be resurrected. A bill that restricts dental insurers and HMOs from establishing fee schedules for non-covered services passed the Senate, with our amendment to accommodate most of the key concerns expressed by opponents of the bill. As the bill stands, dental insurance plans may impose fee schedules for covered services, regardless of whether the plan actually pays for the services rendered.

KANSAS: An amended version of S.B. 389 related to dental services passed the Senate Financial Institutions and Insurance Committee on February 11. The amended bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Committee amendments added to the definition of a “health benefit plan” the following: any subscription agreement issued by a non-profit dental service corporation; any policy of health insurance purchased by an individual; the state children’s health insurance plan; and the state medical assistance program under Medicaid. We will continue to update you as this bill progresses and hope to make favorable changes as the bill moves through the House.

MASSACHUSETTS: Governor Deval Patrick filed a 40-page bill that proposes giving the insurance commissioner the power to hold public hearings on rate adjustments and essentially cap health care price increases. Rate increases for individuals would be held to the rate of medical inflation; those sold to employers with 50 or fewer workers could not exceed one and a half times the level of medical inflation. The legislation would also impose a two-year moratorium on any new health benefit mandates. Legislative leaders praised the intent of the governor’s plan but declined to promise support. Strong opposition is expected from medical provider groups. The Governor simultaneously announced emergency regulations to take immediate effect that will require health insurers to submit proposed small business rate increases for review by the state 30 days before they take effect. Several other proposed provisions include a requirement that insurers offer at least one coverage plan with a limited network of health care providers costing at least 10 percent less than health plans with access to more physicians. The Massachusetts Association of Health plans is lobbying in support of a bill introduced by Senate Insurance Chair Richard Moore that would create a cheaper health insurance product for small employers by capping payments to providers at just 10 percent above Medicare rates. The Massachusetts Medical Society is against that proposal.

MISSOURI: An autism coverage mandate bill was amended and “perfected” by the Senate and then sent to the Government Accountability and Fiscal Oversight Committee from which it must emerge before returning to the floor of the Senate. In addition to two mandate-related amendments, a third amendment to the bill allowing for limited cross border sales of health insurance also passed. In its current form, the bill contains a mandated offering of the coverage in the individual market. Coverage is limited to treatment ordered by a licensed physician or psychologist whose treatment plan the carrier is entitled to review every six months. Coverage for applied behavior analysis (ABA) is limited to $52,000 annually (down from the $72,000 as introduced) for persons under age 21. Meanwhile in the House, a bill containing significant language relating to the credentialing of autism service providers also passed. The bill also contains a mandate to offer coverage in the individual market and to groups of fewer than 25. Groups of 25 to 50 would be entitled to an exemption from the mandate if they could demonstrate an increase in premiums tied to the mandate. The bill limits annual coverage of ABA ($36,000 for children ages 3-9; $20,000 for children ages 9-21). Aetna will continue to monitor the status of these mandates, but it appears fairly clear at this point that something will pass on the issue of autism.

NEW JERSEY: Last week Governor Chris Christie declared a fiscal state of emergency calling a special session of the legislature to lay out his plan for dealing with state’s current $2.2 billion budget shortfall. His plan calls for significant cuts or eliminations across 375 state programs and withholding $500 million of state education aid. Of note on the program side is a $12.6 million reduction in Charity Care funding to hospitals, which pays for care to uninsured residents. In legislative action, the Assembly Financial Institutions and Insurance Committee held a three-hour public hearing on out-of-network reimbursement. Much of the hearing focused on the markedly higher billing practices of ambulatory surgery centers and one non-par hospital. Aetna presented testimony regarding its experience with the non-par hospital, citing their disparate year-over-year increase in charges compared to other similarly situated hospitals. Chairman Schaer indicated the committee will work over the next several months to craft a solution.

NEW YORK: With Democratic Senator Hiram Monserrate officially expelled from the Senate, the Democratic majority (31-30) now faces an uphill battle getting the 32 votes needed to pass legislation. However, both the Senate and the Assembly moved forward with a public hearing on the Executive Budget proposal for health, including the section mandating the prior approval of rate adjustments. The Health Plan Association testified on behalf of the industry. If enacted, Governor Paterson’s proposal for an 85 percent medical loss ratio and a prior approval hearing process for all rate adjustments would essentially amount to government control of health insurance, undermining the private health insurance market in New York. Price controls would weaken health plan solvency, hurt providers and virtually eliminate innovation and efficiency. At the same time, the proposal ignores the underlying cause of the increasing cost of health insurance — the increase in the actual costs of health care services.

OKLAHOMA: The second session of the 52nd Oklahoma Legislature convened in Oklahoma City on February 1. Legislators quickly turned to the state’s $1.3 billion budget deficit described by Governor Brad Henry (D) in his eighth and final state of the state address and FY 2011 executive budget. During his address, the Governor focused on his plans for resolving the $1.3 billion budget deficit through precise budget cuts. 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 affordable health coverage. The legislature is scheduled to adjourn on May 28 but only after addressing a range of legislation including several bills of interest to Aetna.

SOUTH DAKOTA: A dental fee schedule bill (S.B. 108) unanimously passed the Senate Commerce Committee and is expected to be taken up by the full Senate early this week. The bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Aetna will continue to follow the bill’s progress as it progresses.

TENNESSEE: Several bills have been proposed that would make changes to the state’s external review law. Aetna and other industry representatives will be meeting with the Tennessee Department of Commerce and Insurance regarding its proposed changes to the external review law. The bill proposed by the TDCI most closely mirrors the model legislation proposed by the National Association of Insurance Commissioners.

UTAH: The Speaker of the House has introduced a health reform bill addressing health information technology, individual and small group market reforms and transparency. The overarching theme of the reforms is micromanagement of rates and rating factors, and a broadening of the Insurance Commissioner’s authority. The transparency provisions apply plan designs and benefit descriptions submitted by carriers, and would require providers to make available, upon request, a price list for services on both an inpatient and outpatient basis.

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Effective Natural Health & Beauty Products

guzen — Sat, 13 Mar 2010 08:56:21 +0000

All we know well that herbal nutrients are required to support healthy metabolism and maintain functions of our body. Available data indicate that many more vitamins and vitamin-like nutrients are yet to be discovered in herbs today. That is why herbal medicines were used for thousand years to fight diseases and improve body functions. Herbal nutrients have been shown to help heal many maladies, improve general health and specific pathological conditions. Herbs can help fight disease and premature aging, maintain sustainable and enjoyable lifestyle.

Alternative health professionals is a NZ based online shop, offering you the largest range of natural health products, including vitamin supplements. We also offer natural beauty products, herbal medicines and remedies.

At Alternative health professionals you will find information on alternative treatments for mind body and soul within our articles section, and in our online store, you will find naturally good products from aromatherapy supplies to herbal balms and lanolin skincare.

Our all natural herbal supplements are obtained from the herbs proven to be the richest natural sources of specific essential nutrients and are provided in the formulation optimal for assimilation by the body. Herbal antioxidants and essential unsaturated oils are not produced by the body but are required for multiple body functions and promote immunity to keep away diseases.

The essential oils used in aromatherapy are extracted from many parts of the aromatic plant: leaves, stems, flowers, seeds, roots, barks, fruits and resins. The oils are a concentrated form of plant energy possessing the qualities of the particular plant, and are usually many times more potent than the comparable dried herbs.

Now a days mostly people face skin problem. All we have different kind of skin so the treatment must be different. We help you to get the best herbal treatment for your skin. When you start shedding the winter layers of clothing upon spring’s arrival, you will possibly find your skin and scalp are dry and flaky, itchy and uncomfortable. Winter weather dries your skin out. You can bring skin back to a youthful glow by cleansing your body internally and exfoliating and moisturizing your skin.

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Approach Communications to Offer Specialized PR, Communications and Marketing Consultancy Services to Hospitals, Doctors and Healthcare Organizations

guzen — Tue, 23 Feb 2010 08:54:53 +0000

New Delhi:

Approach Healthcare Communications ( www.approachcom.com ) , specialized vertical of India’s leading public relations and marketing communications firm, Approach Communications??will be offering expertise based PR, Media, Healthcare Awareness, Medical Writing, Image Management, Marketing, Branding, Communications, Digital Marketing, Integrated Marketing Communications and other related services to Hospitals, Doctors and other healthcare organizations.

As hospital marketing and communications is a different from other brand and product marketing, the agency has already empanelled professionals from the healthcare industry to offer integrated and knowledge based services to the fast growing sector. Approach Communications expertise in Hospital PR and Marketing services will be a boon for the healthcare, hospital, doctors and other organization who find it difficult to market their services because of the know-how and other constraints. Approach Communications will offer all the marketing, pr and communications services under one roof to hospitals, retail chains, medical devices companies, hospital chains, healthcare facilities, doctors, healthcare professionals and other related sectors.

The fast growing Healthcare Communications and Marketing Agency is also planning to get into HR Consultancy business through its strategic cell which will be looking after the growing need of specialized HR services in Healthcare business. Approach Healthcare is a full-service public relations and marketing communications agency serving the market segment that develops and sells products and services in the healthcare industry. The recently launched division has already some pharma, healthcare, medical devices, hospitals, doctors and other healthcare professionals in its kitty.

Approach Communications is based in New Delhi and already having offices in cities of like Mumbai, Lucknow, Chandigarh, Indore, Ranchi, Dehradun and representatives in all the major cities and towns of India. Approach healthcare Communications is helping healthcare and pharma companies build brand awareness, establish industry expertise, increase sales and improve client retention through strategic, integrated PR and marketing communications services.Approach Healthcare is offering total Media and marketing communications solutions to Pharma, OTC, Herbal, Healthcare and Cosmetics companies in India.

Commenting on the new division, Sonu Tyagi, Director of Approach Communications said “as we have been working with healthcare and pharma industry and seeing the growth in healthcare and hospitals segment, we thought that we should tap the potential available in an organized way. We are already working for corporate clients under Approach Communications brand. Approach Healthcare is a specialized division for healthcare communications and pr services and specialized vertical for hospital PR and marketing is the extension of services in that direction.”

Approach Communications, which is just in 4 year of operations; have already handled leading companies, entertainment and social sector clients. The agency is present in 5 cities of India with its headquarters in Delhi. Agency has handled accounts like Rathi Thermax, U.S.Writopia, SOS Children’s Villages of India, Aaliya Productions, Greentech Foundation, General Motors,{ Regional}, Sutlej Motors Ltd, Malaysian Promotion Council, Handicapped Care Foundation, FMCG International , Jhankar Television, JMD Group among others.

Agency is very excited about future prospects and soon entering in publications in a big way. Agency has already carved a niche in strategic rural communications services and pitching for new clients are already on. Agency has worked across industries like FMCG, Healthcare, Lifestyle, Entertainment and Films. Approach Communications has full fledged operations in Celebrity Management and Below the Line Promotions services as well.

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SHOCK UNCOVERED: Obama IN HIS OWN WORDS admitting his Health Care Plan will ELIMINATE private insurance OBAMA AND THE DEMOCRATS HEATH CARE GOAL IS A PUBLIC OPTION THAT WILL ULTIMATELY ELIMINATE PRIVATE EMPLOYER PROVIDED INSURANCE (Obama SEIU forum on health care 3/24/07, Barney Frank, Jan Schakowsky all admitting a public option will put the private insurance industry out of business) NAKED EMPEROR NEWS (Hat tip to Morgen at Verum Serum for the 2003 clip)

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Do You Need to Obtain a College Health Care Plan?

guzen — Tue, 23 Feb 2010 08:54:38 +0000

Upon graduation from high school, there is no doubt that you will surely start your tertiary education in college or university. At age twenty, children will not be covered by health insurance of their parents and this can be disastrous if they are merely study and do not do part-time job. Some universities or colleges may have insurance plan offered to students. These insurance may not answer all your needs but you need to be meticulously considered it.

Most of the universities and colleges offer student health insurance plans. These plans should absolutely be at reasonable price, and can give you the school’s nearest hospitals. This option is one that you should definitely think of, if your son or daughter is enrolled in a college far away from home.

College health care scheme may vary from college to college due to laws and some other factors. Many students may think medical services are free of charge, but it is not always true. In term of clinic visit or routine checkups they may be free, however students still require to pay for special kinds of lab tests and other specialties such as x-rays, prescriptions, and a wound treatment. Compensation usually covers some types of service stated in the health care offered at college health centre. When you are referred to see an outside doctor, then the coverage will cover only 70% of your total expense and you are at risk to pay high medical cost.

You may have a problem getting treatment at the campus health centre if you have pre-existing condition. Having a pre-existing condition or illness does not mean to prevent you from obtaining health insurance plan, but you may not be eligible to have your treatment on your pre-existing condition. It can be troublesome if your new symptoms develop from a pre-existing one.

Health schemes are different, so be sure you find out everything about your health insurance plans. Be sure that your health plan stretch to summer break when you or your child do not take classes. This is vital for you because you don’t want to find out that your health care does not cover when you need it most. Some college health insurances may not cover during summer break, while others do.

Be certain that you study your plan thoroughly. Is it an HMO, or can the member utilise any service provider they went? This is critical. You need to know where you can go in case of emergency, and there is nothing worse than discovering that you will have to pay off the bill yourself.

There is no definitive solution to whether you should or should not commit yourself to college health insurance. Be certain that you study your plan thoroughly so that it answer to your need when you need it most. Although there is no free health insurance scheme, surely it will save you a lot of money in time of illness or accident.

For more information, please visit http://www.health-care-central.com

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Cooperating In Our Health Care

guzen — Sun, 14 Feb 2010 08:54:43 +0000

Funny thing pain, if you’ve never had a severe pain then the suggestion of taking simple analgesia and resting the affected area all seems quite reasonable. I was reminded of this when I read recently of a doctor’s advice to someone who was suffering from sciatica. Having personally experienced sciatica, it’s a condition I would not recommend to anyone who wishes to walk, sit, laugh, sleep, or to just simply pull up your trousers. It’s a bit like a dentist drilling your teeth without an anaesthetic, but it affects your whole leg. In other words the pain is consuming, exhausting and without respite. Clinical studies do show that in the majority of cases the pain will eventually subside and surgery may not be necessary, but in the meantime the patient has to deal with the pain or deal with the medication required to dull the pain. Remember, pain-killers are not selective to the area affected. They affect the whole of the nervous system and elsewhere so there may be significant side-effects from these medications.

Dealing with severe pain can be a complex issue, but I suggest that you have to treat this sort of pain fairly aggressively as acute severe pain is relatively easier to treat than chronic severe pain. In the early stages of an injury or insult to an area of the body, most of the pathological processes are happening at the site of the injury or insult. Throughout time the brain begins to modulate this pain and so no only do you have the injured area to deal with, but you also have complex neural pathways within the brain to deal with as well. This often means a far more complex management plan and a far more protracted recovery time. Specialists are very skilled at dealing with these issues but they do rely heavily on the stories their patients give them. That means being honest in answering their questions and not being heroic with a grin and bear it grimace! Often the use of a pain scale is helpful with zero being no pain at all and a 10 being the worse pain you have ever experienced.

Another health issue we commonly down play is influenza. Over the years I have frequently heard people say that they would not have the flu vaccine because either they never get the flu or that they had it last week for a couple of days and then it was all over! Influenza is a serious debilitating disease that will usually last from 10 days to two weeks and often leave you flat on your back exhausted. It’s not a happy 10 days either as patients do not have the energy to read a magazine or even watch a DVD. You will literally feel ancient with every movement being a real challenge and that doesn’t include the aching all over or the fevers and sleepless nights. The influenza virus is also extremely contagious and most people are unaware that if you spread it to someone who is more frail than yourself that you may actually be putting their life at risk.

With the ‘flu the big challenge is to vaccinate as many people in the community as possible, including children, those employed and unemployed, the elderly and the infirm, to reduce the chance of an epidemic occurring. Recent research has also showed that vaccinating pregnant women in the last trimester of their pregnancy will help protect their new born infants born during the ‘flu season.

Medicine has evolved over the last 40 years, but the change has been fairly slow with doctors by nature being very cautious and conservative people. But we can’t leave the doctors to take all the initiatives. As patients we need to be good listeners in our approach to health by heeding all the great health messages that keep being given to us about vaccinations, smoking, alcohol, exercise and healthy eating. We also need to be good communicators and tell our doctors how we are feeling with conditions such as pain. If the team treating you doesn’t have the best information then it may be that you will not end up getting the best treatment!

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Weight Loss Diet Program Failure Overcoming Two Leading Problems

guzen — Thu, 21 Jan 2010 08:53:07 +0000

A large number of people around the world are overweight. Most of them have been following different programs that would help them to lose weight but they were not successful. If you ask any person for the reasons of their failure, one way or the other they will give you the following two problems:

1. They could not follow the program.

2. They lost some weight but could not maintain it.

These two problems are the biggest ones that most people face but this does not mean that they are the only ones. Both of these problems are related to the human mind and not human body. Your exercise plan or diet has got nothing to do with the failure. The main cause of this failure is the mind state of a human being; he is expected to follow the program with consistency which for some people is not possible. Another reason for this failure is the conflict between a person’s unconscious and conscious state of mind. These two are the reasons due to which a person fails to lose his or her weight. If you are not prepared then nothing can help you get the required results.

The only solution to this problem is to change the entire life style of a person. This will help his sub-conscious mind to accept it and he will be able to follow the plan with more consistency. This shift will solve all the problems and the person will adapt to the new settings. Now this will be more of an adopted life style than a forced on. Now the person will follow the whole diet and exercise program without any trouble. There are numerous advance mind trainings that can help you achieve this state of mind, magically slim being one of them. With the required mind state in place a person will easily follow all the weight loss programs and will be able to maintain it for a long period of time.

With the mind state in place you will need to find yourself a good diet and exercise plan. You can only lose your weight if you are able to burn more calories than you take in. For this reason you need to have a good diet plan. You can ask a doctor to tell you about healthy foods with low calories or you can ask your friends who are already following a plan. You can also use the internet yourself and then evaluate the food items. This way you can eat what you want and you will know how much calories it contains. With your diet plan in place it’s time to get yourself a good exercise plan. You can go for some basic exercises or advanced exercise but this depends on your level of experience. You can buy the necessary equipment or join a gym for this reason. You also have another option! If you don’t want to follow exercises then you can go out for walking, cycling, swimming or running. They don’t require any specialized equipment so they are much easier to adopt.

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David Elmore Smith was 630 pounds when he met Chris Powell in June of 2003. They made a pact to show the nation that the human body can lose weight safely and naturally. Using alternating patterns of nutrition delivery, daily movement and new lifestyle patterns, David lost a remarkable 401 lbs in just over 2 years. He is now a personal trainer and in the best shape of his life. This is the story of their journey…

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My-Health-Insurance-Info

guzen — Wed, 13 Jan 2010 08:52:34 +0000

My-Health-Isurance.Info

For more info please visit p://my-health-insurance-info.blogspot.com/”>XTRA INFO-Health Articles

Universities usually offer students some type special health insurance benefits that are slightly less expensive and more appropriate for a young, healthy student’s needs than more expensive commercial insurance plans. Many student work while in school and also may be able to get insurance though their employer for a reduced group rate that will cover more for their money. But for the student who does not work or live at home, insurance options can be tough. If the student has no qualifying dependents, they may not be able to qualify for public assisted health benefits. They would have to rely on the school’s health plan or go to a local clinic that pro-rates the cost of care. If you are an international student, you must have complete medical coverage before attending the college of your choice.

The student benefits cover basic health insurance for all students enrolled in 11.5 credit hours per semester automatically. If you have less than 11.5, you will have to purchase the plan for a small fee. Graduate students and teaching assistants get a different type or health insurance package from the school. They have the option of having their health care benefits through an HMO or through a comprehensive type group such as Blue Cross/Blue Shield. With the HMO plan you will pay a monthly fee from your paycheck or a yearly cost that will part of your tuition. That will allow you to receive care at a low fee co-pay option. It also gives you the ability to have extra coverage in case of emergencies or referral to specialists. With the comprehensive plan, you will go to a pre-approved doctor, pay him or her, and then submit your bill or receipt of payment to the insurance company for reimbursement. You will need to take to your particular school to see what benefits are available, who is eligible, and at what cost.

All eligible students are covered by the basic student plan, but many are still either on their parent’s policy, have work related insurance, or are on a spouses plan. The basic plan is additional coverage beyond any other insurance you have. This means that if you have other health insurance coverage you submit medical bills to those companies first for payment. The Student Health Service strongly recommends having additional insurance in the event of a major illness or injury. The basic coverage doesn’t cover emergency or hospital treatments, nor does it allow you to see any doctor off campus in most cases. Students having basic insurance are entitled to receive their health care at the student health centers on campus only. So any other medical need will come out of the students pocket. The coverage of a student health plan begins on the first day of the semester you are enrolled and ends the day the semester closes. During school and semester breaks, with the exception of scheduled school vacations, you will not be covered until the next semester begins. Depending on your individual school, the dates can vary.

The maximum benefit coverage for the basic student health plan is for expenses incurred due to injury as long as treatment was received with in 90 days up to $5000 per injury. The maximum benefit coverage for sickness is $5,000, provided that treatment is received within 12 months from the date of the first treatment for the sickness. If you need to go to the hospital most basic plans will cover up to $5000 for your treatment and stay. Anything accrued above and beyond, including out patient treatments after discharge will be your sole responsibility. The maximum per illness or injury is $5000 no matter what type of treatment and how long you need it for. This is why it is very much recommended to have some alternative form of insurance such as short-term if a regular policy is too expensive. Most universities also offer two major medical plans for student who would like more coverage than the basic plan in case of serious illness or injury that exceeds the $5000 cap. You can choose between a $50,000 or $100,000 maximum benefit for a cost that will be included in your tuition each year. Once you have exceeded the $5000 cap you will be responsible for a deductible of some kind, usually $250-$500. After that the major health plan will pick up 80% of the medical bills till the cap is met or you are done treatment, which ever happens first.

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Health Insurance Info

guzen — Tue, 05 Jan 2010 08:52:38 +0000

Health Insurance Info

Our website provide a few information and advice on the topics of Health and Medical Insurance.

We hope you enjoy our range of informative of the Health and Medical Insuranc articles, topics and latest news. Whether you are doing specific research on this subject, or looking for content for your ezine or websites, you have come to the right place.

1. Five Tips to Trim your Medical Expenses and Save

With the rising cost of healthcare, medications, and insurance, it isn’t surprising that people are trying to figure out ways to avoid getting sick and choosing a better lifestyle to lower insurance costs. There is actually quite a bit one can do to help save same cash. It is just a matter of tweaking ones lifestyle choices and preventing health issues from arising or keeping the immune system up so you just don’t get as sick as much. For those people who are seriously sick of high medical premiums and paying out the nose year round for doctor’s visits and medications, this should be a great thing. Small things make a world of difference when it comes to your health.

a) Stop smoking is the biggest one. Not only do you get sicker than the average person, it is worse. Many smokers are treated for several bouts of bronchitis and pneumonia each year. Smoking also makes you susceptible to colds and other infection. You will also pay a higher premium on your insurance and in some cases won’t get covered in full for cigarette related illnesses or diseases. Plus the money you save from quitting can go to bigger and better things than your medical issues.

2. How to Get a Group Health Insurance Rate as an Individual

Most individuals can get really good group rates through their employers. As long as your place of business has more than 50 employees and actually offers a medical plan, you should get a pretty good deal. The overall cost is based on how many of the employees actually have the insurance plan. The more people who are signed up, the cheaper the plan will be. Most people will choose this over going with a private plan any day because it is so much more cost friendly. That is one of the first things you should be looking for when seeking a job, whether or not they offer insurance benefits or not. At your interview ask to see their healthcare providers plan and rates. If they will let you take it home. This way you can see if the plan offers what you want and at a price you can afford. There are some private insurance companies that have reduced individual rates that are comparable to group ones.

3. Five Ways to Cut your Health Insurance Costs

Nearly one-third of all health-insurance premiums increased to 30 percent or more. At that rate, the average cost of health insurance per employee will exceed $3,000. Seventy-three percent of senior executives believe health-care costs will continue to increase 20 percent or more each year for the next three years. The message here is clear: If you haven’t already gotten serious about cutting your company’s health-insurance costs, now is the time. It can be done. The first thing you should do is learn how the system works–or doesn’t work. Most small employers spend fewer than four hours a year thinking about their company health plans. Learn what your options are. Your insurance agent can help you shop for cheaper plans. But don’t stop there. Compare plan benefits, insurance-company records, and service guarantees.

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