Blue Cross Blue Shield

Bill Schuette for Michigan Attorney General

Michigan’s attorney general says state lawmakers must add more safeguards for seniors to legislation that would overhaul Blue Cross Blue Shield of Michigan.

Bill Schuette testified Monday before the House Insurance Committee.

Schuette said bills passed last month by the Senate did not do enough to make sure Blue Cross continues to offer Medigap plans to seniors.

The program covers costs that Medicare doesn’t.

The attorney general said the proposal would drastically cut funding for Medigap, and only requires Blue Cross to offer it through 2016.

“I think the last thing we want is to have skyrocketing Medigap rates, or Medigap disappear altogether,” Schuette said.

Blue Cross officials say the measure gives seniors plenty of time to switch to more comprehensive and affordable plans.

The legislation would end Blue Cross’ tax exempt status. In return, the state would have less oversight of the Michigan’s largest health insurer.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

Hearings on overhauling Michigan’s biggest health insurance provider continue today in Lansing.

Critics and competitors say other insurers have been forced to subsidize Blue Cross because the company negotiated contracts with many hospitals requiring them to accept payments lower than what they offer any other insurance company.

The practice led to anti-trust lawsuits and an order by the state insurance commissioner banning what’s called “most favored nation” clauses without his prior approval.

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In health news. . .

Officials with Blue Cross Blue Shield of Michigan say the state Legislature must pass bills to overhaul the health insurer by the end of the year. Under the measures, Blue Cross would become a customer-owned non-profit, and would have to pay state and local taxes. The Lansing State Journal reports,

Even though it would lose its tax-exempt status, Blue Cross says the change in classification — and the lower government regulation that goes with it — is essential for it to be able to compete with other insurers under the Affordable Care Act.Under federal law, Blue Cross must have its products and rates ready by March for an online health exchange where people can compare and buy their own insurance plans, but the organization won’t make it because of the way it’s currently regulated by the state.

Meanwhile, as Rick Pluta reports, "Michigan is unlikely to meet a Friday deadline to tell the Obama administration if it will create a statewide online exchange for people to shop for health insurance. The alternative is for Michigan to become part of a federally managed exchange."

Tribe asks federal court to dismiss lawsuit to block Lansing casino

"A federal judge is being asked to dismiss a lawsuit aimed at stopping plans for a casino in downtown Lansing. The Sault Sainte Marie Tribe of Chippewa Indians delivered its response this week to the lawsuit filed by Michigan’s Attorney General in September.  The lawsuit claims the casino project violates federal law as well as a gaming compact between the state and the tribe. The tribe says that’s not true. The tribe wants to resolve this legal challenge before asking the federal government to take the land around Lansing’s convention center into trust.   The land must fall into trust…before the tribe can begin construction of its casino," Steve Carmody reports.

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Blue Cross overhaul on the "lame duck" agenda

"Lawmakers in Lansing say they want to tackle some high-profile bills before this session wraps up at the end of the year. The state House is set to hold its first hearing Tuesday on a proposed overhaul of Blue Cross Blue Shield of Michigan. The measure would turn the state’s largest health insurer into a customer-owned non-profit, and end its tax-exempt status. Nothing is certain, but other items on the “lame duck” agenda could include a repeal of the personal property tax on businesses, legislation to fund roads projects, and a bill to replace the emergency manager law that voters rejected in last week’s election," Jake Neher reports.

Michigan Congressman Mike Rogers possible choice to head up CIA

"Media reports suggest Michigan congressman Mike Rogers could be on a short list of candidates to be the next director of the Central Intelligence Agency. David Petraeus’ abrupt resignation last week opened up the CIA director’s job. Multiple media outlets including the New York Times say Rogers is among those being considered to fill the post. Washington observers say Rogers, a Republican, could speed through the confirmation process. Rogers has been the chairman of the House permanent select committee on Intelligence since January of 2011. Rogers has not commented on the speculation," Steve Carmody reports.

New international bridge could be up and running in 5 years

"Governor Snyder's office and top Canadian officials are getting more information out about a proposed bridge between Detroit and Windsor. Lieutenant Governor Brian Calley and the Canadian Consul General spoke to a group in Grand Rapids about the bridge deal Monday. Calley says trucks could be crossing a new bridge as soon as 2017. Right now the bridge is awaiting permits from the US government," Lindsey Smith reports.

Lester Graham / Michigan Radio

Lawmakers in Lansing say they want to tackle some high-profile bills before this session wraps up at the end of the year.

The state House is set to hold its first hearing tomorrow on a proposed overhaul of Blue Cross Blue Shield of Michigan.

The measure would turn the state’s largest health insurer into a customer-owned non-profit and end its tax-exempt status.

House Insurance Committee Chair Pete Lund expects the chamber to pass some version of the bill before the end of the year.

A week from now, the election will be over, we’ll have more or less digested what happened, and go back to contemplating the other daily dilemmas of life in our state.

There’s the issue of Blue Cross Blue Shield of Michigan, which wants to move from being a tightly regulated charity to being a normal non-profit, with much more freedom to do what it wants, and less responsibility to provide coverage for the uninsured.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

Former state Attorney General Mike Cox says Blue Cross Blue Shield of Michigan illegally denies seniors access to certain plans.

Cox filed a class action lawsuit Wednesday against the state’s largest health insurer.

It claims Blue Cross denies access to its most popular Medigap plan to anyone with a retiree health savings account. Medigap is a program that covers healthcare costs that Medicare does not.

Cox said the policy unfairly forces some customers to buy more expensive plans.

cncphotos / flickr

This week Morning Edition host Christina Shockley talked with Michigan Radio's political analyst about the legislation to overhaul Blue Cross Blue Shield of Michigan, results of a poll that looks at where Michiganders stand when it comes to the six ballot proposals voters will see in the next three weeks and the bankruptcy of U.S. operation of electric car battery maker, A123 Systems.

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Blue Cross Blue Shield overhaul passes Senate

"Legislation to overhaul Blue Cross Blue Shield of Michigan easily passed the state Senate Wednesday. The bills would turn the state’s largest health insurer into a customer-owned non-profit. Only four Senators voted against the package," Jake Neher reports.

Michigan's unemployment rates drops for the first time in 6 months

"Michigan’s jobless rate declined very slightly in September to nine-point-three percent. It’s the first drop in the state’s unemployment rate in six months. The rate is also a full percentage point below where it was at this time last year. The rate of unemployment and under-employment in Michigan is 17 percent. That number takes into account people who have quit looking for work, and part-timers who’d like full-time jobs," Rick Pluta reports.

Lawsuit claims flaws in Michigan's parole system

"A lawsuit filed this week alleges the state Department of Corrections has been too lax in supervising roughly 18 thousand paroled felons in Michigan. The lawsuit was first reported by The Detroit Free Press. It was filed by the family of an elderly Royal Oak woman who was murdered in her home. Two fugitives on parole have been charged with the killing," Rick Pluta reports.

Blue Cross Blue Shield building on Lafayette in Detroit.
Mikerussell / wikimedia commons

LANSING, Mich. (AP) — The Michigan Senate has approved a Blue Cross Blue Shield of Michigan overhaul that supporters say levels the playing field among health insurers and critics argue doesn't adequately protect elderly and vulnerable residents.

The Senate passed the legislation Wednesday. The House is expected to consider it when the chamber returns after the November election.

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Schuette cautious about Blue Cross-Blue Shield overhaul

"Hearings continue at the state Capitol on the future of Blue Cross-Blue Shield of Michigan. Attorney General Bill Schuette showed up to urge a cautious approach to overhauling the state’s largest health insurer. The attorney general would give up a considerable amount of oversight under the plan proposed by Governor Rick Snyder. It would convert Blue Cross from a tax-exempt charity to a member-owned not-for-profit company. Bill Schuette says he wants Blue Cross and its assets audited to make sure this is a fair deal for Michiganders. Schuette says he’s not out to stop the changes. Governor Snyder and Blue Cross executives want the switch done by the end of the year. They say the changes are needed because the new federal health care law will change the mission of the Blues," Rick Pluta reports.

More on the EM saga

The debate over emergency managers and emergency financial managers has been heating up. The Michigan Supreme Court last month ruled a union-backed referendum to repeal the law could go on the ballot. "The leader of the Michigan Senate says he and fellow Republican colleagues are armed with a proposal to replace the state law that lets emergency managers take over local governments in case voters strike it down in November. Senate Majority Leader Randy Richardville told The Associated Press yesterday that a draft is under legal review. The behind-the-scenes effort aims to keep a form of the contentious law on the books. Richardville says it acknowledges some concerns by critics, who say it takes too much power from local leaders struggling with budget deficits," the AP reports.

Trying to uncover death of former Teamsters boss

The Department of Environment Equality work to uncover the death of a former Teamsters boss.  "Soil samples will be taken from beneath a Detroit-area driveway in the search for the body of former Teamsters boss Jimmy Hoffa. The Department of Environmental Equality plans to start its work this morning in Roseville. Authorities are investigating a man's claim that he saw a body buried under the driveway 35 years ago," the AP reports.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

There was another day of hearings yesterday on Governor Rick Snyder’s proposed overhaul of Blue Cross-Blue Shield of Michigan.

Other insurance companies say any reforms should make it easier for them to compete with the Blues.

Other insurers have long complained about their inability to win a bigger piece of Michigan’s insurance marketplace. Blue Cross covers four million Michiganders.

Rick Murdock is with the Michigan Association of Health Plans. It’s an organization of 15 for-profit insurers that compete with Blue Cross.

"There’s no disputing the fact that Blue Cross-Blue Shield has 70 percent of Michigan’s commercial insurance market – a monopoly by any definition," said Murdock.

A Blue Cross representative said the proposal will create more competition, and Blue Cross will, for the first time, pay taxes. But he also said the Blues’ marketplace advantage comes from being a not-for-profit company not focused on maximizing profits, and that would not change under this overhaul.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

State Senate hearings began today on a proposed overhaul of Blue Cross Blue Shield of Michigan.

The plan calls for Blue Cross to become a customer-owned not-for-profit corporation that’s regulated just like other insurance companies.

Right now, Blue Cross has to accept all applicants, regardless of their health. Starting in 2014, the Blues’ role as “insurer of last resort” will become unnecessary. Due to the federal healthcare law, insurance companies will no longer be able to reject people because of their health conditions.

Photo courtesy of the Snyder Administration

This week on It's Just Politics it’s all about the Blues. Blue Cross Blue Shield, that is. BCBS is, by far, the state’s largest health insurance company. It’s also a state government creation; created by state law. It has its own law, separate from all other insurance companies because it is Michigan’s “insurer of last resort,” meaning that Blue Cross has to take everyone who applies. Its mission: to make sure everyone who wants or needs health insurance in Michigan can get it.

Steve Carmody / Michigan Radio

On Thursdays we talk Michigan politics with Susan Demas, political analyst for Michigan Information and Research Service, and Ken Sikkema, former Senate Majority Leader and senior policy fellow at Public Sector Consultants.

This week, Governor Snyder proposed changes to how Blue Cross-Blue Shield, the state’s largest health insurance provider, will operate.  Plus, legislation that would help Detroit and other cities provide street lighting seems dead, at least for now.

Whatever else you think about Governor Rick Snyder, you can’t say he has failed to be bold. He has made or tried to make some stunning changes in the way Michigan works in a little over a year and a half in office. Yesterday, he did it again.

He unveiled a plan to dramatically change the health insurance landscape in Michigan by changing the way Blue Cross/Blue shield does business. He would convert it from its current official status as a charity to a nonprofit mutual company over the next fifteen months.

cnc photos / flickr

Every Wednesday Morning Edition host Christina Shockley and Michigan Radio's political analyst Jack Lessenberry talk about the latest in Michigan politics. This week they talk about updates to emergency financial managers in Allen Park and Flint, the future of Belle Isle and the proposed overhaul to Blue Cross Blue Shield of Michigan.

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Snyder proposes Blue Cross overhaul

"Governor Rick Snyder has proposed an overhaul of the rules covering Blue Cross-Blue Shield of Michigan. It calls for Blue Cross to become a customer-owned not-for-profit insurance company. Blue Cross would have to pay taxes adding up to $100 million a year or more, but it would be better able to shield its rate-setting decisions from competitors. One of the biggest changes under the federal law is insurance companies can no longer reject applicants based on their health history. Right now, Blue Cross is the only insurance company in Michigan that has to accept all applicants, regardless of their age or health history.  For-profit insurance companies say they want the overhaul to make it easier for them to challenge Blue Cross’s market dominance," Rick Pluta reports.

The future of Belle Isle

"Gov. Rick Snyder and Detroit Mayor Dave Bing have called a news conference Wednesday on the future of Belle Isle park, a tattered green gem that has been subject of a city-state power struggle. Proposals for a Michigan takeover of the under-maintained 985-acre park have met fierce opposition from some local officials who call it a state power grab. Michigan promises park improvements under an agreement between Snyder and Bing that staved off a state takeover of Detroit, struggling with a chronic budget deficit. The agreement says Belle Isle will operate "as part of a cooperative relationship with Milliken State Park" along the Detroit River," the AP reports.

Veterans' courts

"On the 11th anniversary of the 9/11 terrorist attacks, state lawmakers pushed forward a plan to give veterans a better shot to stay out of jail if they commit a non-violent crime. The state Senate unanimously passed two bills establishing a framework for creating veterans courts. They offer judges the option to send veterans to rehabilitation programs instead of jail. There are a number of similar courts in Michigan already. The measures passed unanimously in the House in May. They now go to Governor Snyder’s desk," Jordan Wyant reports.

Michigan Gov. Rick Snyder.
Governor Snyder's office / State of Michigan

Update 5:30 p.m.

Governor Rick Snyder has proposed an overhaul of the rules covering Blue Cross-Blue Shield of Michigan. Blue Cross would have to pay taxes adding up to $100 million a year or more.

But the company could also make changes to its rates a lot more quickly and easily. That would help it compete for business.
    
Andy Hetzel is a vice president at Blue Cross. He says the new federal health care law is changing the insurance marketplace and Michigan needs to keep up.

Gabriela Camerotti / Flikr

Patients with heart disease should ask their doctors more questions before undergoing elective heart procedures.

That's according to a study by the Center for Healthcare Research and Transformation at the University of Michigan and Blue Cross/Blue Shield.
 
Marianne Udow-Phillips is Director of the Center and lead author of the study.   

She says whether or not Blue Cross/Blue Shield patients in the study underwent elective heart procedures depended more on where they received their care compared to whether or not it may have been the best option.

"We do believe that most of the use of these services is really more driven by physician preferences than patient preferences," said Udow-Phillips. "Patients do need to be more involved; they need to ask more questions of their physicians before they have a catheterization procedure.  There does need to be a better dialogue between physicians and patients."

The overall rate of these procedures have declined by 19-percent between 1997 and 2008.

An Ottawa County Circuit Court judge is ordering Blue Cross Blue Shield to pay the City of Holland $1.6 million. Holland is one of dozens of communities that sued Blue Cross over variable fees charged on insurance claims filed by employees.  The city claims the insurer didn’t tell them about the fees for 17 years.

Blue Cross Blue Shield spokesperson Helen Stojic says the fees were not hidden.“As the lawsuit proceeds to the appellate courts we’re confident that the legal process will result in a finding that our access fee were known to our customers,” Stojic said.

Beaumont Health System

Blue Cross-Blue Shield of Michigan has reached a five-year deal with Beaumont Health System that will increase reimbursements to the hospital. It also includes a new performance-based payment model.

The health system had threatened to stop accepting patients covered by the Blues’ HMO, Blue Care Network,  starting next Thursday. 

"It was very unfortunate but the good news is that we’ve rescinded that now, and BCN members will not have gone one day without their services being covered at Beaumont and we think that’s a very positive outcome,"  said Beaumont CFO Nick Vitale.

Officials on both sides say the deal will better coordinate care by establishing programs that avoid unnecessary tests "to make sure that the primary care physicians are speaking to the specialists who are speaking to the hospitals to make sure that if there’s a test performed that it’s only performed once," said BCBSM vice president Sue Barkell.

The five-year contract will boost reimbursements to the hospital. But the two sides would not disclose what the rate increase will be.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

LANSING, Mich. (AP) - Michigan Attorney General Bill Schuette says his office is reviewing Blue Cross Blue Shield of Michigan's plans for a joint venture involving a Medicaid coverage company.

The Detroit-based Blue Cross and Philadelphia-based Independence Blue Cross are purchasing AmeriHealth Mercy, which has Medicaid managed-care contracts in states including Pennsylvania, Indiana, and South Carolina.

Schuette said Friday he wants the Michigan-based Blue Cross to provide his office with documentation related to the transaction.

Blue Cross officials said they welcome the inquiry and will work with him to clarify questions about the transaction.

The joint venture could provide an opportunity for Blues insurers nationwide to expand into Medicaid coverage just as states are seeking ways to save money in the program and the ranks of Medicaid enrollees is poised to grow.

Blue Cross/Blue Shield of Michigan is expanding its involvement in Medicaid coverage.  Blue Cross/Blue Shield of Michigan joined a Pennsylvania Blue Cross to buy up a Medicaid health care plan based in Philadelphia.  Amerihealth Mercy ser

Holland is the latest city in Michigan planning to file a lawsuit against Blue Cross Blue Shield over variable fees. The fee is a 13.5% administrative access fee Blue Cross charged the city on any insurance claims filed by employees.  The city claims the insurer didn’t tell them about the fees for 17 years.

Holland Mayor Kurt Dykstra says,

Steve Carmody / Michigan Radio

 Federal and state prosecutors are suing Blue Cross/Blue Shield of Michigan.

 The non-profit health insurance company is accused of violating anti-trust laws. 

When Blue Cross/Blue Shield of Michigan negotiates a contract with a hospital, it includes a provision giving it a discounted rate compared to other health insurance companies. 

Blue Cross insists that allows it to provide its members with discounted hospital stays.    But the US Justice Department and Michigan’s Attorney General’s office disagree.

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