Tagged: Blue Cross Blue Shield

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.

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.

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.

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.

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,