Mary Ellen Schneider

Stroke More Common in Kids?

The rate of childhood stroke in a managed care plan was 2.4 per 100,000 person years, two to four times as high as past estimates, according to an analysis of imaging studies and diagnostic coding. The previous underestimates relied on diagnostic coding alone, researchers from the University of California, San Francisco, wrote online (Stroke 2009 Sept. 17 [doi: 10.1161/strokeaha.109.564633]). The team analyzed the medical records of just over 2 million children aged 19 years or younger who were enrolled in the Kaiser Permanente managed care plan in Northern California from 1993 to 2003. Stroke cases were confirmed through chart reviews by neurologists. They found that radiology was significantly more sensitive (83%) than was diagnostic coding (39%).

State's Epilepsy Foundation Closes

The economic slowdown forced the Epilepsy Foundation of South Carolina to shut down at the end of October, said officials of the national organization. They cited a drop in the chapter's corporate and individual donations and the loss of its annual state funding. Following the closing, calls to the South Carolina office were redirected to the national Epilepsy Foundation. “The national Epilepsy Foundation will cooperate with local volunteers now and in the future to reestablish a presence in South Carolina that will support people with epilepsy,” Gary Berg, vice-president of affiliate relations for the Epilepsy Foundation, said in a statement. The organization estimates that about 65,000 people with epilepsy live in South Carolina.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. The grants, which were announced at a press conference by President Obama, come from the American Recovery and Reinvestment Act that was passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. For example, the NIH will expand the Cancer Genome Atlas so that it eventually sequences DNA from 20,000 tissue samples and 20 types of cancer. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease the prevalence of obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, according to the department.

Stroke More Common in Kids?

The rate of childhood stroke in a managed care plan was 2.4 per 100,000 person years, two to four times as high as past estimates, according to an analysis of imaging studies and diagnostic coding. The previous underestimates relied on diagnostic coding alone, researchers from the University of California, San Francisco, wrote online (Stroke 2009 Sept. 17 [doi: 10.1161/strokeaha.109.564633]). The team analyzed the medical records of just over 2 million children aged 19 years or younger who were enrolled in the Kaiser Permanente managed care plan in Northern California from 1993 to 2003. Stroke cases were confirmed through chart reviews by neurologists. They found that radiology was significantly more sensitive (83%) than was diagnostic coding (39%).

State's Epilepsy Foundation Closes

The economic slowdown forced the Epilepsy Foundation of South Carolina to shut down at the end of October, said officials of the national organization. They cited a drop in the chapter's corporate and individual donations and the loss of its annual state funding. Following the closing, calls to the South Carolina office were redirected to the national Epilepsy Foundation. “The national Epilepsy Foundation will cooperate with local volunteers now and in the future to reestablish a presence in South Carolina that will support people with epilepsy,” Gary Berg, vice-president of affiliate relations for the Epilepsy Foundation, said in a statement. The organization estimates that about 65,000 people with epilepsy live in South Carolina.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. The grants, which were announced at a press conference by President Obama, come from the American Recovery and Reinvestment Act that was passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. For example, the NIH will expand the Cancer Genome Atlas so that it eventually sequences DNA from 20,000 tissue samples and 20 types of cancer. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease the prevalence of obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, according to the department.

Stroke More Common in Kids?

The rate of childhood stroke in a managed care plan was 2.4 per 100,000 person years, two to four times as high as past estimates, according to an analysis of imaging studies and diagnostic coding. The previous underestimates relied on diagnostic coding alone, researchers from the University of California, San Francisco, wrote online (Stroke 2009 Sept. 17 [doi: 10.1161/strokeaha.109.564633]). The team analyzed the medical records of just over 2 million children aged 19 years or younger who were enrolled in the Kaiser Permanente managed care plan in Northern California from 1993 to 2003. Stroke cases were confirmed through chart reviews by neurologists. They found that radiology was significantly more sensitive (83%) than was diagnostic coding (39%).

State's Epilepsy Foundation Closes

The economic slowdown forced the Epilepsy Foundation of South Carolina to shut down at the end of October, said officials of the national organization. They cited a drop in the chapter's corporate and individual donations and the loss of its annual state funding. Following the closing, calls to the South Carolina office were redirected to the national Epilepsy Foundation. “The national Epilepsy Foundation will cooperate with local volunteers now and in the future to reestablish a presence in South Carolina that will support people with epilepsy,” Gary Berg, vice-president of affiliate relations for the Epilepsy Foundation, said in a statement. The organization estimates that about 65,000 people with epilepsy live in South Carolina.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. The grants, which were announced at a press conference by President Obama, come from the American Recovery and Reinvestment Act that was passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. For example, the NIH will expand the Cancer Genome Atlas so that it eventually sequences DNA from 20,000 tissue samples and 20 types of cancer. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease the prevalence of obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, according to the department.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Bill Would Boost Bone Health Efforts

Proposed federal legislation aims to create a national strategy against osteoporosis and other bone diseases. The Bone Health Promotion and Research Act (H.R. 3856) would expand research on osteoporosis at the National Institutes of Health, fund states' surveillance of bone conditions, and increase education activities at the Centers for Disease Control and Prevention. The chief sponsors of the bill are Rep. Shelley Berkley (D-Nev.), who was diagnosed with osteoporosis more than a decade ago, and Rep. Michael C. Burgess (R-Tex.), a physician who has treated patients with that condition. “Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars,” Rep. Burgess said in a statement. “The more we can do to promote and encourage education, awareness, research, and prevention, the better.”

Call for Better Lupus Research

Federal agencies need to work closely with researchers, industry, and patient advocates to overcome barriers that have stymied new lupus treatments for decades, according to a new report commissioned by the Lupus Foundation of America. After a 9-month study, the Lewin Group advised researchers to work with the National Institutes of Health to create an agenda for drug development in lupus. Scientists also need to improve clinical trials' selection of participants, end points, and use of background medications and placebos, the report said. “The recommendations are a call to action requiring the efforts of all key stakeholders,” Sandra C. Raymond, the foundation's president and CEO, said in a statement.

Everywhere, RH Work Challenges

In a recent worldwide survey, more than half of people with rheumatic diseases said that having a supportive boss and coworkers is the key to performing well in the workplace, with flexible working hours also ranking high. The online survey was commissioned by the European League Against Rheumatism (EULAR). The survey included responses from 2,500 people with rheumatic disease, as well as health care providers and employers, in 79 countries. Nearly 70% of employers said that understanding the needs of patients with rheumatic diseases is a challenge, and only about a third of patients said that changes had been made to accommodate them at their workplaces. “We know that workers diagnosed with arthritis leave their jobs earlier than those without arthritis,” Dr. John H. Klippel, president and CEO of the Arthritis Foundation, said in a statement. “Given the recession, any viable health care reform platform must ensure that our valuable workers stay healthy and stay on the job.”

Noted Researcher Shulman Dies

Dr. Lawrence E. Shulman, the first director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, died last month. He was 90. Dr. Shulman served as director of NIAMS from 1986 to 1994 and was known as a strong supporter of research into women's and minority health issues during his tenure. In 1974, he discovered and described eosinophilic fasciitis, the connective tissue disorder now known as Shulman's syndrome. Dr. Shulman served as president of the American Rheumatism Association, which is now the American College of Rheumatology, and was president of the Pan-American League Against Rheumatism. “We at NIAMS will always be indebted to Dr. Shulman for his tremendous vision and dedication to the institute and its public health mission, and he will be greatly missed by his many friends and colleagues,” Dr. Stephen Katz, NIAMS director, said in a statement.

Middle Aged, Elders Are Bingeing

Findings from a survey of 11,000 adults aged 50 years or older have demonstrated that binge drinking of alcohol is common. In all, 14% of men and 3% of women older than age 65 years reported having five or more drinks in a day within the past 30 days. Among 50- to 64-year-old adults, binge drinking was reported by 23% of men and 9% of women. In the study, published online in the American Journal of Psychiatry (doi:10.1176/appi.ajp.2009. 09010016), the researchers analyzed data from the 2005 and 2006 installments of the National Survey on Drug Use and Health. Binge drinking in the over-50 male cohort was associated with higher income and being separated, divorced, or widowed. In both men and women, bingeing tracked with the use of tobacco and illicit drugs. The authors reported that binge drinking was not typically associated with psychological stress, so it might not be detected by typical alcohol screens. “Clinicians who work with this age group would be well advised to ask specifically about binge drinking,” coauthor Dr. Dan G. Blazer of Duke University, Durham, N.C., said in a statement.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its yearly practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008. Practices trimmed their expenses mostly by cutting support-staff costs. However, total worker count remained unchanged over the study period, suggesting that medical practices may have eliminated raises and bonuses or even cut pay to avoid laying off employees, the MGMA said.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Bill Would Boost Bone Health Efforts

Proposed federal legislation aims to create a national strategy against osteoporosis and other bone diseases. The Bone Health Promotion and Research Act (H.R. 3856) would expand research on osteoporosis at the National Institutes of Health, fund states' surveillance of bone conditions, and increase education activities at the Centers for Disease Control and Prevention. The chief sponsors of the bill are Rep. Shelley Berkley (D-Nev.), who was diagnosed with osteoporosis more than a decade ago, and Rep. Michael C. Burgess (R-Tex.), a physician who has treated patients with that condition. “Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars,” Rep. Burgess said in a statement. “The more we can do to promote and encourage education, awareness, research, and prevention, the better.”

Call for Better Lupus Research

Federal agencies need to work closely with researchers, industry, and patient advocates to overcome barriers that have stymied new lupus treatments for decades, according to a new report commissioned by the Lupus Foundation of America. After a 9-month study, the Lewin Group advised researchers to work with the National Institutes of Health to create an agenda for drug development in lupus. Scientists also need to improve clinical trials' selection of participants, end points, and use of background medications and placebos, the report said. “The recommendations are a call to action requiring the efforts of all key stakeholders,” Sandra C. Raymond, the foundation's president and CEO, said in a statement.

Everywhere, RH Work Challenges

In a recent worldwide survey, more than half of people with rheumatic diseases said that having a supportive boss and coworkers is the key to performing well in the workplace, with flexible working hours also ranking high. The online survey was commissioned by the European League Against Rheumatism (EULAR). The survey included responses from 2,500 people with rheumatic disease, as well as health care providers and employers, in 79 countries. Nearly 70% of employers said that understanding the needs of patients with rheumatic diseases is a challenge, and only about a third of patients said that changes had been made to accommodate them at their workplaces. “We know that workers diagnosed with arthritis leave their jobs earlier than those without arthritis,” Dr. John H. Klippel, president and CEO of the Arthritis Foundation, said in a statement. “Given the recession, any viable health care reform platform must ensure that our valuable workers stay healthy and stay on the job.”

Noted Researcher Shulman Dies

Dr. Lawrence E. Shulman, the first director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, died last month. He was 90. Dr. Shulman served as director of NIAMS from 1986 to 1994 and was known as a strong supporter of research into women's and minority health issues during his tenure. In 1974, he discovered and described eosinophilic fasciitis, the connective tissue disorder now known as Shulman's syndrome. Dr. Shulman served as president of the American Rheumatism Association, which is now the American College of Rheumatology, and was president of the Pan-American League Against Rheumatism. “We at NIAMS will always be indebted to Dr. Shulman for his tremendous vision and dedication to the institute and its public health mission, and he will be greatly missed by his many friends and colleagues,” Dr. Stephen Katz, NIAMS director, said in a statement.

Middle Aged, Elders Are Bingeing

Findings from a survey of 11,000 adults aged 50 years or older have demonstrated that binge drinking of alcohol is common. In all, 14% of men and 3% of women older than age 65 years reported having five or more drinks in a day within the past 30 days. Among 50- to 64-year-old adults, binge drinking was reported by 23% of men and 9% of women. In the study, published online in the American Journal of Psychiatry (doi:10.1176/appi.ajp.2009. 09010016), the researchers analyzed data from the 2005 and 2006 installments of the National Survey on Drug Use and Health. Binge drinking in the over-50 male cohort was associated with higher income and being separated, divorced, or widowed. In both men and women, bingeing tracked with the use of tobacco and illicit drugs. The authors reported that binge drinking was not typically associated with psychological stress, so it might not be detected by typical alcohol screens. “Clinicians who work with this age group would be well advised to ask specifically about binge drinking,” coauthor Dr. Dan G. Blazer of Duke University, Durham, N.C., said in a statement.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its yearly practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008. Practices trimmed their expenses mostly by cutting support-staff costs. However, total worker count remained unchanged over the study period, suggesting that medical practices may have eliminated raises and bonuses or even cut pay to avoid laying off employees, the MGMA said.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Bill Would Boost Bone Health Efforts

Proposed federal legislation aims to create a national strategy against osteoporosis and other bone diseases. The Bone Health Promotion and Research Act (H.R. 3856) would expand research on osteoporosis at the National Institutes of Health, fund states' surveillance of bone conditions, and increase education activities at the Centers for Disease Control and Prevention. The chief sponsors of the bill are Rep. Shelley Berkley (D-Nev.), who was diagnosed with osteoporosis more than a decade ago, and Rep. Michael C. Burgess (R-Tex.), a physician who has treated patients with that condition. “Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars,” Rep. Burgess said in a statement. “The more we can do to promote and encourage education, awareness, research, and prevention, the better.”

Call for Better Lupus Research

Federal agencies need to work closely with researchers, industry, and patient advocates to overcome barriers that have stymied new lupus treatments for decades, according to a new report commissioned by the Lupus Foundation of America. After a 9-month study, the Lewin Group advised researchers to work with the National Institutes of Health to create an agenda for drug development in lupus. Scientists also need to improve clinical trials' selection of participants, end points, and use of background medications and placebos, the report said. “The recommendations are a call to action requiring the efforts of all key stakeholders,” Sandra C. Raymond, the foundation's president and CEO, said in a statement.

Everywhere, RH Work Challenges

In a recent worldwide survey, more than half of people with rheumatic diseases said that having a supportive boss and coworkers is the key to performing well in the workplace, with flexible working hours also ranking high. The online survey was commissioned by the European League Against Rheumatism (EULAR). The survey included responses from 2,500 people with rheumatic disease, as well as health care providers and employers, in 79 countries. Nearly 70% of employers said that understanding the needs of patients with rheumatic diseases is a challenge, and only about a third of patients said that changes had been made to accommodate them at their workplaces. “We know that workers diagnosed with arthritis leave their jobs earlier than those without arthritis,” Dr. John H. Klippel, president and CEO of the Arthritis Foundation, said in a statement. “Given the recession, any viable health care reform platform must ensure that our valuable workers stay healthy and stay on the job.”

Noted Researcher Shulman Dies

Dr. Lawrence E. Shulman, the first director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, died last month. He was 90. Dr. Shulman served as director of NIAMS from 1986 to 1994 and was known as a strong supporter of research into women's and minority health issues during his tenure. In 1974, he discovered and described eosinophilic fasciitis, the connective tissue disorder now known as Shulman's syndrome. Dr. Shulman served as president of the American Rheumatism Association, which is now the American College of Rheumatology, and was president of the Pan-American League Against Rheumatism. “We at NIAMS will always be indebted to Dr. Shulman for his tremendous vision and dedication to the institute and its public health mission, and he will be greatly missed by his many friends and colleagues,” Dr. Stephen Katz, NIAMS director, said in a statement.

Middle Aged, Elders Are Bingeing

Findings from a survey of 11,000 adults aged 50 years or older have demonstrated that binge drinking of alcohol is common. In all, 14% of men and 3% of women older than age 65 years reported having five or more drinks in a day within the past 30 days. Among 50- to 64-year-old adults, binge drinking was reported by 23% of men and 9% of women. In the study, published online in the American Journal of Psychiatry (doi:10.1176/appi.ajp.2009. 09010016), the researchers analyzed data from the 2005 and 2006 installments of the National Survey on Drug Use and Health. Binge drinking in the over-50 male cohort was associated with higher income and being separated, divorced, or widowed. In both men and women, bingeing tracked with the use of tobacco and illicit drugs. The authors reported that binge drinking was not typically associated with psychological stress, so it might not be detected by typical alcohol screens. “Clinicians who work with this age group would be well advised to ask specifically about binge drinking,” coauthor Dr. Dan G. Blazer of Duke University, Durham, N.C., said in a statement.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its yearly practice-cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue in 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008. Practices trimmed their expenses mostly by cutting support-staff costs. However, total worker count remained unchanged over the study period, suggesting that medical practices may have eliminated raises and bonuses or even cut pay to avoid laying off employees, the MGMA said.

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, preauthorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said that AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policy makers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians, and on learning which functions are most helpful.

The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, whereas his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is akin to what banks did when they first allowed customers to withdraw money from any ATM.

Source MS. IGNAGNI

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, preauthorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said that AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policy makers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians, and on learning which functions are most helpful.

The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, whereas his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is akin to what banks did when they first allowed customers to withdraw money from any ATM.

Source MS. IGNAGNI

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, preauthorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said that AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policy makers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians, and on learning which functions are most helpful.

The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, whereas his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is akin to what banks did when they first allowed customers to withdraw money from any ATM.

Source MS. IGNAGNI

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise the premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise the premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise the premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The regulations bar health insurers from increasing premiums or denying enrollment based on genetic information. The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

“Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases,” Ms. Sebelius said in a statement. “Genetic testing will encourage the early diagnosis and treatment of certain diseases while allowing scientists to develop new medicines, treatments, and therapies.”

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the “medical appropriateness” of a certain treatment. Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

HHS officials also issued a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) to comply with the provisions of GINA. Like the GINA rule, the HIPAA rule bars health plans from using and disclosing genetic information for underwriting purposes. However, since HIPAA applies more broadly, the prohibition in the proposed rule also affects employee welfare benefit plans and long-term care policies. It would exclude nursing home fixed indemnity policies.

If the proposed rule is finalized, then plans would have 180 days to comply with the provisions.

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference. “It's a step that will ultimately transform our system to one that takes advantage of technology, to the benefit of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings from automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“Most policy makers understand that health reform that doesn't address the cost of care will fail,” she said, adding that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is expected to decrease hassles for physicians and significantly reduce costs.

Source Ms. Ignagni

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference. “It's a step that will ultimately transform our system to one that takes advantage of technology, to the benefit of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings from automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“Most policy makers understand that health reform that doesn't address the cost of care will fail,” she said, adding that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is expected to decrease hassles for physicians and significantly reduce costs.

Source Ms. Ignagni

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference. “It's a step that will ultimately transform our system to one that takes advantage of technology, to the benefit of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings from automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“Most policy makers understand that health reform that doesn't address the cost of care will fail,” she said, adding that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The initiative is expected to decrease hassles for physicians and significantly reduce costs.

Source Ms. Ignagni

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The new regulations bar health insurers from increasing premiums or denying enrollment based on genetic information.

The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

"Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases," Ms. Sebelius said in a statement.

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the "medical appropriateness" of a certain treatment.

Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The new regulations bar health insurers from increasing premiums or denying enrollment based on genetic information.

The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

"Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases," Ms. Sebelius said in a statement.

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the "medical appropriateness" of a certain treatment.

Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

The federal government has issued new rules spelling out how it intends to police the use of genetic information by health plans.

The new regulations bar health insurers from increasing premiums or denying enrollment based on genetic information.

The regulations implement certain provisions in the Genetic Information Nondiscrimination Act (GINA), which was signed into law by President Bush in May 2008.

Beefing up consumer protections for genetic information should help accelerate progress in genetic testing and research, said Health and Human Services secretary Kathleen Sebelius.

"Consumer confidence in genetic testing can now grow and help researchers get a better handle on the genetic basis of diseases," Ms. Sebelius said in a statement.

In an interim final rule, federal officials provide details on how health plans can obtain and use genetic information. The regulation generally bars health plans from increasing premiums based on genetic information. They also cannot require, or even request, that individuals or family members undergo genetic testing. And health plans cannot request, require, or purchase genetic information at any time for underwriting purposes, or prior to or in connection with enrollment.

Although the rule bars insurers from charging its members more based on genetic information, it doesn't limit them from doing so because of the manifestation of a disease. However, a health plan can't use the manifestation of a disease in one of its members as genetic information for a family member and raise their premiums, according to the interim final rule.

The rule does allow plans to request limited genetic information if it's necessary to determine the "medical appropriateness" of a certain treatment.

Plans also can request that individuals participate in research where genetic testing will be conducted. However, none of the genetic information collected during that research can be used for underwriting purposes.

The interim final rule goes into effect 60 days after publication in the Federal Register.

This month, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

"It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients," she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

"As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve," Ms. Ignagni said. "Most policymakers understand that health reform that doesn't address the cost of care will fail."

She added that projects like the ones in Ohio and New Jersey have "great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform."

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. "If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after."

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great "first step" to try to reduce the administrative burden on physician practices, he said.

This month, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

"It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients," she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

"As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve," Ms. Ignagni said. "Most policymakers understand that health reform that doesn't address the cost of care will fail."

She added that projects like the ones in Ohio and New Jersey have "great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform."

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. "If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after."

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great "first step" to try to reduce the administrative burden on physician practices, he said.

This month, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

"It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients," she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

"As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve," Ms. Ignagni said. "Most policymakers understand that health reform that doesn't address the cost of care will fail."

She added that projects like the ones in Ohio and New Jersey have "great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform."

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. "If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after."

Mr. Jarvis estimated that the average physician spends 3–4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great "first step" to try to reduce the administrative burden on physician practices, he said.

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policymakers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, who is senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3-4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policymakers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, who is senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3-4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

In November, physicians in Ohio and New Jersey will begin to test a single, online portal through which they can access health insurance eligibility and benefits information for most of their privately insured patients.

Physicians and their staffs in those states will have access to data on copayments, deductibles, in-network and out-of-network coverage, and the status of claims from multiple plans in one place. They will also be able to submit referrals, pre-authorization requests, and claims under a test project spearheaded nationally by America's Health Insurance Plans and the Blue Cross and Blue Shield Association.

Ultimately, the initiative will be rolled out across the country, AHIP President and CEO Karen Ignagni said during a press conference.

“It's a step that will ultimately transform our system to one that takes advantage of technology to the benefits of clinicians and their patients,” she said.

The changes are significant, Ms. Ignagni said, and are akin to what the banks did when they first allowed consumers to withdraw money from any ATM around the world.

The initiative is expected to decrease hassles for physicians and significantly reduce costs for both physicians and health plans. Ms. Ignagni estimated that the entire health system could see savings of hundreds of billions of dollars once these administrative simplification tools are available around the country, based on estimates of savings automating administrative tasks and implementing consistent business practices.

The insurers' announcement comes as Congress debates comprehensive health reform, including tighter regulation of the insurance industry. Ms. Ignagni said AHIP has been exploring projects to simplify insurance administration over the last year and has kept the Obama administration and congressional leaders apprised of their progress. Some simplifications are already part of health reform proposals circulating in Congress, she said.

“As Congress considers health care reform, I think all of us believe that it's critical that we bend the cost curve,” Ms. Ignagni said. “Most policymakers understand that health reform that doesn't address the cost of care will fail.”

She added that projects like the ones in Ohio and New Jersey have “great potential to slow the growth in the cost of care and contribute to savings needed nationally for reform.”

Although this type of Web-based tool has been possible for years, the standards for sharing information across multiple health plans were only recently completed, Ms. Ignagni said. With the standards in place, the state-level pilot projects will focus on making sure the Web portal is user friendly for physicians and learning which functions are most helpful. The project will begin with physicians and will be extended to hospitals later, according to AHIP.

The initiative was praised by physician organizations that are working on the project in Ohio, where eight health plans representing 91% of privately insured residents will participate in the Web portal. Mark Jarvis, who is senior director of practice economics at the Ohio State Medical Association, said that the ability to access insurance information through one online source will make administrative tasks easier, faster, and more accurate.

This type of tool is critical, he said, because it allows the physician's staff to let patients know up front what their coverage is and how much they will end up paying. “If you can have that conversation before the encounter, the transaction works much better and [is] less confusing than if you're trying to chase it after.”

Mr. Jarvis estimated that the average physician spends 3-4 hours a week on administrative dealings with insurance companies, while his or her staff spends another 58 hours on insurance-related administration in a given week. Creating a one-stop shop for insurance information is a great “first step” to try to reduce the administrative burden on physician practices, he said.

The federal government has officially recognized a link between being a prisoner of war (POW) and the development of osteoporosis.

The Department of Veterans Affairs has established a presumption of service connection for osteoporosis in former POWs who were interned for at least 30 days and whose osteoporosis is at least 10% disabling. The VA also established the connection for POWs, regardless of length of imprisonment, who have a diagnosis of posttraumatic stress disorder and osteoporosis that is at least 10% disabling.

Creating a presumption of service connection means that these veterans will not have to prove that their condition was caused by their military service in order to receive VA benefits. The VA said that several studies have shown that POWs have suffered serious bone loss because of dietary deficiencies during their imprisonments.

The federal government has officially recognized a link between being a prisoner of war (POW) and the development of osteoporosis.

The Department of Veterans Affairs has established a presumption of service connection for osteoporosis in former POWs who were interned for at least 30 days and whose osteoporosis is at least 10% disabling. The VA also established the connection for POWs, regardless of length of imprisonment, who have a diagnosis of posttraumatic stress disorder and osteoporosis that is at least 10% disabling.

Creating a presumption of service connection means that these veterans will not have to prove that their condition was caused by their military service in order to receive VA benefits. The VA said that several studies have shown that POWs have suffered serious bone loss because of dietary deficiencies during their imprisonments.

The federal government has officially recognized a link between being a prisoner of war (POW) and the development of osteoporosis.

The Department of Veterans Affairs has established a presumption of service connection for osteoporosis in former POWs who were interned for at least 30 days and whose osteoporosis is at least 10% disabling. The VA also established the connection for POWs, regardless of length of imprisonment, who have a diagnosis of posttraumatic stress disorder and osteoporosis that is at least 10% disabling.

Creating a presumption of service connection means that these veterans will not have to prove that their condition was caused by their military service in order to receive VA benefits. The VA said that several studies have shown that POWs have suffered serious bone loss because of dietary deficiencies during their imprisonments.