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Walt Bernard Podgurski,  Editor,  440-773-1108, 

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.
  Thursday, 04/18/19 - https://DailyInsuranceReport.com 

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Medicare chief (Seema Verma) says 'Medicare-for-all' is ‘biggest threat to American health care system’
Adam Shaw / Fox News

Centers for Medicare & Medicaid Services Administrator Seema Verma warns the Medicare system cannot function with millions more Americans added.

The nation’s top Medicare official said on ‘Fox & Friends’ Wednesday that Democrats' “Medicare-for-all” proposal amounts to “the biggest threat to the American health care system,” claiming the policy would lead to worse care and longer wait times.

“I’ve been saying that Medicare-for-all is the biggest threat to the American health care system,” Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said. “What we’re talking about is stripping people of their private health insurance, forcing them into a government-run program.”

But Verma noted that socialized health care systems in other countries have problems of their own -- including long wait times and poor care -- leading citizens to travel to the U.S. for drugs and care they can't access at home.

“So this is a bureaucracy that’s going to be making decisions about everybody’s healthcare, what kind of benefits they can have, what kind of medications that they can have access to,” she said. “And if we look at other socialized countries that have tried this approach, what do we see there? Long wait times, poor quality health care and that’s why those people are flying to the United States to get their health care.”

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ACP experts offer 7 ways to improve Obamacare

The American College of Physicians (ACP) published a position paper April 16 in the Annals of Internal Medicine, voicing their discontent with recent federal actions to weaken the Affordable Care Act and offering seven recommendations on how to improve it.

The ACP committee reviewed studies, reports and surveys on the ACA from PubMed, Google Scholar, news articles, policy documents and medical journals and agreed on seven recommendations that could strengthen Obamacare. In brief, these were their points:

Act fast: Immediate efforts are needed to strengthen the ACA and prepare for an overhaul of the healthcare system, especially if we’re looking to achieve universal coverage.

Redesign tax credits: Eligibility requirements for premium tax credits and cost sharing should be reworked to enhance individual market insurance affordability, and the 400% federal poverty level premium tax credit eligibility cap should be eliminated.

Establish a reinsurance program: Federal and state regulators should stabilize the marketplace by establishing a permanent reinsurance program and limit the sale of individual market plans that don’t comply with ACA regulations.

Ensure funding: The government will need sustained funding for outreach, consumer assistance and education to promote open enrollment.

Mandate insurance: Federal and state governments should ensure all residents (with some exemptions) enroll in coverage, either by establishing an auto-enrollment program, an individual mandate or enacting a penalty for failing to enroll.

Expand Medicaid further: The ACP supports full Medicaid expansion in all states. Expansion began in 2014 and has allowed millions of low-income adults to enroll in health coverage.

Authorize a public plan: Congress should enact legislation to authorize the development of a public insurance plan, ensuring enrollees have access to a multitude of coverage options and encouraging market competition.

Crowley and Bornstein said that to accomplish universal coverage—the source of an ongoing debate in Congress—lawmakers will need to transform the U.S. healthcare system into one that’s less complex and less costly.

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VA ensures Veterans have same-day access to emergency mental health care
Office of Public and Intergovernmental Affairs

WASHINGTON — As part of the U.S. Department of Veterans Affairs’ (VA) efforts to provide the best mental health care access possible, VA is reminding Veterans that it offers all Veterans same-day access to emergency mental health care at any VA health care facility across the country.

“Providing same-day 24/7 access to mental health crisis intervention and support for Veterans, service members and their families is our top clinical priority,” said VA Secretary Robert Wilkie. “It’s important that all Veterans, their family and friends know that help is easily available.”

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From 401(k) cash outs to splashy weddings, here are America’s biggest money regrets, as told to CNBC
Kenneth Kiesnoski / CNBC

When asked what their biggest regret is when it comes to money, participants in the new CNBC and Acorns Invest in You Savings Survey certainly didn’t hold back. From dipping into retirement plan savings to frivolous spending and being too much of an easy touch, here’s a look at some of Americans’ biggest financial fouls they wish they could do over.

The survey, conducted for CNBC by SurveyMonkey in March, polled more than 2,300 adults about various aspects of financial wellness.

“I didn’t start saving early enough in life.”
“Gym memberships I don’t use and other unnecessary subscriptions.”
“Retail therapy ... with stuff I didn’t need!”
“Not eloping.”
“Not divorcing my gambling-addicted spouse sooner.”
“Cashing out retirement accounts when I changed jobs.”
“Maxing out my credit cards in a family emergency.”
“Selling stock too early.”
“Racking up so much student loan debt — I should have picked a cheaper college.”
“Didn’t save for my child’s college education so I pulled money from my retirement fund.”
“Not tithing or giving to charities.”
“Letting bills pile up.”

Humana launches oncology payment model
MARIA CASTELLUCCI / Modern Heatlhcare

Humana launched a new payment model for Medicare Advantage and commercial members receiving treatment for cancer, the Louisville, Ky.-based insurer announced Tuesday.

The program, called the Oncology Model of Care, will offer additional payment to participating cancer practices for improved performance on certain metrics over a one-year period. There are currently 16 practices participating in the model, which started in January.

"The experience for cancer care is fragmented," said Dr. Bryan Loy, corporate medical director of Humana's oncology, laboratory and personalized medicine strategies group. "Humana wants to improve the patient experience and health outcomes for members. We are looking to make sure the care is coordinated."

Why clients shouldn't use their 401(k)s to pay off debt
Jessica Mathews / FinancialPlanning

Why clients should never use a 401(k) to pay off debt
Clients may want to avoid tapping 401(k) savings to pay off debt and stave off bankruptcy, according to this article on Money. The law prohibits creditors from seizing debtors' 401(k) assets to repay debt. Money transferred out of employer-sponsored retirement accounts is no longer protected from creditors.

How clients could forfeit Social Security benefits
Social Security will withhold $1 in retirement benefits for every $2 of income exceeding $17,640. These benefits will be recalculated once they reach their FRA, although the increase will not commensurate what they lost.

Clients aren’t using catch-up contributions in 401(k)s
Only 30% of workers in their 50s are taking advantage of catch-up contributions in their 401(k) plans, according to this article on Yahoo Finance. Socking away additional $6,000 in a 401(k) plan could mean $250,000 more in savings and a reduced tax bill, assuming a 7% annual return, according to industry data.

Exempting your client’s retirement account from taxes
Saving in a Roth IRA could be a better option than funding a traditional IRA, especially for clients who are likely to move to a higher tax bracket in retirement, according to this article in Forbes.

DFR orders CMFG to pay $231,000 penalty for improper life insurance interest payments
Vermont Business Magazine

The Vermont Department of Financial Regulation (DFR) has entered into a Stipulation and Consent Order with the CMFG Life Insurance Company (link is external) (CMFG) of Madison, Wisconsin, for improperly calculating interest amounts resulting in underpayments to approximately 200 life insurance policy beneficiaries. Under the terms of the settlement, CMFG will pay a $231,000 administrative penalty and implement a corrective action plan. CMFG has also paid the correct interest amounts to the affected beneficiaries.

Since the investigation process began, CMFG provided accurate information, initiated a comprehensive system overhaul, and made verifiable improvements to its supervisory procedures by implementing a detailed compliance program and enhanced reporting. CMFG’s response was forthcoming, detailed, and timely.

Study: Health care industry worst at protecting consumer data, federal government is best
Zlati Meyer / USA TODAY

The federal government is best at protecting consumer data and the health care sector is the worst, according to a new study by the not-for-profit Internet Society’s Online Trust Alliance.

The 10th annual Online Trust Audit and Honor Roll analyzed more than 1,200 consumer-facing websites to determine which industry values security and privacy the most.

Here's how the seven industries the Online Trust Alliance examined ranked:

U.S. government – 91% of audited U.S. federal government sites made the Honor Roll)
consumer services (everything from social media to travel-booking websites to tax-prep services) – 85%
news and media – 78%
banks – 73%
internet retailers – 65%
internet service providers, carriers, hosters and e-mail providers – 63%
health care – 57%

Former Most Wanted Fugitive Pleads Guilty to Multi-Million Dollar Health Care Fraud
Department of Justice, U.S. Attorney’s Office, Eastern District of New York

Former Co-Owner of Long Island Company Defrauded Medicare and Medicaid of Millions of Dollars for Medical Supplies Never Provided to Patients

Earlier today, at the federal courthouse in Central Islip, Etienne Allonce, the former co-owner of Medical Solutions Management, Inc. (MSM), a medical equipment company in Hicksville, New York, pleaded guilty to health care fraud. In September 2018, Allonce was expelled from Haiti where he had fled 11 years earlier following the filing of an indictment in the Eastern District of New York charging him with billing Medicare and Medicaid for medical supplies never delivered to patients and never ordered by MSM. Prior to his return to the United States, Allonce was placed on the Most Wanted List of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). Allonce pleaded guilty before United States District Judge Joseph F. Bianco.

According to court filings, MSM, formerly co-owned by Allonce and his wife, Helen Michel, provided durable medical equipment and supplies to nursing homes. Between April 2003 and March 2007, Allonce and Michel submitted approximately $10 million in false claims to Medicare and Medicaid, seeking payment for medical supplies purportedly provided to patients at nursing homes when those medical supplies had not actually been provided. 

When sentenced, Allonce faces up to 10 years in prison, as well as restitution and a fine.

Accenture and Generali launch blockchain solution for the employee benefits industry
MARCUS LAWRENCE / Gigabit Magazine

Digital solutions giant Accenture and insurance firm Generali have launched the first blockchain-based solution for the employee benefits (EB) industry to mitigate processing errors in the reinsurance process through smart contracts and automatic reconciliation.

Generali Employee Benefits (GEB) benefit operating model, which serves enterprises worldwide with a broad range of employee benefits solutions including life, short and long-term disability, accident and healthcare insurance, is set to be streamlined significantly by the application of the blockchain solution.

The firms highlighted the success of a prototype demonstration last year that was trialled with agricultural firm Syngenta and insurers based in Spain, Switzerland and Serbia.

Costs were cut, time was saved and data quality was improved as a result of the blockchain solution’s integration at the firms undertaking the trial.

A 30-year Harvard Study Reveals The 5 Simple Habits That May Prolong Your Life By 10 years or More
John Hall / Calendar.com

Luckily, a 2018 study from Harvard University’s T.H. Chan School of Public Health found five habits that could prolong a person’s life by up to a decade or more. For the study, researchers reviewed 34 years’ worth of data from 78,000 women and 27 years’ worth from more than 44,000 men.

The results showed a correlation between healthy behaviors and cardiovascular issues: Women and men who maintained the healthiest lifestyles were 82% less likely to die from cardiovascular disease and 65% less likely to die from cancer when compared to those with the least healthiest lifestyles over the course of the roughly 30-year study period.

The study suggested that maintaining these five habits could add up to 10 years or more to a person’s life:

1. Maintain a healthy diet
2. Exercise daily
3. Keep a healthy weight
4. Limit your alcohol intake
5. Don’t smoke


Monday, 04/15/19 - Fidelity Launches Benefits Package Catered to Small and Midsized Businesses

Tuesday, 04/16/19 - Democratic proposals to overhaul health care: A 2020 primer

Wednesday, 04/17/19 - UnitedHealth CEO says ‘Medicare for All’ would ‘destabilize the nation’s health system’

Thursday, 04/11/19 -
Health-Care CEOs Made an Infuriating Amount of Money Last Year

Friday, 04/12/19 - How your health care would change under "Medicare for All"

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Walt Bernard Podgurski - - Editor