MICHIGAN CITY Human resource managers from businesses throughout the region on Tuesday learned important information about how federal law will impact the insurance coverage they offer to employees. <\/p>\n
Presented by General Insurance Services, the Northern Indiana Human Resource Management Association and Strategic Management, the two-hour lunch-time seminar touched on the basic changes employers would have to adapt to to comply with the Patient Protective and Affordable Care Act. The Supreme Court recently decided in favor of the act, which goes into effect in 2014. <\/p>\n
The discussion was moderated by Craig Menne, the vice president of General Insurance Services. Panelists included: Mark Rafalski, chief financial officer of Indiana University La Porte Hospital; Paul Houchens, a consultant with Milliman, Inc; Mark Schmidtke, an attorney with the law firm of Ogletree, Deakins; and Bruce McFee, chairman and CEO of Sullivan-Palatek, Inc. <\/p>\n
Menne told those who gathered in the gallery at the Lubeznik Center that the event was meant to be an interactive round table discussion about the law and what would be required of companies in the near future. Its a large law with a lot of moving parts, Menne said. The panelists, he said, were selected to give a wide range of perspectives on the act. <\/p>\n
Other changes that apply to plans which are not grandfathered in include: no pre-authorization on emergency services, no penalty on the use of out-of-network services, coverage of preventable care and immunizations; and patient choice in most service providers. <\/p>\n
Houchens told the crowd that there were no easy answers in how businesses will address the changes and adhere to the requirements. Its complicated because each employer is different, he said. There are different plans and different makeup of employees. <\/p>\n
One significant push at the federal level is a change in federal poverty rate scale, which is used to determine eligibility for programs such as Medicaid. The federal government is setting the eligibility criteria at 138 percent of the federal poverty level, which is about $11,000. This change would increase the number of Americans eligible for Medicaid by as much as 50 percent, Houchens said. <\/p>\n
Each state is given the opportunity to accept the new levels or keep a lower eligibility level. If more employees meet this level, the employees could be covered by Medicaid, which means their employer would not have to provide coverage for them. This would reduce any penalties imposed by the government for a business not complying with federal requirements under the law. <\/p>\n
The changes will drive up costs for medical service providers, Rafalski said. Some of these costs are incurred because of a requirement to move towards electronic storage of medical records. Another cost factor is inefficiencies in the processes, he said. As an example, he said patients who move between physicians may experience duplication in services or conflicting treatment methods. <\/p>\n
A focus on wellness and keeping employees healthy is one component of these efforts, Rafalski said. When you do that the costs go down because you are not using as much of the services. <\/p>\n<\/p>\n
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Health care reform: Businesses learn how new federal rules will affect plans<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" MICHIGAN CITY Human resource managers from businesses throughout the region on Tuesday learned important information about how federal law will impact the insurance coverage they offer to employees. Presented by General Insurance Services, the Northern Indiana Human Resource Management Association and Strategic Management, the two-hour lunch-time seminar touched on the basic changes employers would have to adapt to to comply with the Patient Protective and Affordable Care Act. The Supreme Court recently decided in favor of the act, which goes into effect in 2014. Continue reading