Anthem to remove lifetime maximum limits on all plans
August 21, 2010
By James Wilson Jones
Anthem Blue Cross announced today that it has begun the process to remove lifetime maximum payouts to its health insurance plans. The recent health care reform legislation states that insurance plans can no longer have lifetime and annual dollar limits on “essential health benefits” as soon as September 23, 2010.
Since the U.S. Department of Health and Human Services (HHS) has yet to clarify its definition of “essential health benefits,” Anthem Blue Cross has come up with the following list of the services they believe will be affected:
- Alcoholism-related services
- Ambulance services
- Asthma education
- Bariatric surgery
- Chiropractic manipulation and osteopathic manipulation services
- Diabetic supplies
- Diagnostic services
- Durable medical equipment
- Enteral formula and food products
- Hearing aids
- Home health care
- Hospice
- Infusion therapy
- Kidney disease treatment
- Mental health/substance abuse
- Ostomy supplies
- Outpatient occupational therapy
- Outpatient physical therapy
- Outpatient speech therapy
- Pharmacy
- Physician office visit (diagnostic services)
- Preventive services
- Prosthetic devices/limbs
- Skilled nursing services
- Prosthetic devices/limbs
- Skilled nursing services
- Transplant services
- Treatment of temporomandibular joint disorder (TMJD or TMJ)
Anthem states that the listed services still may be subject to copays and other cost shares and will be phased in over time. Annual dollar limits of at least $750,000 will be allowed for plan years from September 23, 2010, to September 23, 2011. Annual dollar limits of at least $1.25 million will be allowed for plan years from September 23, 2011, to September 23, 2012.Annual dollar limits of at least $2 million will be allowed for plan years from September 23, 2012, to January 1, 2014. After January 2014 there will be no lifetime limits and annual dollar limits.
Nevada Joins Health Care Reform Lawsuit without Attorney General
June 01, 2010
By Mike Rose
Without the Nevada Attorney General’s consent, Governor Jim Gibbons announced that the State of Nevada will join the federal lawsuit that states the recent health care reform act is unconstitutional.
Gibbons, who spearheaded the Silver State’s involvement in the lawsuit, said in a recent press release that the Health Care reform act is, A>?,?_"a national disgrace,A>?,?A_ that A>?,?_"clearly exceeds constitutional authority.A>?,?A_
(Governor Jim Gibbons before he was defeated in the Nevada State Primary. Source: gov.state.nv.us)
The lawsuit follows a political tug of war with Attorney General Catherine Cortez Masto. When Cortez Masto refused to file the lawsuit, Gibbons sought outside lawyers who agreed to take the case for free and raised additional money for the litigation through donations.
With the lawsuit, Nevada joins 19 states in the litigation stating that the new legislation would force all Nevada citizens to buy health insurance or face tax penalties.
The governor went on to say that the act is A>?,?_”...patently unconstitutional for the federal government to break the backs of Nevadans by trampling the Constitution and then threaten to use IRS agents to enforce this ridiculous plan.A>?,?A_
Gibbons claimed that the act has already cost the state of Nevada $250,000 in tax money just “to pay for pre-planning for the Nationalized Health Care Plan.A>?,?A_
