Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Your feedback is
extremely important to us. Please contact Tracy Duffield at 215.947.7167 or tduffield@modelconsultinginc.com to share your ideas, comments
and/or suggestions. We look forward to hearing from you!
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AmeriHealth NJ: September 2009 Updates
AmeriHealth NJ released updates regarding self-injectable
drug coverage, Medicare secondary payer reporting, and ARRA deadline as
follows.
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Capital BlueCross: Mandated Coverage for Dependents Through Age
29
On
June 10, 2009, Governor Rendell signed legislation expanding insured group
health insurance coverage to adult unmarried children up to age 30. The new
Pennsylvania Law (Act 4 of 2009) requires health insurers to continue coverage
of unmarried children through age 29 at the option of the employer. This law
will go into effect for group policies renewing on or beginning January 1,
2010.
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Capital BlueCross: PT/OT
Reimbursement Changes for Freestanding Facilities
Effective October 1, 2009, Capital BlueCross implemented updates
to the reimbursement methodologyfor physical medicine (physical
therapy/occupational therapy) services rendered by a physical therapist oroccupational therapist at a freestanding facility. For details,
please refer to the letter attached that wasissued
to freestanding providers in August 2009.
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Horizon BCBSNJ: Fall 2009 Updates
Horizon recently released
their fall 2009 Broker News
newsletter. The newsletter includes
information on Convenient Access to Nurses 24/7, Updates to Mental Health
Parity and Addiction Equity Act, Student Verification Process, Children's
Health Insurance Program Reauthorization Act reminder, and Health Care Dollars
& Sense campaign.
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Horizon BCBSNJ: Hospital Network Update
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) has
terminated its hospital contract with Capital Health System - Mercer Campus.
Under state law, the terms of Horizon BCBSNJ's hospital contract with Capital
Health System - Mercer Campus are extended for four months through January 15,
2010, and Horizon HMO members may continue to use Capital Health System -
Mercer Campus as a network hospital through January 15, 2010 (prior
authorization must be obtained when required).
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Independence Blue Cross:
New & Improved Healthy LifestylesSM
Rewards
We
are pleased to announce availability of the enhanced Healthy Lifestyles Rewards
program. The expanded version of Healthy Lifestyles Rewards may be offered to
100+, experience-rated groups that are looking for a solution to reward members
for healthy behaviors.
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Pennsylvania: State Issues Swine Flu Guidance
The
PA Insurance Department announced that the PA Department of Health has a web
site www.H1N1inPA.com
where consumers
can obtain information about H1N1 (swine flu). Examples of information are
symptoms, treatment, and vaccine details. Other questions about H1N1 may go to
877-PAHEALTH (877/724-3258). |
Walgreens/CVS Caremark: Pharmacy Initiatives Launched
Pharmacy-retail chains Walgreens and CVS Caremark
recently rolled out programs aimed at improving medication adherence and care
coordination for their pharmacy customers.
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