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Inside This Issue A Publication of NYCHSRO/MEDREVIEW VOLUME 12, NO. 2 July-December 2009 www.medreview.us NYCHSRO/MedReview’s Joe Stamm Joins Mike Huckabee on Israel Trip YCHSRO/MedReview’s President and Chief Executive Officer, Joseph B. Stamm joined former Governor of Arkansas, Mike Huckabee and New York State the Hon. Assemblyman Dov Hikind Non a two day fact finding visit to Israel. The visit consisted of a broad range of sites starting in the Old City of Jerusalem archaeological exca- vations, proceeding to the Yemenite Village of Silwan and on to Ma’aleh Hazeytim on the Mount of Ol- ives. On the second day of the visit, the group met with Israeli IDF soldier Benzi Gruber who outlined the Israeli military’s efforts to limit civilian casualties. The group then visited a “settlement” – Ma’aleh Adumim and the Shomrom including Beit El, Givat Hayoel and Givat Olam. The visit ended with an emotional visit to Nitzam, a Jewish refugee camp and a viewing of a video showing the horror of the destruction of Gush Katif. The mission concluded with a reception honoring Governer Huckabee for his continued support pf the State of Israel. (see related article) Counterclockwise: Joe Stamm with Governor Huckabee. Joe Stamm with Deputy Speaker of Knesset Danny Danon. Members of the Fact Finding Mission. Joe Stamm with Knesset member Tzipi Hotovely and Governor Huckabee. Joe Stamm with Mike Huckabee-. NYCHSRO Team Members Receive Commissioner Recognition Award hree NYCHSRO employees re- ceived the Commissioner’s Recog- Inside This Issue.... Tnition Award from the New York w Joe Stamm Joins Mike Huckabee On Israel Trip State Health Commissioner Richard R. Daines, M.D. on November 10, w NYCHSRO Team Members Receive Commissioner Recognition Award 2009. w Healthcare Headline Summaries The award was for their participa- w tion and work effort as members of the Breakfast with Comptroller John Lui Monticello Manor Closure Monitoring w News in Review Profile: Marvin Lieberman, JD,PhD Team. The award cited the individuals w 2009-25th Annual Teamster Center Health & Benefits Expo on the team for “performance/activi- ties during the 2008 award period that w 55th Annual Employee Benefits Conference in Orlando were exemplary, above and beyond w Huckabee Visits Israel the expectations of their job duties.” w Legislative Update Continued... w 2009 Year End Review w Medreview’s Healthcare Allegiance Above: Dr. Rich- w Janet Stieg Promoted to Director of Special Projects ard Daines, State Health Commis- w NYCHSRO/MedReview Holiday Party sioner. Left: w NYCHSRO/MedReview Staff Charitable Activities Commissioner Daines with w Tufts University Honors NYCHSRO/MedReview Chairman Harriet Starr and w MedReview at 2009 World Series NYCHSRO Staff w Allan Messer's Exhibit at Museum of American Finance On National Scale, New York Hospitals Fare by 15 percent, to $110.50 a month, federal If you have a young family - Consider an Poorly on Readmissions - NY Times- July 10, officials said Monday.The increase means that H.M.O. - health maintenance organization . 2009 – Hospitals in New York State are signifi- monthly premiums would top $100 for the first Your premiums will be relatively low, and most cantly worse than those elsewhere in the nation time, a stark indication of the rise in medical preventive services will be free or very low-cost. at limiting patients from having to return shortly costs that is driving the debate in Congress In some companies, these may be known as after being treated for a major illness, accord- about a broad overhaul of the health care sys- E.P.O.s - for exclusive provider organization ing to federal data released on Thursday. tem. -which generally work much the same way. Critics of hospitals with high readmission About 12 million people, or 27% of Medi- If you want a flexible PPO - preferred pro- rates have long accused the institutions of hav- care beneficiaries, will have to pay higher vider organization — might be a good option, ing a financial motive for creating what they premiums or have the additional amounts paid because you can use both network and non- call a revolving door for patients. Generally, on their behalf. The other 73 percent will be network doctors. You can use whichever doctor hospitals are paid for each admission, regard- shielded from the increase because, under you choose or use specific specialists who may less of how long the patient stays in the hospi- federal law, their Medicare premiums cannot not be part of a network. A P.P.O. with a low tal. So when patients return, the hospital is paid go up more than the increase in their Social premium but high deductibles is generally best again for the new treatment. Security benefits, and Social Security officials for someone who doesn’t use a lot of health Some hospitals like Harlem Hospital Center, announced last week that there would be no care services. A P.P.O. with a high premium a city-run institution, managed to do well on re- increase in benefits in 2010 because inflation but low deductibles is a better choice if you or admissions, while others, like Montefiore Medi- had been extremely low. someone in your family has a chronic condition cal Center, a large academic institution in the Among those who face higher premiums next like asthma or diabetes, or you tend to see Bronx, did not, suggesting that there was more year are new Medicare beneficiaries, high- many doctors throughout the year. to the equation than demographics. income people and those whose Medicare pre- Seldom see a Doctor? Consider a high- The information looks at how many Medicare miums are paid by Medicaid. e higher premi- deductible plan, which trades lower monthly patients had to be readmitted to hospitals with- ums will impose “an additional and significant premiums for a high annual deductible -which in a month of being discharged after treatment burden” on states, which help pay Medicaid starts at $1,200 for single employees and for heart attack, heart failure or pneumonia or costs, along with the federal government. $2,400 for families in 2010. Such insurance between July 2005 and June 2008. In all three can be an option for people who don’t use categories, New York hospitals, when mea- Study Finds Steady Drop in Hip Fracture a lot of health care services and who have sured against the national rate, fared poorly. Rates, but Reasons Are Unclear - NY Times- Au- enough cash on hand to cover the initial costs gust 26, 2009 - Rates of hip fractures, an often of a medical emergency, should one occur. N.Y. State, City Pay $540 Million to Settle devastating consequence of osteoporosis, have Medicaid Case – WSJ – July 23, 2009 - New been steadily falling for two decades in Cana- Drug Makers Raise Prices in Face of Health York state and New York City have agreed to da, a new study finds. And a similar trend oc- Care Reform - NY TIMES- November 16, 2009 pay $540 million to settle charges that they curred in the United States, researchers found. - Even as drug makers promise to support Wash- submitted false claims to Medicaid, the Justice But it is not clear why. ington’s health care overhaul by shaving $8 bil- Department announced. Drugs that slow the rate of bone loss may be lion a year off the nation’s drug costs after the The settlement is the largest dollar amount part of the reason, but they cannot be the en- legislation takes effect, the industry has been ever recovered for the Medicaid program, the tire explanation, osteoporosis researchers say. raising its prices at the fastest rate in years. department said. The deal settles allegations And although experts can point to other pos- In the last year, the industry has raised the that the state and city knowingly submitted sible factors — like fall prevention efforts and wholesale prices of brand-name prescription false claims for reimbursement for school-based a heavier population — the declining rates re- drugs by about 9%, according to industry ana- health-care services from 1990 to 2001. main a medical mystery. lysts. That will add more than $10 billion to the Under the Medicaid program, the federal The risk of hip fractures can be lowered by a nation’s drug bill, which is on track to exceed government shares the cost of medical services class of drugs, bisphosphonates, that can slow $300 billion this year. By at least one analysis, for the poor and disabled with the states. The bone loss. They are likely to have played a role it is the highest annual rate of inflation for drug Justice Department said New York state passed in the declining hip fracture rates in the US and prices since 1992. on claims to the federal government for services Canada, researchers say, but other factors must The drug trend is distinctly at odds with the it knew weren’t covered or properly document- also be involved. direction of the Consumer Price Index, which ed. has fallen by 1.3% in the last year. The false claims allegedly were made through Picking the Right Health Insurance Plan for Drug makers say they have valid business two New York programs that provide school- Right Now -NY Times- October 24, 2009 - reasons for the price increases. Critics say the based health services to students with disabili- “Most people choose more insurance than they industry is trying to establish a higher price ties. The department also said New York City really need,” said Randall Abbott, a benefits base before Congress passes legislation that submitted false claims to the state for speech consultant at Watson Wyatt.
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