The Daily Item, Sunbury, PA

News

November 20, 2012

With health-care law set, now come the new rules

(Continued)

"The big one that everyone's watching is more definition around the exchanges," said Chas Roades, chief research officer at the Advisory Board, a Washington consultancy.

The government also has to specify how cost-sharing rules for consumers will work and what types of medical services must be covered in health plans sold in the exchanges. Twenty-six states have already chosen an existing health plan as a benchmark identifying what "essential benefits" their state's insurers must provide. In those states that don't establish a benchmark, the administration is empowered to choose one. Until the government does, insurers say they are hampered in devising what kind of insurance policies to offer.

"Unless such guidance is forthcoming, it will be difficult for health plans to complete product development, fulfill network adequacy requirements, obtain necessary state approvals and reviews, and ensure that their operations, materials, training and customer service teams are fully prepared," Daniel Durham, a vice president for America's Health Insurance Plans, testified before a House subcommittee in September.

Debra Ness, president of the National Partnership for Women and Families, said consumer advocates are concerned that the rules may give insurers too much leeway in deciding how skimpy or rich benefits are within the 10 broad categories of coverage the health law requires. "You can end up with places that have fine prescription drug treatment and really lousy maternity care," she said.

Other insurance regulations are also expected. The government has to clarify new standards for companies that insure their own workers, including what level of coverage is sufficient, how a new tax on premiums included in the health law will be assessed and how wellness programs designed to encourage employees to adopt health behaviors will operate.

Several of these insurance rules appear to be far along in the pipeline and are pending before the White House Office of Management and Budget, the final stage before issuance. The office's Web site shows that three rules — on exchanges, the health insurance market and wellness programs_ were submitted by HHS to the OMB days after the election.

Text Only
News
  • Fatal24 Danville woman dies as logging truck crushes car in Valley Township

    DANVILLE — An 84-year-old Danville woman was killed when her car and a logging truck collided Wednesday afternoon at Routes 642 and 54 in Valley Township.

    July 24, 2014 1 Photo

  • Rabbi Conflict in Israel grounds Sunbury rabbi

    TEL AVIV, Israel — While the Israelis and Hamas traded rocket and missile strikes for a 16th day, Rabbi Nina Mandel is struggling to find her way back to Sunbury after the FAA on Wednesday announced that it would extend its ban on travel at Ben-Gurion International Airport for another 24 hours.

    July 24, 2014 1 Photo

  • Docs: Fractures helped save rock victim's life

    DANVILLE — Sharon Budd’s condition is progressing nearly a week after a 13 1/2-hour procedure in which a team of surgeons rebuilt her facial bones and removed a damaged part of her brain, said two Geisinger Health System physicians who are part of that team

    July 24, 2014

  • Magistrate judge sides with Warrior Run

    WILLIAMSPORT — A federal magistrate judge says he agrees with a hearing officer that a Warrior Run student does not need special-education services,

    July 23, 2014

  • Inaugural Lewisburg BrewBQue Musical Festival is Saturday

    LEWISBURG — Not a beer fan? Not a problem. This Saturday’s inaugural Lewisburg BrewBQue Musical Festival, taking place from 2 to 6 p.m. on Market Street from Sixth Street to the Susquehanna River, welcomes brew lovers, barbecue fans, dancers in the street and little tykes alike with an array of events and offerings, organizers said.

    July 23, 2014

  • Decision coming on police shooting of city man

    SUNBURY — Brad Hare, the city’s former acting police chief, will learn by Friday whether he was justified in shooting a city man earlier this month, Northumberland County District Attorney Ann Targonski said Wednesday.

    July 23, 2014

  • Union County bridge replacement project begins Aug. 4

    HARTLETON — A PennDOT maintenance crew in Union County will begin a bridge replacement project Aug. 4 on Pleasant Grove Road, Route 3005, in Lewis Township, between Moll Road and Wirth Road, north of Pleasant Grove.

    July 23, 2014

  • DanCrash23.jpg BREAKING NEWS: Woman killed today in Danville area collision

    [UPDATED -- 12:18 a.m., 07/24/14]

    VALLEY TWP. — An 84-year-old Danville woman was killed when her car and a logging truck crashed Wednesday afternoon at Routes 642 and 54 in Valley Township.

    July 23, 2014 1 Photo

  • Jay Paterno sues Penn State for 'rush to judgment'

    STATE COLLEGE - Two former Penn State assistant football coaches, including a son of the late Joe Paterno, are suing the university, alleging that it fired them prematurely after the Jerry Sandusky child sex-abuse scandal surfaced.

    July 23, 2014

  • 400-pound bull on the lam

    State police and a western Pennsylvania cattle owner are looking for a 2-year-old bull that has been missing for more than a week.

    July 23, 2014

The Daily Marquee
Video
Parade
Magazine

Click HERE to read all your Parade favorites including Hollywood Wire, Celebrity interviews and photo galleries, Food recipes and cooking tips, Games and lots more.