Let Them Drink Soda

A New York state appeals court struck down Mayor Michael Bloomberg's plan to prohibit restaurants and other eateries from selling large sodas and other sugary drinks over 16 oz. The decision upheld a lower court's ruling in March that struck down the law.  

In the appeals court opinion, the four-judge panel agreed that the state's health board had acted beyond the scope of its power to regulate public health by usurping the policy-making role of the legislature.

Addressing the odd list of exceptions carved out in the law -- such as large soda and juice sold at grocery stores, 7 Eleven's 64 oz.Big Gulp, and Starbucks Frappucinos -- Justice Dianne Renwick wrote, "The exceptions did not ... reflect the agency's charge to protect public health but instead reflected the agency's own policy decisions regarding balancing the relative importance of protecting public health with ensuring the economic viability of certain industries."

A spokesman for the American Beverage Association, an industry group that served as the lead plaintiff in challenging the law, said, "With this ruling behind us, we look forward to collaborating with city leaders on solutions that will have a meaningful and lasting impact on the people of New York City."

[Source: Bloomberg News]

Demystifying Hospital Bills

A new price transparency law in North Carolina now requires hospital bills to be "in plain, easy-to-understand language without obscure codes and medical jargon." (Raleigh News & Observer.)  

Beginning next June, North Carolina hospitals must post pricing and payments for their most common admissions, surgeries, and imaging procedures.  Hospitals must also list prices and reimbursement rates for Medicare, Medicaid, large private insurers, and uninsured patients.

The bill also provides increased patient protection from bill-collecting, requiring hospitals to provide written notice to patients before sending the patient's bill to a collection agency, and to not refer unpaid bills to collection agencies while a patient request for charity care is pending.  Finally, the bill prevents hospitals from collecting unpaid bills from pateints' state tax return or lottery winnings.

"Financially speaking, patients soon will find visits to North Carolina hospitals to be a less painful and less mystifying experience." (Raleigh News & Observer.)

Read more here: http://www.newsobserver.com/2013/07/28/3064787/under-new-law-patients-hospital.html#storylink=cpy

Read more here: http://www.newsobserver.com/2013/07/28/3064787/under-new-law-patients-hospital.html#storylink=cpy

Medical Malpractice Damages Cap May Be Put to a Vote in CA

California voters may soon go to the polls to decide whether pain and suffering damages in medical malpractice cases, currently capped at $250,000, should increase to $1 million. The current cap has been in place since 1975, and proponents of the initiative claim that the increase would bring the recovery amount up to date with inflation. 

The voter initiative is backed by Santa Monica-based Consumer Watchdog and the father of two children killed by a drug-abusing driver. Proponents need petitions with valid signatures from 504,760 registered voters to qualify for the November 2014 election ballot.

The LA Times reported that "[t]he proposal also would require mandatory drug and alcohol testing for doctors and mandatory use by doctors of an electronic database that tracks prescriptions dispensed in California."

Healthcare providers who oppose the proposed ballot measure claim the initiative is only a way for attorneys to make more money from trying these types of cases.  They also argue that it could potential raise medical costs - an effect that would be contrary to the goal of the ACA and current efforts of many organizations to lower the overall cost of health care. 

Make Good Choices: Free Decision Aid for Choosing a Health Plan

Choosing the best health insurance plan can be a daunting task.  Do you need access to out-of-network providers? Do you prefer a large selection of providers within your network, or are you mostly concerned with overall cost? Should you sign up for an HMO? Or would a PPO better suit your healthcare needs?

These are just a few of the questions that healthcare start-up eChoiceAdvisor can help individuals to answer in order to select the health insurance plan that is right for them.

eChoiceAdvisor, like "a mint.com for health care," helps consumers simplify health insurance decisions based on large-scale consumer surveys. We constantly survey our members and industry experts to ask about their health insurance experiences and money saving tips. We make it fun and easy for you to share your opinions, find relevant information and advice, advocate for more affordable and secure health care for everyone in this country.  [http://echoiceadvisor.com/contact.html]

Founder and CEO Maggie Wu (BA in Economics, UC Berkeley; MBA, Chicago Booth School of Business) is an experienced market research professional who has conducted numerous focus groups and large scale consumer and business surveys.  Her company not only helps simplify health insurance decisions for individual healthcare consumers, but it also provides money-saving tips and an Insurance Jargon Dictionary to help define the multitude of insurance terms that can often confuse the average consumer.

If you're switching jobs, interested in switching insurance providers, or simply curious if your current plan is right for you, visit eChoiceAdvisor and start making good choices about your health plan!

Illegal Diabetes "Remedies"

It's not big news that products marketed as "all-natural dietary supplements" should be approached with caution because -- surprise! -- all-natural does not always mean all-good.  Often times these products claim to speed up weight-loss or hair growth, but certain all-natural supplements have purported to help treat one of the country's most prevalent chronic diseases: diabetes. These so-called supplements, the FDA has revealed, actually contain unapproved formulations of prescription medications, such as Merck's Januvia, that misleadingly claim to treat, cure or alleviate the symptoms of diabetes.

The U.S. Drug and Food Administration issued a statement Tuesday outlining actions it is taking against to remove these illegal diabetes treatments from the market.  The FDA has already issued letters to 15 companies that are selling these illegal diabetes products, and stated the agency will take further action, including product seizure or criminal prosecution, if companies to not appropriately address the violations.

In its press release, the FDA noted that it "is not aware of any reports of injury or illness associated with the illegally sold products but is taking action to protect the public health from potential harm related to these violative products."

Health care professionals and consumers can report adverse reactions to any of the products pictured above through the FDA's MedWatch program.

GINA Claims Rise Against Employers

In 2008, The Genetic Information Nondiscrimination Act (GINA) was enacted to include genetic information in the definition of personal health information.  GINA prohibits health insurers and employers from using an individual's genetic information to raise health insurance premiums or to make decisions on hiring and firing of employees. The Wall Street Journal reported that employee claims against employers for GINA violations have consistently risen since 2008, totaling 762 as of last November.

What Employees Should Know
Employees who believe their employer has violated GINA may file a charge of discrimination with the Equal Employment Opportunity Commission (EEOC).  The charge must be filed within 180 days. After the charge is filed, the EEOC will conduct an investigation.  If the EEOC finds a violation, they will pursue the case themselves through either mediation with the employer or by filing a lawsuit themselves. However if the EEOC finds no violation or cannot reach a settlement, they will issue the employee a "Right to Sue" letter, giving the employee permission to file a claim in court.

What Employers Should Know
Employers must be extremely careful about how they seek employee genetic information.  The ACA offers new incentives for employers to offer wellness programs to employees in order to improve health and drive down health insurance costs.  Sometimes it may be helpful for an employer to gather information on employee health information, including genetic information, in order to decide which wellness programs to implement.  However if an employer or its agent (someone working on behalf of the employer) asks about the health of an employee or a member of their family, that inquiry could violate GINA and subject the employer to fines by the EEOC if the employer uses that information to discriminate against the employee. Employers who wish to utilize company questionnaires to help shape their wellness programs should stress that employee participation is optional and ensure employees understand they are free to not answer questions. Employers can familiarize themselves with the charge handling process on the EEOC website.

Obamacare Swindles

Beware of scams already underway to swindle consumers into buying fake health insurance and steal their identities.  The Federal Trade Commission (FTC) said that dozens of consumers have already reported fraud since healthcare reform was upheld by the Supreme Court last summer, and predicts more prevalent abuse once open enrollment begins this October.

Be on the look-out for:

• a caller promising to send a healthcare card if the person reveals personal and financial information. 
• false enrollment websites. Note: you can only enroll in a new health plan via your state's official website OR https://www.healthcare.gov/, which can direct you to purchase insurance for any state.
• companies using Obamacare to trick customers into purchasing fake insurance.

According to the L.A. Times, those who speak limited English and those who have never had health insurance before are especially at risk.  In California, where large numbers of people who are newly eligible for insurance are Spanish-speaking, the risk is compounded. 

An added potential for fraud comes from those hired by states to help consumers navigate their new healthcare options under the exchanges. For instance, California plans to hire 20,000 enrollment counselors to tell consumers about their enrollment options and potential tax penalties. While these counselors must go through training and background checks, "fraud is inevitable," said Covered California spokeswoman Dana Howard.

If you believe you have been the victim of identity theft, or want to know more about how to keep your personal information secure, visit the FTC's website on medical ID theft, or call them at 877.382.4357.

Friday Variety: The Uninsured Gap, Veterans' Mobile Health, & (of course) Abortion

The Uninsured Gap

In the 27 states that have not committed to expanding Medicaid, many individuals and families could fall into a health insurance "black hole" where coverage would continue to be unaffordable.  In those states, individuals or families whose income amounts to 99% of the federal poverty level would not be eligible for Medicaid or premium subsidies on their state health insurance exchange. However individuals or families making 101% of the federal poverty level would be eligible for those premium subsidies that would make purchasing health coverage more affordable. 

According to a new analysis by the Kaiser Commission on Medicaid and the Uninsured, about 6.4 million people will be uninsured next year, unless those 27 states change their minds and agree to expand Medicaid coverage.  Nearly 2/3 of the uninsured live in 21 of the states that are not expected to expand as of January 1, and the six states that are on the fence.  The Kaiser Commission analysis reported that 55 percent of the uninsured live in Texas, Florida and Georgia alone.

Veterans' Mobile Health

The Department of Veterans Affairs has begun "testing the viability and potential of mobile health technologies after launching several pilot projects," according to Healthcare IT News. One such pilot is a Veteran Appointment Request App.  The App offers approximately 600 veterans the ability to request primary care and mental health appointments from their computer or mobile device.

Additionally, the Family Caregiver pilot is offering iPads to 1,000 caregivers of serious injured veterans of the Iraq and Afghanistan wars enrolled in the program.

Abortion Rights Groups to Challenge Texas Bill

On Thursday, Texas Governor Rick Perry signed the controversial abortion bill into law.  The law includes some of the nation's toughest restrictions on abortion, effectively forcing the closure of all but 5 of the state's 42 abortion clinics, unless those clinics can can upgrade their facilities within a year after the law takes effect this October.

Opponents of the bill may file a lawsuit against the state of Texas to stop the implementation of the law.  Executive Director of the Texas ACLU, of of several organization considering a legal challenge to the bill, stated, "There are no decisions about litigation, but I think that maybe the course we have to follow."

According to Planned Parenthood v. Casey, the Supreme Court case that followed Roe v. Wade, state laws cannot erect substantial obstacles to women seeking abortions.  If the Texas law causes the widespread closure that many have projected, this "serious obstacle" standard may have a fighting chance in court.