Federal regulators charged with implementing the Affordable Care Act stated Monday they are trying to work with states to start up the law’s health care "exchanges" -- exchanges are one-stop consumer markets for buying insurance.
But they said they will install a federal health care exchange if a state refuses to set one up on its own.
The news carries weight for Florida, because Gov. Rick Scott, who first came onto the political scene as a staunch opponent of the federal overhaul of health care signed into law by President Barack Obama last year, is not moving from his stance that state agencies should not begin implementing the law.
The health care exchanges -- scheduled to be in place by January 2014 -- are touted as a more transparent way for individuals to compare health insurance policies’ coverage and prices online, over the phone or in person. They can be set up by the states themselves, done locally or regionally, or operated by a nonprofit, or can be done in partnership with the federal government.
States will be in charge of selecting plans in the exchanges, but they must meet minimum coverage and quality standards set forth by the federal Health and Human Services agency. Those standards are scheduled to be released later this year.
HHS officials said the guidelines for the exchanges give states enough flexibility to adjust the federal exchanges to their unique circumstances, but the final say on what plans qualify will remain in federal hands.
“In terms of setting up an exchange and meeting minimum standards, those would still apply,” said Steve Larsen, HHS director of the Center for Consumer Information and Insurance Oversight.
The proposals and claims of flexibility for states did not thaw Scott’s position on the law, or its implementation.
“As proposals, we are not about to change our policy to start implementing Obamacare,” Scott spokesperson Lane Wright said.
Under the law, states must get approval from HHS for their exchange plan by January 2013, but a conditional approval can be given if a state is on track to be ready to implement its exchange plan by January 2014.
Larsen held out hope that states would get on board and begin to lay the groundwork for the exchanges; he stated the federal government would be ready to step in and impose an exchange system if a state did not do so.
“If a state on January 2013 has not received approval or conditional approval, then we would be able to have an exchange in place by 2014,” Larsen said.
Yet most states are trying to avoid the federally imposed exchanges.
Two federal judges have declared the Affordable Care Act’s individual mandate, which imposes a tax or penalty on individuals who do not obtain health insurance, unconstitutional. One of those rulings came from a Pensacola judge in a lawsuit filed by Florida and 25 other states against the health care law. The Atlanta 11th Circuit Court of Appeals heard oral arguments in the case last month but has yet to issue a decision. In a separate lawsuit, the 6th Circuit Court of Appeals upheld the individual mandate as constitutional last month.
The issue will likely be settled by the U.S. Supreme Court, but in the interim, states opposed to the Affordable Care Act are caught between readying themselves for it, or counting on its cancellation by the courts.
“All we know is that a (federal judge) in Florida has ruled it unconstitutional, so we’re not going to be implementing it,” Wright said.
Scott stated in February, after the ruling in the Florida case, that he did not anticipate the law being upheld and he would not move to implement it until its legal fate was settled. He insisted that Florida would be ready if the law was deemed constitutional, despite the lack of preparation.
“I personally always believed it was going to be repealed. We are not going to spend a lot of time and money with regard to trying to get ready to implement it,” Scott said at the time. To make sure your coverage for your health is up to date and affordable. go to our site.
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Thursday, July 14, 2011
Monday, July 11, 2011
Florida Homeowners Coverage Problems Resolved?
It is the biggest gamble - homeowners insurance in Florida time at the helm of state government, one still condemned as reckless, irresponsible and a disaster waiting to happen.
Indeed, average property insurance premiums in Florida have fallen 16 percent since the Legislature approved a Crist-led reform package in the governor's first month in office in 2007.
And Citizens, the state-run insurer that is now Florida's largest insurer, has seen its reserves more than triple, making it more able to pay off storm damages.
The changes are dramatic when contrasted with what confronted the state just a few years ago, when runaway insurance costs were considered the No. 1 problem facing Florida.
From 2003 to 2006, average property insurance premiums nearly doubled, going from $949 to $1,635 annually, according to the state Office of Insurance Regulation.
More double-digit increases were forecast in 2007 and beyond as insurance companies sought to make up for nearly $40 billion in losses from eight hurricanes and four tropical storms that hit Florida in 2004 and 2005.
To make sure your florida homeowners coverage is up to date, please contact us here.
Indeed, average property insurance premiums in Florida have fallen 16 percent since the Legislature approved a Crist-led reform package in the governor's first month in office in 2007.
And Citizens, the state-run insurer that is now Florida's largest insurer, has seen its reserves more than triple, making it more able to pay off storm damages.
The changes are dramatic when contrasted with what confronted the state just a few years ago, when runaway insurance costs were considered the No. 1 problem facing Florida.
From 2003 to 2006, average property insurance premiums nearly doubled, going from $949 to $1,635 annually, according to the state Office of Insurance Regulation.
More double-digit increases were forecast in 2007 and beyond as insurance companies sought to make up for nearly $40 billion in losses from eight hurricanes and four tropical storms that hit Florida in 2004 and 2005.
To make sure your florida homeowners coverage is up to date, please contact us here.
Wednesday, July 6, 2011
Key aspect of auto insurance laws in Florida
Florida like the rest of the 50 states in the country has its own set of insurance laws which must be followed by all the citizens who drive on its roads. Firstly, vehicle owners should purchase auto insurance only from those providers who are authorized to sell insurance in Florida. Secondly, those who move from another state to Florida are not allowed to hold on to the same policy while driving on the Florida roads. In fact, everyone must carry sufficient insurance coverage as mandated by the laws in Florida. The specific limits which are mandatory for vehicle owners in Florida are $10,000 for physical injury to one person in a car accident, $10,000 for property damage during car accident as per the liability on the guilty driver and $20,000 for physical injury to more than one person in the car accident.
The auto insurance laws in Florida also include a Financial Responsibility Law. As per this law, all the drivers in the state of Florida should carry sufficient insurance coverage for a few more risks. These risks include DUI citation and revocation of license as a result, car accident that results in injuries and involves the insured driver, suspension of the license of the driver due to too many points brought up against the driver and revocation of license for habitual violation of traffic laws.
Also, the rental cars operating in Florida must have the minimum protection as mandated by the insurance laws in the state. If the credit card of the insured driver or the insurance policy for the car doesn’t cover the rental for the car, the rental agreement copy must be present in the vehicle all the time. This copy should also highlight the insurance coverage that is in place for the rental car. As per the laws in Florida car rental companies have to offer the minimum coverage for liability insurance and this has to be offered at a reasonable price to the customer. Florida being a no fault state means that under the no-fault conditions, personal injury protection doesn’t have to be purchased or carried by the drivers.
The car insurance for comprehensive coverage and collision coverage aren’t required either. There isn’t any provision that mandates insurance against accidents caused by uninsured motorists. Although these provisions aren’t really mandated by law, they are recommended for the sake of the drivers especially when trapped in unforeseen situations. To make sure your auto coverage is low in Florida, contact us here.
The auto insurance laws in Florida also include a Financial Responsibility Law. As per this law, all the drivers in the state of Florida should carry sufficient insurance coverage for a few more risks. These risks include DUI citation and revocation of license as a result, car accident that results in injuries and involves the insured driver, suspension of the license of the driver due to too many points brought up against the driver and revocation of license for habitual violation of traffic laws.
Also, the rental cars operating in Florida must have the minimum protection as mandated by the insurance laws in the state. If the credit card of the insured driver or the insurance policy for the car doesn’t cover the rental for the car, the rental agreement copy must be present in the vehicle all the time. This copy should also highlight the insurance coverage that is in place for the rental car. As per the laws in Florida car rental companies have to offer the minimum coverage for liability insurance and this has to be offered at a reasonable price to the customer. Florida being a no fault state means that under the no-fault conditions, personal injury protection doesn’t have to be purchased or carried by the drivers.
The car insurance for comprehensive coverage and collision coverage aren’t required either. There isn’t any provision that mandates insurance against accidents caused by uninsured motorists. Although these provisions aren’t really mandated by law, they are recommended for the sake of the drivers especially when trapped in unforeseen situations. To make sure your auto coverage is low in Florida, contact us here.
Tuesday, July 5, 2011
Seniors caught between cancer and the cost of treatment
Seniors caught between cancer and the cost of treatment
Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.
New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.
For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher co-payment for drugs than for some other medical services.
Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.
For more on cancer, see:
Seniors fear cancer and Alzheimer’s
Health update: New 'virtual' colonoscopy
Costly Provenge gets Medicare seal of approval
Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.
New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.
For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher copayment for drugs than for some other medical services.
Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.
For more on cancer, see:
Seniors fear cancer and Alzheimer’s
Health update: New 'virtual' colonoscopy
Costly Provenge gets Medicare seal of approval
WASHINGTON BUREAU -- The U.S. Government Accountability Office (GAO) says Internal Revenue Service (IRS) top managers must do more to ensure smooth implementation of the Patient Protection and Affordable Care Act (PPACA).
IRS officials are not doing enough to ensure on-time and on-target implementation of the 47 PPACA provisions that it will be responsible for complying with through 2018, James White, a GAO director, writes in a report summarizing the GAO's findings.
“While implementation for some provisions is years away, making improvements to the planning process now would reduce risks and might minimize future problems,” White says.
To ensure compliance, the IRS “must improve aspects of its planning, particularly at an agencywide or strategic level,” White says.
The RS has defined strategic-level goals and project plans in multiple documents but has not integrated the goals or plans, White says.
White says the GAO has given briefings to members of Congress and their staff on its findings, starting June 8, in response to lawmakers' concerns that the IRS would not be able to properly implement PPACA provisions on their effective dates.
In its briefings, GAO officials have said that the IRS management team has not developed a timeline for developing performance measures and collecting associated data.
The IRS also has not provided a cost estimate for all of PPACA, and the risk management framework does not assure that all risks, especially strategic-level risks, are identified and analyzed, White says.
The GAO is recommending that the commissioner of Internal Revenue move to define program goals and develop a project plan in one document that effectively integrates all aspects of the program.
The GAO also is recommending that top IRS managers document a schedule for developing performance measures that link to program goals and develop a more complete cost estimate that is consistent with the GAO Cost Estimating Guide.
Top managers also should modify and document the IRS risk management approach, to have more assurance that all risks, including strategic-level risks for the program, “are identified and analyzed, and that mitigation options are assessed,” White says.
The GAO acknowledges that the IRS management team has generally followed leading practices in planning to implement the PPACA provisions, White says.
The GAO also acknowledges that top IRS leadership has been involved; that cost estimates for information technology projects have specified ground rules and assumptions, data sources, and supporting calculations; and that work has started on compliance controls.
White notes that risks are being identified and analyzed at the individual project level.
OTHER COVERAGE THE IRS ROLE IN IMPLEMENTING PPACA FROM NATIONAL UNDERWRITER LIFE & HEALTH:
IRS Gives Nonprofit Plans, Hospitals More Time to Comply with PPACA
PPACA: IRS Starts to Design Health Plan Quality Research Fee
PPACA: IRS Looks at Group Health Definitions
IRS Might Issue ACO Guidance
PPACA Stars at IRS Budget Hearing
To make sure you are up to date on this and all medicare information, contact us at here
Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.
New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.
For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher co-payment for drugs than for some other medical services.
Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.
For more on cancer, see:
Seniors fear cancer and Alzheimer’s
Health update: New 'virtual' colonoscopy
Costly Provenge gets Medicare seal of approval
Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.
New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.
For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher copayment for drugs than for some other medical services.
Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.
For more on cancer, see:
Seniors fear cancer and Alzheimer’s
Health update: New 'virtual' colonoscopy
Costly Provenge gets Medicare seal of approval
WASHINGTON BUREAU -- The U.S. Government Accountability Office (GAO) says Internal Revenue Service (IRS) top managers must do more to ensure smooth implementation of the Patient Protection and Affordable Care Act (PPACA).
IRS officials are not doing enough to ensure on-time and on-target implementation of the 47 PPACA provisions that it will be responsible for complying with through 2018, James White, a GAO director, writes in a report summarizing the GAO's findings.
“While implementation for some provisions is years away, making improvements to the planning process now would reduce risks and might minimize future problems,” White says.
To ensure compliance, the IRS “must improve aspects of its planning, particularly at an agencywide or strategic level,” White says.
The RS has defined strategic-level goals and project plans in multiple documents but has not integrated the goals or plans, White says.
White says the GAO has given briefings to members of Congress and their staff on its findings, starting June 8, in response to lawmakers' concerns that the IRS would not be able to properly implement PPACA provisions on their effective dates.
In its briefings, GAO officials have said that the IRS management team has not developed a timeline for developing performance measures and collecting associated data.
The IRS also has not provided a cost estimate for all of PPACA, and the risk management framework does not assure that all risks, especially strategic-level risks, are identified and analyzed, White says.
The GAO is recommending that the commissioner of Internal Revenue move to define program goals and develop a project plan in one document that effectively integrates all aspects of the program.
The GAO also is recommending that top IRS managers document a schedule for developing performance measures that link to program goals and develop a more complete cost estimate that is consistent with the GAO Cost Estimating Guide.
Top managers also should modify and document the IRS risk management approach, to have more assurance that all risks, including strategic-level risks for the program, “are identified and analyzed, and that mitigation options are assessed,” White says.
The GAO acknowledges that the IRS management team has generally followed leading practices in planning to implement the PPACA provisions, White says.
The GAO also acknowledges that top IRS leadership has been involved; that cost estimates for information technology projects have specified ground rules and assumptions, data sources, and supporting calculations; and that work has started on compliance controls.
White notes that risks are being identified and analyzed at the individual project level.
OTHER COVERAGE THE IRS ROLE IN IMPLEMENTING PPACA FROM NATIONAL UNDERWRITER LIFE & HEALTH:
IRS Gives Nonprofit Plans, Hospitals More Time to Comply with PPACA
PPACA: IRS Starts to Design Health Plan Quality Research Fee
PPACA: IRS Looks at Group Health Definitions
IRS Might Issue ACO Guidance
PPACA Stars at IRS Budget Hearing
To make sure you are up to date on this and all medicare information, contact us at here
Tuesday, June 28, 2011
Take Care Of Your Health With Blue Cross Blue Shield of Florida
It's time to take charge of your health! Schedule an appointment with your health care provider to discuss what preventive health services you need and when you need them.
You may also want to start a campaign in your community (i.e. a faith-based setting, workplace, school, or civic group) to encourage others to make an appointment for a check-up or health screening on National Women's Check-Up Day (the day after Mother's Day each year) or National Men's Health Week (the week before Father's Day each year).
Why are Check-Ups Important?
Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how active you are, whether you smoke), and other important factors impact what and how often you need services and screenings.
To make sure you have the most savings in health insurance, contact us at www.fiorellainsurance.com or call us toll free.
You may also want to start a campaign in your community (i.e. a faith-based setting, workplace, school, or civic group) to encourage others to make an appointment for a check-up or health screening on National Women's Check-Up Day (the day after Mother's Day each year) or National Men's Health Week (the week before Father's Day each year).
Why are Check-Ups Important?
Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how active you are, whether you smoke), and other important factors impact what and how often you need services and screenings.
To make sure you have the most savings in health insurance, contact us at www.fiorellainsurance.com or call us toll free.
Wednesday, April 13, 2011
Real Miami Vice on Healthcare reform and Medicare Fraud. Find More information on Medicare Supplements and Medicare Fraud at www.fiorellainsurance.com
By Tom Brown
REUTERS
MIAMI — If Peter Budetti gets his way, the criminals who gorge on the U.S. healthcare system, bilking the government out of billions of dollars a year, will soon be on a much leaner diet.
As Washington's point man on healthcare fraud, the 66-year-old Budetti knows there are no quick fixes to a mind-boggling mess that ranks as one of America's top crime problems. But he has been working to develop new technological tools and a comprehensive, long-term strategy to rein in fraud since his appointment as director of Program Integrity at the Centers for Medicare and Medicaid Services (CMS) last year.
Although fraudsters have had the run of the place for some two decades, life is about to get "an awful lot tougher" for them, Budetti told Reuters in a recent interview. He promised new measures to curb waste and fraud in Medicare and Medicaid, the massive federal programs that provide healthcare for America's elderly and poor, will soon pay big dividends.
If he's right, American taxpayers and even budget hawks will have reason to smile.
There are no official estimates for how much fraud costs but the National Healthcare Anti-Fraud Association (NHCAA), a watchdog group, cites information from the FBI that anywhere between $70 billion and $234 billion is lost annually. That ranges between 3 percent and 10 percent of the $2.34 trillion Americans spent on healthcare in 2008.
Just this week, the third-largest U.S. hospital operator, Tenet Healthcare Corp, sued the No. 2 operator, Community Health Systems Inc, which is trying to buy it, for Medicare abuse. Tenet accuses its unwanted suitor of admitting patients for needless stays and bilking the U.S. government and private insurers.
The Obama administration has committed significant resources to fighting healthcare fraud as it grapples with the untold damage it is doing to the economy along with concerns about deficits and runaway healthcare spending.
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But some fear the administration's focus on the issue may come as too little, too late after years of inaction, political missteps and bureaucratic incompetence.
Budetti, who is focusing as much on prevention as he is on detection, appears confident about clamping down on scammers. New computer programs and sophisticated "data detective" work are beefing up the arsenal of weapons to fight fraud, he said.
'A cancer that's now quite aggressive'
Thomson Reuters, an industry leader in healthcare data, estimates the cost of fraud at about $150 billion per year. The stakes are huge for taxpayers and the government, which spent $895.9 billion on Medicare, Medicaid and the Children's Health Insurance Program in fiscal 2009, the last year for which official figures are available.
"It's a cancer that's now quite aggressive," Malcolm Sparrow of the Kennedy School of Government at Harvard University said of fraud.
No state comes close to matching Florida as a haven for crooked healthcare businesses. Long known for its unsavory links with drug cartels, money launderers and swampland real estate deals, Florida is an obvious magnet for Medicare scammers since so many elderly Americans have retired to end their days in its famous sunshine.
As it happens, Florida is also leading a legal challenge by 26 states to overturn President Barack Obama's healthcare reform. And Republican Governor Rick Scott, a fierce opponent of the law, has a controversial past as chief executive of a healthcare corporation that paid a record $1.7 billion in fines for defrauding Medicare and other federal programs. Scott has emphasized that he was never charged with any crimes as chief executive of the giant Columbia/HCA hospital chain.
A senior federal agent highlighted Florida's role as "ground zero" for the crime in congressional testimony last month, saying it was now "accepted as a safe and easy way to get rich quick" in the state.
It has drawn in people from all walks of life, including high school dropouts now making millions of dollars a year, said Omar Perez, an agent with the U.S. Department of Health and Human Services' Office of Inspector General.
"In South Florida, Medicare fraud is not only perpetrated by independent, scattered groups, but also by competitive, organized businesses complete with hierarchies and opportunities for advancement," Perez said.
"The money involved is staggering. We see business owners, healthcare providers and suppliers, doctors, and Medicare beneficiaries participating in the fraud. We also see drug dealers and organized criminal enterprises defrauding the system."
It has never been difficult to become a provider under government healthcare programs, and the money has been notoriously easy too.
The Medicare system, which processes millions of claims daily and is one of the biggest drains on the federal budget, was set up on the assumption that providers, including doctors, medical equipment suppliers and home healthcare agencies, were all essentially trustworthy.
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Once fraudsters learn how to electronically submit payment claims, using a government-issued National Provider Identifier number and the appropriate Medicare or Medicaid beneficiary numbers and billing codes, government computers tend to cough up payments automatically.
"Our program has had vulnerabilities that we need to overcome at this point in time," said Budetti, a pediatrician and lawyer. "It has been relatively easy for providers and suppliers to get into the program, because most of them are law-abiding legitimate people," he added.
Sparrow describes the system as "a giant money machine."
"The crooks know now that these computerized payment systems are their best friend," he said. "They will study carefully the art of billing correctly, they will produce electronic transactions that are perfect on their face, but it's just a pack of lies."
New anti-fraud tools
Several little-noticed provisions of Obama's healthcare reform law, including some that took effect last month, will step up enforcement action against fraudsters.
They include risk-based screening of the people behind roughly 19,000 new requests to become healthcare providers under the Medicare system every month. Applicants who fall into a "high risk" category will be subject to fingerprinting and criminal background checks through the FBI, Budetti said.
Another new provision will allow U.S. Health and Human Services Secretary Kathleen Sebelius to clamp a temporary moratorium on new enrollments of providers and suppliers to government-run healthcare programs, whenever such a move is deemed necessary to fight fraud.
More importantly, Budetti said, the Medicare and Medicaid computer payment systems are being made far less vulnerable to fraud, thanks to new and smarter software programs and algorithms. And payments to the hundreds of thousands of providers and suppliers already in the system can now be suspended in cases involving credible allegations of fraud.
"We are in the process of taking advantage of modern technology and sophisticated analytic systems," he said. "We're going to be intervening in the claims payment process in a very new set of ways that hasn't happened before."
Critics of data mining say it has offered no "silver bullet" for fighting healthcare fraud in the past.
But David Nelson, director of strategy and market planning for a division of Thomson Reuters that specializes in the field, said "clinical intelligence building" was expanding rapidly, making data and Web analytics key to fraud prevention, detection, investigation and recovery.
"We find that our customers who are really seriously engaged in data analytics to detect fraud get back $3 to $12 for every dollar they invest," Nelson said.
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Skeptics like Harvard's Sparrow are wary of claims about information technology, especially after all the promises made about a decade ago about so-called "neural networks."
"Neural networks were introduced with a lot of marketing hype. The companies that promoted neural network algorithms said they work like a brain, that you won't have to think about fraud anymore," he said. "That didn't solve it," he added. "In fact most neural network algorithms didn't do any better than standard rule-based approaches."
Budetti, who has served in numerous healthcare positions in the government and private sector and worked recently on anti-fraud initiatives with the National Association of Insurance Commissioners in Washington, seems certain that "smart" computers can be used outsmart criminal gangs. "We will be able to run every (billing) claim through advanced technology screening by the middle of next year. Every claim will be subjected to a wide range of analytics all of the time and it will be a system that learns on top of itself," he said.
'It's set up to be ripped off'
Any effective use of technology would be more than welcome by officials like Timothy Donovan, a senior FBI agent who works closely with the interagency fraud prevention and enforcement team, known as the HEAT task force, in the Miami area.
The first HEAT team was established in Miami in 2007 but fraud strike forces have since been deployed in other cities as well. "It's just set up to be ripped off," Donovan said of the CMS payment system. "A law enforcement response to this is not the answer. It's not going to cure it," he said.
Fraud cases detected in Florida have typically involved multimillion-dollar schemes featuring bogus suppliers of wheelchairs, or other so-called durable medical equipment devices, and sham infusion therapies for the treatment of HIV and AIDS patients. Elaborate scams involving kickbacks and stolen identities have often been the norm. But less sophisticated ways of bilking Medicare and Medicaid, sometimes even involving medical services and equipment prescribed by dead doctors, have also been documented.
One recent trend, according to FBI agents who work the healthcare fraud beat, involved fictitious billings for prosthetic limbs. At first all the bills, and there were hundreds of them, involved prosthetic left arms. Then suddenly, the bills submitted were all for right-arm prostheses.
More recently the scammers have focused on home healthcare agencies and mental health services, along with rehab sessions and physical therapy.
"If it pays, they just latch into a code and keep billing it. If it's paying they just put the gas pedal to the floor," said Randall Culp, a senior agent in the FBI's Miami division.
Law enforcement officials note that less than 5 percent of all payment claims submitted to CMS have traditionally been subjected to rigorous audits involving any actual human intervention, and say prison sentences are too light.
As a deterrent, the Obama administration recently stepped up federal sentencing for healthcare fraud by up to 50 percent for crimes that involve more than $1 million in losses.
Sparrow, who once served as a policeman in Britain where he rose to the rank of Detective Chief Inspector, says a focus on law enforcement is also crucial.
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He said CMS and other government agencies had consistently taken a "quality control mindset" approach to healthcare fraud, failing to recognize it as a crime control problem above all else. "In a nutshell, that's the biggest thing they get wrong, and they get it wrong constantly," Sparrow said.
Patrick Burns of Taxpayers Against Fraud, a non-profit public interest watchdog group, is a big supporter of Budetti, who formerly chaired the organization's board of directors.
But Burns wonders whether Budetti can win the fight against a problem that he says has mushroomed totally out of control since 1993, when former Attorney General Janet Reno identified it as the No. 2 crime problem in America after violent crime.
The problem, as Burns sees it, is a weak U.S. regulatory environment and lack of financial commitment in Congress.
"I'm not sure it's a winnable war without putting more money into investigators," Burns said. "You have to have people on the street," Burns said. "The truth is that CMS doesn't have the resources and investigators to go out and rodeo all the fraud. It just doesn't."
The FBI does not disclose the number of agents working on healthcare fraud cases. But Congressman Henry Waxman, a California Democrat who has worked closely with Budetti on healthcare, said the Affordable Care Act had given CMS hundreds of millions of dollars and unprecedented powers.
"An astounding amount of money is lost through fraud and when we've got more cops on the beat and more personnel enforcing these laws and trying to prevent fraud, I think we will eliminate a lot of that absolute waste," Waxman said.
Senate Finance Committee Chairman Max Baucus said last month tougher enforcement was already starting to pay off with $4 billion recovered last year.
U.S. healthcare expenditures totaled $2.34 trillion, or 16.2 percent of GDP in 2008, the last year for which official figures are available. They are outpacing economic growth and projected to total $3.02 trillion, or $9,505 per person and 17.3 percent of GDP, by 2013.
There are no reliable estimates of the extent to which fraud contributes to those costs.
Every now and then, a big bust will make news, such as one last October involving a Miami-based chain of community health centers called American Therapeutic that was charged with billing for about $200 million in services that were either unnecessary or never provided to patients. But such successes are relatively few and far between.
Given the potential scope of the crime, and the low detection rates normally associated with white-collar crime, Sparrow said authorities may need to dismantle a $100 million billing scam on average every day to put "a serious dent" in the problem.
"We're seeing one once about every two months," he said.
REUTERS
MIAMI — If Peter Budetti gets his way, the criminals who gorge on the U.S. healthcare system, bilking the government out of billions of dollars a year, will soon be on a much leaner diet.
As Washington's point man on healthcare fraud, the 66-year-old Budetti knows there are no quick fixes to a mind-boggling mess that ranks as one of America's top crime problems. But he has been working to develop new technological tools and a comprehensive, long-term strategy to rein in fraud since his appointment as director of Program Integrity at the Centers for Medicare and Medicaid Services (CMS) last year.
Although fraudsters have had the run of the place for some two decades, life is about to get "an awful lot tougher" for them, Budetti told Reuters in a recent interview. He promised new measures to curb waste and fraud in Medicare and Medicaid, the massive federal programs that provide healthcare for America's elderly and poor, will soon pay big dividends.
If he's right, American taxpayers and even budget hawks will have reason to smile.
There are no official estimates for how much fraud costs but the National Healthcare Anti-Fraud Association (NHCAA), a watchdog group, cites information from the FBI that anywhere between $70 billion and $234 billion is lost annually. That ranges between 3 percent and 10 percent of the $2.34 trillion Americans spent on healthcare in 2008.
Just this week, the third-largest U.S. hospital operator, Tenet Healthcare Corp, sued the No. 2 operator, Community Health Systems Inc, which is trying to buy it, for Medicare abuse. Tenet accuses its unwanted suitor of admitting patients for needless stays and bilking the U.S. government and private insurers.
The Obama administration has committed significant resources to fighting healthcare fraud as it grapples with the untold damage it is doing to the economy along with concerns about deficits and runaway healthcare spending.
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But some fear the administration's focus on the issue may come as too little, too late after years of inaction, political missteps and bureaucratic incompetence.
Budetti, who is focusing as much on prevention as he is on detection, appears confident about clamping down on scammers. New computer programs and sophisticated "data detective" work are beefing up the arsenal of weapons to fight fraud, he said.
'A cancer that's now quite aggressive'
Thomson Reuters, an industry leader in healthcare data, estimates the cost of fraud at about $150 billion per year. The stakes are huge for taxpayers and the government, which spent $895.9 billion on Medicare, Medicaid and the Children's Health Insurance Program in fiscal 2009, the last year for which official figures are available.
"It's a cancer that's now quite aggressive," Malcolm Sparrow of the Kennedy School of Government at Harvard University said of fraud.
No state comes close to matching Florida as a haven for crooked healthcare businesses. Long known for its unsavory links with drug cartels, money launderers and swampland real estate deals, Florida is an obvious magnet for Medicare scammers since so many elderly Americans have retired to end their days in its famous sunshine.
As it happens, Florida is also leading a legal challenge by 26 states to overturn President Barack Obama's healthcare reform. And Republican Governor Rick Scott, a fierce opponent of the law, has a controversial past as chief executive of a healthcare corporation that paid a record $1.7 billion in fines for defrauding Medicare and other federal programs. Scott has emphasized that he was never charged with any crimes as chief executive of the giant Columbia/HCA hospital chain.
A senior federal agent highlighted Florida's role as "ground zero" for the crime in congressional testimony last month, saying it was now "accepted as a safe and easy way to get rich quick" in the state.
It has drawn in people from all walks of life, including high school dropouts now making millions of dollars a year, said Omar Perez, an agent with the U.S. Department of Health and Human Services' Office of Inspector General.
"In South Florida, Medicare fraud is not only perpetrated by independent, scattered groups, but also by competitive, organized businesses complete with hierarchies and opportunities for advancement," Perez said.
"The money involved is staggering. We see business owners, healthcare providers and suppliers, doctors, and Medicare beneficiaries participating in the fraud. We also see drug dealers and organized criminal enterprises defrauding the system."
It has never been difficult to become a provider under government healthcare programs, and the money has been notoriously easy too.
The Medicare system, which processes millions of claims daily and is one of the biggest drains on the federal budget, was set up on the assumption that providers, including doctors, medical equipment suppliers and home healthcare agencies, were all essentially trustworthy.
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Once fraudsters learn how to electronically submit payment claims, using a government-issued National Provider Identifier number and the appropriate Medicare or Medicaid beneficiary numbers and billing codes, government computers tend to cough up payments automatically.
"Our program has had vulnerabilities that we need to overcome at this point in time," said Budetti, a pediatrician and lawyer. "It has been relatively easy for providers and suppliers to get into the program, because most of them are law-abiding legitimate people," he added.
Sparrow describes the system as "a giant money machine."
"The crooks know now that these computerized payment systems are their best friend," he said. "They will study carefully the art of billing correctly, they will produce electronic transactions that are perfect on their face, but it's just a pack of lies."
New anti-fraud tools
Several little-noticed provisions of Obama's healthcare reform law, including some that took effect last month, will step up enforcement action against fraudsters.
They include risk-based screening of the people behind roughly 19,000 new requests to become healthcare providers under the Medicare system every month. Applicants who fall into a "high risk" category will be subject to fingerprinting and criminal background checks through the FBI, Budetti said.
Another new provision will allow U.S. Health and Human Services Secretary Kathleen Sebelius to clamp a temporary moratorium on new enrollments of providers and suppliers to government-run healthcare programs, whenever such a move is deemed necessary to fight fraud.
More importantly, Budetti said, the Medicare and Medicaid computer payment systems are being made far less vulnerable to fraud, thanks to new and smarter software programs and algorithms. And payments to the hundreds of thousands of providers and suppliers already in the system can now be suspended in cases involving credible allegations of fraud.
"We are in the process of taking advantage of modern technology and sophisticated analytic systems," he said. "We're going to be intervening in the claims payment process in a very new set of ways that hasn't happened before."
Critics of data mining say it has offered no "silver bullet" for fighting healthcare fraud in the past.
But David Nelson, director of strategy and market planning for a division of Thomson Reuters that specializes in the field, said "clinical intelligence building" was expanding rapidly, making data and Web analytics key to fraud prevention, detection, investigation and recovery.
"We find that our customers who are really seriously engaged in data analytics to detect fraud get back $3 to $12 for every dollar they invest," Nelson said.
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Skeptics like Harvard's Sparrow are wary of claims about information technology, especially after all the promises made about a decade ago about so-called "neural networks."
"Neural networks were introduced with a lot of marketing hype. The companies that promoted neural network algorithms said they work like a brain, that you won't have to think about fraud anymore," he said. "That didn't solve it," he added. "In fact most neural network algorithms didn't do any better than standard rule-based approaches."
Budetti, who has served in numerous healthcare positions in the government and private sector and worked recently on anti-fraud initiatives with the National Association of Insurance Commissioners in Washington, seems certain that "smart" computers can be used outsmart criminal gangs. "We will be able to run every (billing) claim through advanced technology screening by the middle of next year. Every claim will be subjected to a wide range of analytics all of the time and it will be a system that learns on top of itself," he said.
'It's set up to be ripped off'
Any effective use of technology would be more than welcome by officials like Timothy Donovan, a senior FBI agent who works closely with the interagency fraud prevention and enforcement team, known as the HEAT task force, in the Miami area.
The first HEAT team was established in Miami in 2007 but fraud strike forces have since been deployed in other cities as well. "It's just set up to be ripped off," Donovan said of the CMS payment system. "A law enforcement response to this is not the answer. It's not going to cure it," he said.
Fraud cases detected in Florida have typically involved multimillion-dollar schemes featuring bogus suppliers of wheelchairs, or other so-called durable medical equipment devices, and sham infusion therapies for the treatment of HIV and AIDS patients. Elaborate scams involving kickbacks and stolen identities have often been the norm. But less sophisticated ways of bilking Medicare and Medicaid, sometimes even involving medical services and equipment prescribed by dead doctors, have also been documented.
One recent trend, according to FBI agents who work the healthcare fraud beat, involved fictitious billings for prosthetic limbs. At first all the bills, and there were hundreds of them, involved prosthetic left arms. Then suddenly, the bills submitted were all for right-arm prostheses.
More recently the scammers have focused on home healthcare agencies and mental health services, along with rehab sessions and physical therapy.
"If it pays, they just latch into a code and keep billing it. If it's paying they just put the gas pedal to the floor," said Randall Culp, a senior agent in the FBI's Miami division.
Law enforcement officials note that less than 5 percent of all payment claims submitted to CMS have traditionally been subjected to rigorous audits involving any actual human intervention, and say prison sentences are too light.
As a deterrent, the Obama administration recently stepped up federal sentencing for healthcare fraud by up to 50 percent for crimes that involve more than $1 million in losses.
Sparrow, who once served as a policeman in Britain where he rose to the rank of Detective Chief Inspector, says a focus on law enforcement is also crucial.
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He said CMS and other government agencies had consistently taken a "quality control mindset" approach to healthcare fraud, failing to recognize it as a crime control problem above all else. "In a nutshell, that's the biggest thing they get wrong, and they get it wrong constantly," Sparrow said.
Patrick Burns of Taxpayers Against Fraud, a non-profit public interest watchdog group, is a big supporter of Budetti, who formerly chaired the organization's board of directors.
But Burns wonders whether Budetti can win the fight against a problem that he says has mushroomed totally out of control since 1993, when former Attorney General Janet Reno identified it as the No. 2 crime problem in America after violent crime.
The problem, as Burns sees it, is a weak U.S. regulatory environment and lack of financial commitment in Congress.
"I'm not sure it's a winnable war without putting more money into investigators," Burns said. "You have to have people on the street," Burns said. "The truth is that CMS doesn't have the resources and investigators to go out and rodeo all the fraud. It just doesn't."
The FBI does not disclose the number of agents working on healthcare fraud cases. But Congressman Henry Waxman, a California Democrat who has worked closely with Budetti on healthcare, said the Affordable Care Act had given CMS hundreds of millions of dollars and unprecedented powers.
"An astounding amount of money is lost through fraud and when we've got more cops on the beat and more personnel enforcing these laws and trying to prevent fraud, I think we will eliminate a lot of that absolute waste," Waxman said.
Senate Finance Committee Chairman Max Baucus said last month tougher enforcement was already starting to pay off with $4 billion recovered last year.
U.S. healthcare expenditures totaled $2.34 trillion, or 16.2 percent of GDP in 2008, the last year for which official figures are available. They are outpacing economic growth and projected to total $3.02 trillion, or $9,505 per person and 17.3 percent of GDP, by 2013.
There are no reliable estimates of the extent to which fraud contributes to those costs.
Every now and then, a big bust will make news, such as one last October involving a Miami-based chain of community health centers called American Therapeutic that was charged with billing for about $200 million in services that were either unnecessary or never provided to patients. But such successes are relatively few and far between.
Given the potential scope of the crime, and the low detection rates normally associated with white-collar crime, Sparrow said authorities may need to dismantle a $100 million billing scam on average every day to put "a serious dent" in the problem.
"We're seeing one once about every two months," he said.
Tuesday, February 1, 2011
Florida Federal Judge Declares Individual Mandate and the Reform Law Unconstitutional Appeal to Supreme Court Likely
PPACA Still the Law of the Land
Since the individual mandate is not effective until 2014, the court’s ruling has no immediate impact and does not affect ongoing implementation of the PPACA. Unless and until the Supreme Court decides otherwise, the law remains in effect.
CIGNA is continuing its PPACA implementation and remains compliant with those provisions already effective.
On Jan. 31, 2011, Florida U.S. District Court Judge Roger Vinson, declared the "individual mandate" of the Patient Protection and Affordable Care Act (PPACA) unconstitutional, ruling the government cannot require Americans to purchase health insurance starting in 2014. Vinson concluded that, "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void."
The Department of Justice will appeal the decision in this case, which was filed in March 2010 by Florida and joined by 25 other states. The constitutionality of the individual mandate is expected to eventually be decided by the Supreme Court.
In December 2010, a Virginia federal district court decided against the individual mandate, but didn't declare the entire law unconstitutional. Two earlier decisions in Virginia and Michigan found the mandate constitutional. Other cases are pending while several other lawsuits have been dismissed.
Under the PPACA, starting in 2014, individuals must be enrolled in a health insurance plan that meets basic minimum standards. Health care exchanges, also starting in 2014, will provide a new insurance marketplace where individuals and small businesses can buy qualified health benefit plans.
Next Steps
It's still unknown if the Supreme Court will agree to bypass the federal appeals courts and hear the appeal of one of the federal court decisions. It's likely to be some time before there's a final decision. For updated information as the case progresses, please visit www.fiorellainsurance.com.
For more information or to see if your health policy is current with health care reform visit us at www.fiorellainsurance.com
Since the individual mandate is not effective until 2014, the court’s ruling has no immediate impact and does not affect ongoing implementation of the PPACA. Unless and until the Supreme Court decides otherwise, the law remains in effect.
CIGNA is continuing its PPACA implementation and remains compliant with those provisions already effective.
On Jan. 31, 2011, Florida U.S. District Court Judge Roger Vinson, declared the "individual mandate" of the Patient Protection and Affordable Care Act (PPACA) unconstitutional, ruling the government cannot require Americans to purchase health insurance starting in 2014. Vinson concluded that, "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void."
The Department of Justice will appeal the decision in this case, which was filed in March 2010 by Florida and joined by 25 other states. The constitutionality of the individual mandate is expected to eventually be decided by the Supreme Court.
In December 2010, a Virginia federal district court decided against the individual mandate, but didn't declare the entire law unconstitutional. Two earlier decisions in Virginia and Michigan found the mandate constitutional. Other cases are pending while several other lawsuits have been dismissed.
Under the PPACA, starting in 2014, individuals must be enrolled in a health insurance plan that meets basic minimum standards. Health care exchanges, also starting in 2014, will provide a new insurance marketplace where individuals and small businesses can buy qualified health benefit plans.
Next Steps
It's still unknown if the Supreme Court will agree to bypass the federal appeals courts and hear the appeal of one of the federal court decisions. It's likely to be some time before there's a final decision. For updated information as the case progresses, please visit www.fiorellainsurance.com.
For more information or to see if your health policy is current with health care reform visit us at www.fiorellainsurance.com
Wednesday, October 20, 2010
Who pays for COBRA coverage?
Beneficiaries may be required to pay for COBRA coverage. The premium cannot exceed 102 percent of the cost to the plan for similarly situated individuals who have not incurred a qualifying event, including both the portion paid by employees and any portion paid by the employer before the qualifying event, plus 2 percent for administrative costs.
For qualified beneficiaries receiving the 11 month disability extension of coverage, the premium for those additional months may be increased to 150 percent of the plan's total cost of coverage.
COBRA premiums may be increased if the costs to the plan increase but generally must be fixed in advance of each 12-month premium cycle. The plan must allow you to pay premiums on a monthly basis if you ask to do so, and the plan may allow you to make payments at other intervals (weekly or quarterly).
The initial premium payment must be made within 45 days after the date of the COBRA election by the qualified beneficiary. Payment generally must cover the period of coverage from the date of COBRA election retroactive to the date of the loss of coverage due to the qualifying event. Premiums for successive periods of coverage are due on the date stated in the plan with a minimum 30-day grace period for payments. Payment is considered to be made on the date it is sent to the plan.
If premiums are not paid by the first day of the period of coverage, the plan has the option to cancel coverage until payment is received and then reinstate coverage retroactively to the beginning of the period of coverage.
If the amount of the payment made to the plan is made in error but is not significantly less than the amount due, the plan is required to notify you of the deficiency and grant a reasonable period (for this purpose, 30 days is considered reasonable) to pay the difference. The plan is not obligated to send monthly premium notices.
COBRA beneficiaries remain subject to the rules of the plan and therefore must satisfy all costs related to co-payments and deductibles, and are subject to catastrophic and other benefit limits.
To go over your COBRA coverage or to see if you can save money by going to an individually underwritten medical insurance policy by Blue Cross and Blue Shield, please contact us at contact@fiorellainsurance.com or apply online at http://www.fiorellainsurance.com
For qualified beneficiaries receiving the 11 month disability extension of coverage, the premium for those additional months may be increased to 150 percent of the plan's total cost of coverage.
COBRA premiums may be increased if the costs to the plan increase but generally must be fixed in advance of each 12-month premium cycle. The plan must allow you to pay premiums on a monthly basis if you ask to do so, and the plan may allow you to make payments at other intervals (weekly or quarterly).
The initial premium payment must be made within 45 days after the date of the COBRA election by the qualified beneficiary. Payment generally must cover the period of coverage from the date of COBRA election retroactive to the date of the loss of coverage due to the qualifying event. Premiums for successive periods of coverage are due on the date stated in the plan with a minimum 30-day grace period for payments. Payment is considered to be made on the date it is sent to the plan.
If premiums are not paid by the first day of the period of coverage, the plan has the option to cancel coverage until payment is received and then reinstate coverage retroactively to the beginning of the period of coverage.
If the amount of the payment made to the plan is made in error but is not significantly less than the amount due, the plan is required to notify you of the deficiency and grant a reasonable period (for this purpose, 30 days is considered reasonable) to pay the difference. The plan is not obligated to send monthly premium notices.
COBRA beneficiaries remain subject to the rules of the plan and therefore must satisfy all costs related to co-payments and deductibles, and are subject to catastrophic and other benefit limits.
To go over your COBRA coverage or to see if you can save money by going to an individually underwritten medical insurance policy by Blue Cross and Blue Shield, please contact us at contact@fiorellainsurance.com or apply online at http://www.fiorellainsurance.com
Tuesday, September 28, 2010
Tropical Storm Nicole - September 27, 2010
With Tropical Storm Nicole upon us it is important to get together your policy information in the event you have damage and need to file a claim. Below is a list of Florida insurance companies and their respective claims phone numbers. Be sure to have your policy number ready if you need to call.
Homeowner Companies
American Integrity
866-277-9871
Frontline
877-744-5224
Tower Hill/ Royal Palm
800-216-3711
American Traditions
866-270-8430
First Protective/ Flood
888-486-4663
Tower Hill Flood
877-254-6819
ASI/ Ark Royal
866-274-8765
Fl. Penninsula
877-994-8368
United
800-861-4370
Bankers
800-627-0000
Hull/Geovera
800-678-4855
United Flood
800-637-3846
National Flood
800-759-8656
Universal
800-218-3206
Olympus
866-281-2242
Universal North America
866-999-0898
US Insurance Services
800-245-1505
St. Johns
877-748-2059
Citizens
866-411-2742
Southern Fidelity
866-772-4995
Sawgrass
877-853-4430
Tapco
888-437-0373
Cypress
888-352-9773
Landmark One
866-243-5163
Liberty
866-219-7100
Federated
800-293-2532
Auto Companies
AIC
800-841-5241
GMAC
800-468-3466
Safeco
800-874-7342
AIG/ 21st Century
888-244-6163
Infinity
800-334-1661
Travelers
800-252-4633
Progressive
800-274-4499
Bristol West
800-274-7865
As always, we are here to help in any way we can so please feel free to contact us with any questions.
Homeowner Companies
American Integrity
866-277-9871
Frontline
877-744-5224
Tower Hill/ Royal Palm
800-216-3711
American Traditions
866-270-8430
First Protective/ Flood
888-486-4663
Tower Hill Flood
877-254-6819
ASI/ Ark Royal
866-274-8765
Fl. Penninsula
877-994-8368
United
800-861-4370
Bankers
800-627-0000
Hull/Geovera
800-678-4855
United Flood
800-637-3846
National Flood
800-759-8656
Universal
800-218-3206
Olympus
866-281-2242
Universal North America
866-999-0898
US Insurance Services
800-245-1505
St. Johns
877-748-2059
Citizens
866-411-2742
Southern Fidelity
866-772-4995
Sawgrass
877-853-4430
Tapco
888-437-0373
Cypress
888-352-9773
Landmark One
866-243-5163
Liberty
866-219-7100
Federated
800-293-2532
Auto Companies
AIC
800-841-5241
GMAC
800-468-3466
Safeco
800-874-7342
AIG/ 21st Century
888-244-6163
Infinity
800-334-1661
Travelers
800-252-4633
Progressive
800-274-4499
Bristol West
800-274-7865
As always, we are here to help in any way we can so please feel free to contact us with any questions.
Tuesday, September 21, 2010
Under COBRA, what benefits must be covered?
Qualified beneficiaries must be offered coverage identical to that available to similarly situated beneficiaries who are not receiving COBRA coverage under the plan (generally, the same coverage that the qualified beneficiary had immediately before qualifying for continuation coverage). A change in the benefits under the plan for the active employees will also apply to qualified beneficiaries. Qualified beneficiaries must be allowed to make the same choices given to non-COBRA beneficiaries under the plan, such as during periods of open enrollment by the plan. To make sure your not paying too much on your health insurance, contact us at wwww.fiorellainsurance.com today.
Wednesday, September 1, 2010
Can individuals qualify for longer periods of COBRA continuation coverage?
Yes, disability can extend the 18 month period of continuation coverage for a qualifying event that is a termination of employment or reduction of hours. To qualify for additional months of COBRA continuation coverage, the qualified beneficiary must:
* Have a ruling from the Social Security Administration that he or she became disabled within the first 60 days of COBRA continuation coverage
* Send the plan a copy of the Social Security ruling letter within 60 days of receipt, but prior to expiration of the 18-month period of coverage
If these requirements are met, the entire family qualifies for an additional 11 months of COBRA continuation coverage. Plans can charge 150% of the premium cost for the extended period of coverage. For more information, visit us online at www.fiorellainsurance.com or call us at 772-283-0003.
* Have a ruling from the Social Security Administration that he or she became disabled within the first 60 days of COBRA continuation coverage
* Send the plan a copy of the Social Security ruling letter within 60 days of receipt, but prior to expiration of the 18-month period of coverage
If these requirements are met, the entire family qualifies for an additional 11 months of COBRA continuation coverage. Plans can charge 150% of the premium cost for the extended period of coverage. For more information, visit us online at www.fiorellainsurance.com or call us at 772-283-0003.
Wednesday, August 25, 2010
Is a flood covered under my homeowners policy?
No, a standard homeowners policy does not include flood coverage. Flood is an inexpensive yet separate policy that is underwritten through FEMA and the rates are standardized so no matter what company your policy is through, the premium is the same. If your property is not in a flood zone, rates are as follows:
Building/Contents Premium
$20,000/$8,000 $119
$30,000/$12,000 $150
$50,000/$20,000 $201
$75,000/$30,000 $237
$100,000/$40,000 $264
$125,000/$50,000 $284
$150,000/$60,000 $303
$200,000/$80,000 $333
$250,000/$100,000 $355
For more information, or to see if you are covered, contact us at www.fiorellainsurance.com
Building/Contents Premium
$20,000/$8,000 $119
$30,000/$12,000 $150
$50,000/$20,000 $201
$75,000/$30,000 $237
$100,000/$40,000 $264
$125,000/$50,000 $284
$150,000/$60,000 $303
$200,000/$80,000 $333
$250,000/$100,000 $355
For more information, or to see if you are covered, contact us at www.fiorellainsurance.com
Monday, August 23, 2010
How long after a qualifying event do I have to elect COBRA coverage?
Qualified beneficiaries must be given an election period during which each qualified beneficiary may choose whether to elect COBRA coverage. Each qualified beneficiary may independently elect COBRA coverage. A covered employee or the covered employee's spouse may elect COBRA coverage on behalf of all other qualified beneficiaries. A parent or legal guardian may elect on behalf of a minor child. Qualified beneficiaries must be given at least 60 days for the election. This period is measured from the later of the coverage loss date or the date the COBRA election notice is provided by the employer or plan administrator. The election notice must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.
Note: If your qualifying event was involuntary termination of employment that occurred on or after September 1, 2008 through February 16, 2009, you may go online to www.fiorellainsurance.com or call 772-283-0003 to speak to a Benefits Advisor.
Note: If your qualifying event was involuntary termination of employment that occurred on or after September 1, 2008 through February 16, 2009, you may go online to www.fiorellainsurance.com or call 772-283-0003 to speak to a Benefits Advisor.
Thursday, August 12, 2010
Why did my auto insurance rates go up after a ticket even though I went to traffic school?
The short answer to this question is that traffic school does nothing for you except remove the points from your license. It is a fallacy that your insurance company will not find out about a ticket if you go to school; school or not, your rates will increase by the same amount. Unless you are about to lose your license for too many points, don’t bother going to traffic school…and definitely don’t do it save your auto rates. For a free no hassle quote, contact us online at www.fiorellainsurance.com
Thursday, August 5, 2010
Why did my auto insurance rates go up after an accident that wasn’t even my fault?
Unfortunately, from an auto insurance perspective, an accident effects your rates regardless of fault. It doesn’t seem right, but it’s just the way it is.
To find out more or to get a new quote on your Florida Insurance, go to www.fiorellainsurance.com.
To find out more or to get a new quote on your Florida Insurance, go to www.fiorellainsurance.com.
Monday, August 2, 2010
Why is my homeowner’s insurance company requiring me to have a fence or screen enclosure around my pool when my pool complies with all county codes?
This is a very good question that comes up a lot. As a general rule, all insurance companies require that a swimming pool be enclosed by a 4 foot, permanent fence or a screen enclosure, regardless of whether or not your county code requires it. And a baby fence does not qualify as it is not a permanently installed fence. This causes a problem for many homeowners and the only real option is to either purchase a homeowners policy that excludes pool liability or to bite the bullet and install a fence. For more information contact us online or email contact@fiorellainsurance.com.
Wednesday, July 28, 2010
“Why did my insurance company send an inspector to look at my property?”
This is a common practice for all insurance companies. When a new policy is issued, and normally upon policy renewal, Insurance companies will send a representative to your property to perform an EXTERIOR inspection on your house. The purpose of this inspection is to make sure the property is in good condition and there is no existing damage or liability risks. Do not be alarmed, you have done nothing wrong, this is common industry practice. Once again, this is an EXTERIOR inspection only and no one should request to come into your house.
Friday, July 23, 2010
With hurricane season upon us and the impending Tropical Storm, Bonnie, it is important to get together your policy information in the event you have damage and need to file a claim. Below is a list of Florida insurance companies and their respective claims phone numbers. Be sure to have your policy number ready if you need to call.
Homeowner Companies
American Integrity
866-277-9871
Frontline
877-744-5224
Tower Hill/ Royal Palm
800-216-3711
American Traditions
866-270-8430
First Protective/ Flood
888-486-4663
Tower Hill Flood
877-254-6819
ASI/ Ark Royal
866-274-8765
Fl. Penninsula
877-994-8368
United
800-861-4370
Bankers
800-627-0000
Hull/Geovera
800-678-4855
United Flood
800-637-3846
National Flood
800-759-8656
Universal
800-218-3206
Olympus
866-281-2242
Universal North America
866-999-0898
US Insurance Services
800-245-1505
St. Johns
877-748-2059
Citizens
866-411-2742
Southern Fidelity
866-772-4995
Sawgrass
877-853-4430
Tapco
888-437-0373
Cypress
888-352-9773
Landmark One
866-243-5163
Liberty
866-219-7100
Federated
800-293-2532
Auto Companies
AIC
800-841-5241
GMAC
800-468-3466
Safeco
800-874-7342
AIG/ 21st Century
888-244-6163
Infinity
800-334-1661
Travelers
800-252-4633
Progressive
800-274-4499
Bristol West
800-274-7865
As always, we are here to help in any way we can so please feel free to contact us with any questions.
Homeowner Companies
American Integrity
866-277-9871
Frontline
877-744-5224
Tower Hill/ Royal Palm
800-216-3711
American Traditions
866-270-8430
First Protective/ Flood
888-486-4663
Tower Hill Flood
877-254-6819
ASI/ Ark Royal
866-274-8765
Fl. Penninsula
877-994-8368
United
800-861-4370
Bankers
800-627-0000
Hull/Geovera
800-678-4855
United Flood
800-637-3846
National Flood
800-759-8656
Universal
800-218-3206
Olympus
866-281-2242
Universal North America
866-999-0898
US Insurance Services
800-245-1505
St. Johns
877-748-2059
Citizens
866-411-2742
Southern Fidelity
866-772-4995
Sawgrass
877-853-4430
Tapco
888-437-0373
Cypress
888-352-9773
Landmark One
866-243-5163
Liberty
866-219-7100
Federated
800-293-2532
Auto Companies
AIC
800-841-5241
GMAC
800-468-3466
Safeco
800-874-7342
AIG/ 21st Century
888-244-6163
Infinity
800-334-1661
Travelers
800-252-4633
Progressive
800-274-4499
Bristol West
800-274-7865
As always, we are here to help in any way we can so please feel free to contact us with any questions.
Friday, July 9, 2010
More Options For Blue To Help You
Blue Cross and Blue Shield of Florida, Inc. (BCBSF) puts health care in the palm of Floridians' hands with the launch of its new mobile website. The company's latest innovation is designed to help consumers save time and money, and can be accessed from any Smartphone including the latest Blackberry, iPhone, Droid and even the iPad. By simply typing www.bcbsfl.com into their mobile browser, members and non-members can easily get important health information and tools, as well as details about their plan and coverage benefits.
Now with just one click members can view their ID card and get instant snapshots of their plan benefits, Health Savings Account (HSA) balance and more. Members can also utilize the mobile website site to find a doctor based on their current GPS location, review details for that provider such as office hours, language spoken and map directions to their office. If a member leaves the doctor's office with a prescription in hand, they can save money by comparing drug costs at local pharmacies.
To learn more see this video or to get a free quote on any other products from Blue Cross Blue Shield,call us toll free at 1-800-509-2844 or contact us today.
www.fiorellainsurance.com
Now with just one click members can view their ID card and get instant snapshots of their plan benefits, Health Savings Account (HSA) balance and more. Members can also utilize the mobile website site to find a doctor based on their current GPS location, review details for that provider such as office hours, language spoken and map directions to their office. If a member leaves the doctor's office with a prescription in hand, they can save money by comparing drug costs at local pharmacies.
To learn more see this video or to get a free quote on any other products from Blue Cross Blue Shield,call us toll free at 1-800-509-2844 or contact us today.
www.fiorellainsurance.com
Thursday, July 1, 2010
Congress Reauthorizes the NFIP until September 30, 2010
As anticipated, the National Flood Insurance Program (NFIP) funding has once again been extended until September 30, 2010 in the latest extension granted by Congress until they can consider more meaningful changes to the Federal flood insurance program.
The Senate last night passed/adopted H.R. 5569 by unanimous consent and it is anticipated to be signed into law by the President today. The bill includes retroactive funding to cover the hiatus that began on June 1 when the NFIP program was allowed to lapse.
“During the lapse in the NFIP, Fidelity has been accepting new business applications and premium and taking all available steps to proactively handle flood insurance transactions as much as possible under the guidance of the NFIP and will now move forward to issue those policy transactions on hold pending the authorization”, stated Fidelity VP and NFIP Program Coordinator, Patty Templeton-Jones.
Renewal billings that have been on hold will be sent out immediately.
Fidelity National Property and Casualty Insurance Group is the largest provider of NFIP flood policies in the U.S. The National Flood Insurance Program (NFIP), a component of FEMA, provides flood insurance in more than 20,000 communities across the United States.
For further information, contact customer service via www.fiorellainsurance.com
The Senate last night passed/adopted H.R. 5569 by unanimous consent and it is anticipated to be signed into law by the President today. The bill includes retroactive funding to cover the hiatus that began on June 1 when the NFIP program was allowed to lapse.
“During the lapse in the NFIP, Fidelity has been accepting new business applications and premium and taking all available steps to proactively handle flood insurance transactions as much as possible under the guidance of the NFIP and will now move forward to issue those policy transactions on hold pending the authorization”, stated Fidelity VP and NFIP Program Coordinator, Patty Templeton-Jones.
Renewal billings that have been on hold will be sent out immediately.
Fidelity National Property and Casualty Insurance Group is the largest provider of NFIP flood policies in the U.S. The National Flood Insurance Program (NFIP), a component of FEMA, provides flood insurance in more than 20,000 communities across the United States.
For further information, contact customer service via www.fiorellainsurance.com
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