Over the years our firm has periodically sent out a newsletter to advise our clients and friends about recent changes, trends and happenings in the healthcare field.  We are pleased to share the August issue of our newsletter with you.  Periodically, we will do our best to share with you "insight" that we find helpful in our practice and that should be helpful for you in yours. 

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Jay B. Umansky
The Law Offices of Jay B. Umansky PC 


A bipartisan health care compromise?

By Rebecca Schatz
August 27, 2017

Washington (CNN)Senators may seek a bipartisan compromise next month on health care reform. President Trump hits the road to plug tax reform. And comments by a GOP elder may complicate Trump's trip to Missouri.

It's all part of this week's "Inside Politics" forecast, where you get tomorrow's headlines today.

1) Senators reach across the aisle on health care

Congress reconvenes after Labor Day with a very full agenda: tax reform, the debt ceiling and a furious, behind-the-scenes effort to cut a bipartisan bill on health care.

As CNN's Manu Raju explains, all eyes are on two senators when it comes to the deal-making.

"Senator Lamar Alexander, the Republican from Tennessee, and Senator Patty Murray of Washington -- they're working on a narrow health care fix to try to shore up the individual insurance markets. This, of course, after a bunch of big insurers have left some key state exchanges. It's something that could look along the lines of insuring those subsidies that go to insurance companies, the one the Trump administration has threatened to cut off," Raju reports.

"We know how difficult the health care (issue) is, but there is a possibility of getting something done," he adds. "They're trying to do something in September, something to ensure there's some certainty before the enrollment period begins for some of these insurance companies."

2) The John Danforth factor

President Trump has picked an interesting time to make his first trip as president to Missouri.

As Trump prepares to head to Springfield, Missouri, to tout tax reform, one of Missouri's most well-known Republican political figures is calling Trump "hateful." That would be former Senator John Danforth, who says the President is corrupting the GOP.

As Jonathan Martin of the New York Times reports, the Danforth pushback could mean trouble for Trump in the state.

"Danforth is not just some retired politician. He still looms large on the Missouri political landscape. He's a mentor for a lot of folks in the GOP," Martin explains. "It puts a lot of the current members of the party in Missouri in a tough spot. Who do they side with: the godfather of the party in their state, or of the rank and file who like Trump just fine?

"I think it gets to the larger split -- a lot of folks in the party, the rank and file, are just fine with the President. The elites in the party increasingly believe that he is a perilous figure for the GOP."

Is Anthem's ER policy legal? Health executives want state insurance director to weigh in

By Samantha Liss  
August 4, 2017
St. Louis Post-Dispatch

A few health care industry executives have sent a letter to Missouri's insurance director, asking her to take a "hard and earnest look" at Anthem's emergency room policy and whether it is legal.

This summer, Anthem began warning members that if they were to go to the ER for a minor ailment, then the patients would be stuck with the entire bill. Anthem said it would no longer cover emergency visits for such ailments as the common cold amid what Anthem said is an increasing trend of unnecessary ER visits by its members.

"We think this policy is unfair to policyholders, and downright dangerous for patients," according to a letter dated July 27 and addressed to Insurance Director Chlora Lindley-Myers.

The letter was signed by Herb Kuhn, CEO of the Missouri Hospital Association; Dr. Jonathan Heidt, president of the Missouri College of Emergency Physicians; Brian Bowles, executive director of the Missouri Association of Osteopathic Physicians and Surgeons; and Thomas Holloway, executive vice president of the Missouri State Medical Association.

The signers allege that Anthem's policy violates the "prudent layperson" standard. In other words, there are legal protections for people with limited medical knowledge who need what they believe is immediate care.

That standard is "critically important," the letter said. "Is that chest pain just unwelcome indigestion, or is it a life-threatening cardiac event?"

The letter calls the policy by Anthem a way to shift costs from the insurer to the patient and says it will have a "chilling effect" on patients who will forgo care, worried they may be on the hook for the entire bill.

Editorial: Looking Beyond the Obamacare Debate to Improve Health Care

By The Editorial Board, New York Times
August 26, 2017 

Now that Republicans in Congress appear to have at least temporarily abandoned their crusade against the Affordable Care Act, it seems like a good time for lawmakers to come up with plans to fulfill their promises to increase access to health care and to lower costs.

Let's stipulate up front that congressional leaders and President Trump are unlikely to lead that effort, given that they narrowly failed to take health insurance away from millions of people. This conversation would need to be led by senators who have committed to a bipartisan approach, and by state governments, some of which have already begun to take action.

Change might not come soon enough for the 29 million people without health insurance or the many millions who struggle to afford high premiums, deductibles and other health costs. But even the A.C.A., the 2010 health law also known as Obamacare, was the product of many years of spadework and was based on a Massachusetts health reform bill signed into law by Gov. Mitt Romney in 2006.

Obamacare has helped 20 million people gain access to insurance, and it appears to have helped slow the growth in health care costs. But even former President Barack Obama has said that there is still work to be done. The United States spends much more on medical care than other rich countries, like Britain, Australia and the Netherlands, according to a recent Commonwealth Fund report, yet its citizens live shorter lives and suffer from more illnesses and injuries than people in other industrialized nations.

One option that appears to have gained support among the public is a single-payer system, which proponents like Senators Bernie Sanders and Elizabeth Warren call "Medicare for All." A Kaiser Family Foundation poll found in June that 53 percent of Americans favor such a system. This was up from 46 percent, according to an average of seven polls conducted in 2008 and 2009. But moving to a single-payer system from one dominated by employer-paid health coverage would be a big leap, and in any case the political climate is clearly not ready for it. Many Democratic voters as well as party leaders like Representative Nancy Pelosi and Senator Chuck Schumer have been reluctant to embrace the idea, and, no surprise, most Republican voters and lawmakers oppose it.


On February 21, 2017, The Law Offices of Jay B. Umansky, P.C. celebrated our FIFTEENTH ANNIVERSARY. While this date was certainly a milestone, another celebration will soon be shared. Sometime before the end of 2017, we will have collected ONE HUNDRED MILLION DOLLARS on behalf of our clients. In recognition of this achievement we are announcing a contest for our clients. Guess the date and time at which we deposit the payment representing this achievement. The first prize winner will receive $1,000.00 in cash (or if they would prefer a donation to their favorite charity), the second prize winner $500.00 in cash (or if they would prefer, a donation to their favorite charity) and the third prize winner $250.00 in cash (or if they would prefer, a donation to their favorite charity). 

Entries can be made by emailing Entries must be received by September 15, 2017.  

The contest is open to clients of the office effective June 1, 2017.

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