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 February 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

Three corporate giants - Amazon, Berkshire Hathaway and JPMorgan Chase - are forming a company that could disrupt U.S. health care

New York Times
January 30, 2018 

Amazon, Berkshire Hathaway and JPMorgan Chase announced on Tuesday that they would form an independent health care company to serve their employees in the United States.

The three companies provided few details about the new entity, other than saying it would initially focus on technology to provide simplified, high-quality health care for their employees and their families, and at a reasonable cost. They said the initiative, which is in the early planning stages, would be a long-term effort "free from profit-making incentives and constraints."

The partnership brings together three of the country's most influential companies to try to improve a system that other companies have tried and failed to change: Amazon, the largest online retailer in the world; Berkshire Hathaway, the holding company led by the billionaire investor Warren E. Buffett; and JPMorgan Chase, the largest bank in the United States by assets.

It also illustrates the rapid changes affecting the health care industry in the United States, where lines that have separated traditionally distinct sectors, like care provision and insurance, are increasingly blurred. CVS Health's deal last month to buy the health insurer Aetna for about $69 billion is just one example of the shifts underway.

"It could be big," Ed Kaplan, who negotiates health coverage on behalf of large employers as the national health practice leader for the Segal Group, said of the announcement. "Those are three big players, and I think if they get into health care insurance or the health care coverage space they are going to make a big impact."

Missouri Medical Fee Schedule Bill (Senate Bill 601) Referred to Small Business and Industry Committee.  

By Andrew Babitz 
February 1, 2018 

As you may be aware, Senate Bill 601, the bill that would create a Missouri Worker's Compensation Medical Fee Schedule has been introduced by Republican Senator Dave Schatz.  The next step in the bill's process is to be referred to a Senate Standing Committee.  The bill has been referred to the Senate Small and Industry Committee.  The next step in the process will be a public hearing on the bill.  At the hearing, members of the public are allowed to testify as to the pros and cons of the bill.  

After the hearing, the 8 members (6 Republicans and 2 Democrats) will vote to pass the bill out of Committee. If a majority of the Senators on the Committee vote to pass it out of Committee, the bill would then be given a time to be debated on the floor of the Senate for the entire body to vote on.  In the meantime, it is important that medical providers contact these Senators and advise them that they are against a fee schedule.  The members of the Committee are:
  1. Doug Libla (R), Chair,13th District, Butler, Carter, Dunklin,Mississippi, New Madrid,Pemiscot, Shannon and Stoddard Counties; (573) 751-4843
  2. Paul Wieland (R) Vice-Chair, 22nd District, Part of Jefferson County; (573) 751-1492
  3. Andrew Koenig (R), 15th District, Part of West St. Louis County; (573) 751-5568
  4. Brian Munzlinger, (R), 18th District, Adair, Chariton, Clark, Knox, Lewis, Linn, Macon, Marion, Pike, Ralls, Randolph, Schuyler, Scotland and Shelby Counties; (573) 751-7985
  5. Robert Schaaf (R), 34th District, Buchanan and Platte Counties;  (573) 751-2183
  6. Wayne Wallingford (R), 27th District Bollinger, Cape Girardeau, Madison, Perry, Scott, and Wayne Counties; (573) 751-2459  
  7. Jacob Hummel (D), 4th District, Parts of St. Louis City and St. Louis County; (573) 751-3599
  8. Scott Sifton (D), 1st District, Parts of St. Louis County; (573) 751-0220
In today's climate, where each provider's reimbursement is being reduced and challenged at every turn, it is important to stand up and oppose a bill which most certainly would reduce recoveries on treatment following work related injuries.

If you have any questions or concerns, please don't hesitate to contact our office at any time.  

Editorial: These Trump administration changes could make health-care coverage worse

The Editorial Board 
The Washington Post
January 15, 2018 

SINCE THE big Obamacare repeal-and-replace bills failed in the Senate, Congress and President Trump have sought to undermine the law in subtler ways. First, Republican lawmakers repealed Obamacare's individual mandate, a key element of the law's design. Now the Trump administration is rolling out rules that threaten to damage the structure further.

The Labor Department this month proposed looser regulations on so-called association health plans, under which small businesses, professional associations and others in similar circumstances can band together and buy insurance coverage for their groups as though they were large employers. The department argues that up to 11 million people working at small businesses or as sole proprietors lack health insurance, and that the new rules would help provide them more options.

In fact, there is a potentially large downside. The rules would also excuse association health plans from covering 10 classes of essential health benefits. Plans would probably be cheaper, but they would likely cover less than the comprehensive ones Obamacare sought to make the national standard. It is likely that some people who buy these plans will develop significant health problems and find themselves disastrously under-covered. Some may be willing to take that risk. The bigger problem is that opening a new avenue to buying shoddier insurance may harm everyone else seeking affordable, comprehensive coverage when they cannot get it from a large employer.

Obamacare was built for these individual insurance buyers, who are guaranteed comprehensive coverage that includes those 10 essential health benefits if they buy in the Obamacare marketplace. Over time, new, cheaper association plans might draw healthy people out of the well-regulated Obamacare market and into the more loosely regulated world of association plans. The more healthy insurance buyers exit the Obamacare system, the higher premiums would have to rise in the system's marketplace to offset the medical costs of those who remain. Many people who need coverage - or who simply want comprehensive policies - would have to pay more for it.

The rules' defenders argue that association plans would not be allowed to discriminate against people based on their health status, so it would be hard for them to draw only healthy customers. But experts worry the rules may allow plans to discriminate heavily based on age and sex. Plans could also find subtle ways of weeding out sick customers, for example by designing benefits packages that do not cover expensive treatments that some customers need.

Denelle Joehl

Joined JBU  Law: October 2017

Family:  Mother of two daughters (19) and (15) 

Favorite Hobbies:  Going to concerts, reading gardening, spending time with friends and family, cardinals baseball

Quote:  "Our greatest glory is not in never falling, but in rising every time we fall."  Confucius

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Jay B. Umansky, Principal Attorney - jumansky@stllaw.net - 314-628-1177 X 101
Andrew F. Babitz, Associate Attorney - ababitz@stllaw.net - 314-628-1177 X 103
Kellie L. Roland, Office Administrator - kroland@stllaw.net - 314-628-1177 X 102