April 2, 2007

Insurance For 'Gravity Benders' Could Break Everyone Else
Last Chance To Apply For National Provider Identifier
2007 MSMS House Of Delegates
Doctors' Night At The Science Center, April 20
Mind, Mood, Medicine
MSMS Accepting BOM Nominations

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Insurance For 'Gravity Benders' Could Break Everyone Else

By PAUL NATINSKY
As physicians, patients and policy makers wrestle with a wide array of potential solutions to America's growing health care cost crisis, new challenges continue to present themselves...some in the under the guise of health care reform.

Various universal health coverage schemes have their supporters as do solutions featuring medical savings accounts and low-premium catastrophic insurance coverage.

But one plan that has recently come to light seems fraught with danger. WellPoint, Inc., a marketer for Blue Cross and Blue Shield plans, is designing bare bones, low-cost health insurance policies for so-called "young invincibles," people in their 20s who face few serious health risks and perceive themselves as invulnerable to illness and its associated costs.

According to BusinessWeek Magazine (March 19, page 84), policies titled "Part-Time Daredevil" and "Gravity Bender" offer basic coverage for as little as $67 per month. WellPoint CEO Angela Braly touts the policies as making inroads in covering the uninsured (a significant portion of which are working people in their 20s). The policies exclude some coverages, such as maternity benefits, and feature limits of as few as four doctor visits per year with deductibles as high as $5,000 ($10,000 for out-of-network services), reported BusinessWeek.

Some critics consulted for the article charged that Wellpoint's products provide too little coverage for the money, despite the fact that they cost about one-third as much as many employer-sponsored plans. There are also criticisms that the scaled-down plans, if successful in their marketing would "cherry pick" many of the low-risk patients from the insurance pool, leaving traditional plans and government payers caring for the sickest patients and suffering rapidly increasing costs and premiums.

WellPoint, which markets its plans on Web sites such as www.Tonik.com and www.Soundhealth.com, can't be dismissed as just a short-term fad or small player in the market. The company weighed in at No. 2 on BusinessWeek's list of best corporate performers for 2006 with sales of $60 billion (up from $6 billion eight years ago). Wellpoint has bought up a number of Blues Cross Blue Shield Plans and the Indianapolis-based firm has made it clear, through CEO Braly, that it will be a player in any health care reform debate that takes place in the near future.

Perhaps the best policy angle to take to stem this potential tide would be to force the company to change the names of its plans. Perhaps the "God-help-you-if-you-get-cancer" plan would be a good start; or the "Geez-I-didn't-plan-on-kids-until-later" program." The best of all might be the "Send-The-Bill-To-Braly" benefit.

Feel free to send your suggestions to us.

Last Chance To Apply For National Provider Identifier

The NPI compliance date is May 23, 2007. However, according to the Centers for Medicare & Medicaid Services, once a physician obtains an NPI, it may take up to 120 days to implement the NPI into current business practices.

With this timeframe, it may be YOUR LAST CHANCE TO APPLY FOR AN NPI and implement it without adversely affecting claims made in HIPAA standard transactions.

MSMS is encouraging physicians to apply for their National Provider Identifier (NPI) now. The NPI is an Administrative Simplification mandate of HIPAA. It is a 10-digit number that will be used to identify physicians to their health care partners, including all payers, in all HIPAA standard transactions. The NPI will replace the identifiers physicians currently use when submitting claims to the various payers. All health care providers are eligible to receive NPIs. All HIPAA-covered health care providers, whether they are individuals or organizations, must obtain an NPI to identify themselves in HIPAA standard transactions.

Physicians can obtain an NPI by applying online at https://nppes.cms.hhs.gov or by calling 800-465-3203 to request a paper application.

For more information, visit www.cms.hhs.gov/NationalProvIdentStand or contact Stacie Saylor at MSMS at 517-336-5722 or ssaylor@msms.org

2007 MSMS House Of Delegates

The 142^nd annual MSMS House of Delegates meeting will take place Friday, April 27 - Sunday, April 29, at The Ritz-Carlton Hotel in Dearborn.

Last year, more than 300 physician leaders, delegates, and alternate delegates turned out to make policy in Michigan during the 141^st annual MSMS House of Delegates meeting in Grand Rapids. Delegates and alternates considered 99 resolutions and 23 Board Action Reports on a host of topics ranging from universal health coverage to flu vaccine availability.

For more information about the MSMS House of Delegates, visit www.msms.org/hod. Or contact Jennifer Finney at (517) 336-5735 or jfinney@msms.org; David Fox at (517) 336-5731 or dkfox@msms.org; or Jeanne Miller at (517) 336-5726 or jkmiller@msms.org.

Doctors' Night At The Science Center, April 20

By JOSEPH WEISS, MD
Please set aside Friday evening April 20th from 5:30 p.m. onward. The Wayne County Medical Society, in conjunction with the Oakland County Medical Society, the Young Physicians Committee, and Alice Haidostian, has reserved the Detroit Science Center for us. Members of WCMSSM, their families and friends, will have the Science Center exhibit: OUR BODY *The Universe Within - for our viewing alone. In addition, we have admission to the IMAX Theater presentation: OUR BODY.

The exhibit provides a unique view of human anatomy. The opportunity of a personal showing allows a viewing without obstruction or hurry. A physician will be able to undertake a visual dissection of the body more thoroughly than possible in the anatomy laboratory of medical school years. The chance to show anatomy to others is another plus. The Center cafeteria will remain open for anyone who wants to take a break in seeing the exhibit for coffee or a snack.

WCMS members have another reason to attend. The Science Center is initiating a revamped Health Science Exhibit Hall. It is worth physicians’ efforts to take a long-term interest in the project. Attending this event on Friday, April 20 will provide doctors a sense of the role the Center can play in educating the public. See what possibilities exist for learning for yourself, your family, and your patients.

Note: tickets for the evening are $25/person. See the accompanying application or contact Jason Riske at the WCMS (313) 874 1360 ext. 23 for further information.

To sign up click here

Mind, Mood, Medicine

2007 Retreat for Women Physicians - "Mind, Mood and Medicine"
Friday-Sunday, April 13-15, Kalamazoo

The MSMS Foundation is proud to announce that the 2007 Retreat for Women Physicians will take place Friday-Sunday, April 13-15, at the Kalamazoo Radisson. This year’s event, titled "Mood, Mind and Medicine," will focus on the needs and interests unique to women physicians, including life transitions for women, scope of practice, epilepsy in women, sexual dysfunction, depression, and more.

Now in its fourth year, the Retreat for Women Physicians will provide attendees with the opportunity to network with colleagues while learning about topics that affect their personal and professional lives. Breakout sessions covering a wide array of topics will allow attendees to choose which sessions best suit their needs and interests.

The weekend also will include a number of recreational/non-medical opportunities, such as spa services and a Saturday evening showing of "The Women," by Clare Boothe Luce, at the Kalamazoo Civic Theatre.

Registration begins at 8:30 a.m. and the daily program will run from 9:00 a.m. to 2:00 p.m. Cost is $200 for MSMS & MMGMA members, $275 for non-members.

For more information or to register, visit www.msms.org/events or contact the MSMS Registrar at (517) 336-5784 or abatten@msms.org.

MSMS Accepting BOM Nominations

The MSMS Committee on Licensure & Discipline has begun the process of soliciting candidates who wish to receive the recommendation of MSMS for appointment to the Michigan Board of Medicine. On Dec. 31, 2007, the terms of five Board of Medicine members will expire. Of those five, four are eligible to be reappointed to a second four-year term. One position will be vacant and require an appointment by the governor. The Committee considers many key factors (peer review experience, board certification, and involvement in organized medicine) when selecting a candidate it believes to be qualified to serve in this capacity. The Committee will begin accepting candidates this month and will continue to do so through the end of April so that the recommendations may be brought to the July MSMS Board of Directors meeting for final approval.

For more information or to obtain a nomination application, visit www.msms.org/advocacy. Or contact Colin Ford at MSMS at (517) 336-5737 or cford@msms.org.

This publication brought to you by Natinsky Publishing Network.

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