Health for Life

Excerpt: "This district court opinion holds interest for health care providers and benefit fiduciaries alike. As against a motion to dismiss, the district court holds that the plaintiffs have stated a cause of action against the health care provider for balance billing, i.e., billing the balance 'owed' after their health plan paid the PPO discounted rate." (Attorney Roy F Harmon III in the Health Plan Law blog)

13 pages. Excerpt: "Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. . . . Despite [the] challenges, researchers have used the data available to study competition in health insurance markets, typically using one of two measures of competition: (1) HMO market concentration or (2) the number of HMOs in a market." (U.S. Government Accountability Office)

3 pages. Excerpt: "On July 29, 2009, New York Governor David Paterson (D) signed into law three health reform bills -- one extending the period for state health coverage continuation rights from 18 to 36 months, one requiring insurers to offer continued coverage for unmarried adults through age 29 under their parent's individual or group health insurance policies, and one instituting a series of managed care reforms." (Buck Consultants)

The New Jersey Division of Disability Services has decided to change the Traumatic Brain Injury (TBI) Fund. Current financial conditions and a growth in the number of fund cases has resulted in changes which will impact benefits and coverage. As a result, medical co-pays for doctor visits; pharmaceutical co-pays; health insurance / COBRA premiums; disposable medical supplies; co-pays for therapy services; and medical gym memberships will no longer be covered.

For those individuals who have previously been awarded coverage for these items, the Division will continue payments for up to 90 days of service ending on or before December 31, 2009. As of January 1, 2010, no further payments will be made.

For more information on what these changes will mean to you and your family, visit the Division of Disability Serives online here.

The Brain Injury Association of New Jersey’s Children & Adolescents Committee will hold the next session of Brain Injury Basics for Parents & School Professionals next Tuesday October 20, 2009 from 6:30 – 8:30 PM at Rowan University, Chamberlain Building, Room 221, 201 Mullica Hill Road, Glassboro, NJ 08028. The seminar will be presented by Barbara Leech, Ph.D., a Pediatric Neuropsychologist.

The educational seminars are intended for parents, school professionals, and other interested health and disability professionals. During the seminar, attendees will learn to identify, understand and respond to the special needs of students with brain injuries. Professional Development Hour certificates can be presented to school professionals. For additional information or to RSVP, contact Justin Stanley of the Brain Injury Association of New Jersey at 732-745-0200 or by email at jstanley@bianj.org.