New government reporting requirements
The Centers for Medicare and Medicaid Services (CMS) recently announced a new requirement that states health plans must gather additional personal information about group plan enrollees. Employers are starting to hear about this change and could be concerned.
In order to comply with this new directive, HealthPartners will need your clients’ assistance in gathering key data about their employees, spouses and dependents during 2009.
- HealthPartners must gather certain personal data, including Social Security numbers, for employees and spouses age 45 or older and Medicare-eligible dependents (i.e. End-Stage Renal Disease or disabled individuals). Data must be retroactive back to 1/1/09.
- HealthPartners must also gather additional business information quarterly, including Tax ID Number and number of active full and part-time employees.
- While some health plans have to fulfill this requirement by January 1, 2009, HealthPartners has until April 1, 2009, to begin testing data files with CMS. The extra time was provided to establish a voluntary data sharing agreement with CMS for plans that do not currently have such an agreement in place. We will be working with employers over the coming months to obtain the required information.
Medicare intends to use this data to coordinate benefits of people who have both Medicare and private insurance to ensure Medicare is not paying claims that should be paid by insurance plans.
Additional guidance from CMS is expected in late December. We will update you as more details are released so you can assist your clients with this new requirement.
HEADLINES
Caps off to a great dental year!
This past year, HealthPartners dental plans have given you and your clients even more to smile about. In addition to simplifying our product portfolio to make our plans easier to understand and administer, we made some significant benefit changes for members.
Here’s a re-cap of our enhanced benefits:
- Dental Benefits for Little Partners, which includes full coverage for kids age 12 and under. This benefit takes effect on your clients’ renewal dates.
- Dental Implants, which includes both the surgical placement of the implant and the implant prosthetic. This benefit takes effect on your clients’ renewal dates.
- Diabetes and Maternity Care, which include enhanced periodontal benefits for members who are diabetic and/or pregnant. This benefit took effect for all members enrolled in group plans July 1, 2008.
These enhancements, combined with our constantly growing dental network, great discounts and affordability definitely differentiate HealthPartners dental plans from our competitors. Don’t forget our value-adds, too, like our orthodontic discount, vision discount and tobacco cessation program!
Thank you for supporting our dental plans in the past year – we look forward to working with you in 2009!
Health Reform Coalition Membership
HealthPartners is part of an unprecedented and diverse health reform coalition called the National Priorities Partnership. The group unveiled its plans for improving the quality of U.S. healthcare last month in Washington, D.C.
George Isham, MD, HealthPartners chief health officer, is representing HealthPartners on the coalition. The National Priority Partnership plans are designed to improve quality by better engaging patients in their own care, promoting health and disease prevention, improving care coordination and care at the end of life and ensuring that care is safe, efficient, affordable and provides a superior patient experience.
The National Priorities Partnership includes 28 high-profile groups representing consumers, providers, practitioners, purchasers, health plans, government, accreditation and certification organizations and quality alliances.
Learn more about the National Priorities Partnership.
Experience Healthy Benefits!
Now, you and your clients can experience Healthy Benefits online! Our new interactive Web tool gives a “live” view of this program’s member experience.
While we plan to continue building this online demonstration, phase I is appropriate for:
- Pre-sale use with employers who would like to get an idea of what the program has to offer
- Post-sale use with employers who would like to train staff and give them the experience of participating in Healthy Benefits
The demonstration is located on the Health Solutions page of healthpartners.com/employer. Review now.
"Best Value" Hospitals Nationwide
Thirteen hospitals nationwide earned the distinction of “highest value” for patients in the 2008 Leapfrog Hospital Survey. Three of those hospitals are in Minnesota – Fairview Southdale, Methodist and Regions. The hospitals earned the “highest value” distinction based on how well and how efficiently they treat patients for pneumonia and heart disease. In selecting the highest value hospitals, Leapfrog reviewed more than 1,220 hospitals nationwide. Learn more.
Regions Hospital Has Heart
For the second year in a row, Regions Hospital has been named one of the nation’s top 100 hospitals for cardiovascular care by Thomson Reuters. The rankings are based on Thomson’s 2008 “Cardiovascular Benchmarks for Success Study.” The annual study examined the performance of 970 hospitals across the nation by analyzing clinical outcomes for patients diagnosed with heart failure and heart attacks and for those who received coronary bypass surgery and angioplasties. Regions is one of only seven Minnesota hospitals on the list. Learn more.
Broker Firm Agreements
Don’t forget to return your 2008 Broker Firm Agreements. These agreements went into effect November 1, 2008. If you did not receive a copy or need a new copy, please contact Marsha Johnston to receive another copy. Marsha can be reached by phone at 952-883-7237 or by e-mail at marsha.a.johnston@healthpartners.com.
IN EVERY ISSUE
Frequent Fitness Update
Our Frequent Fitness program continues to grow. Members now have even more choices and chances to save money while achieving a healthy lifestyle. Now, members who enroll or are enrolled in the Frequent Fitness program will have access to more than 850 locations in the HealthPartners service region.
The Frequent Fitness program offers fully insured members (two per household) up to a $20 reimbursement for working out 12 times a month.
Learn more about Frequent Fitness.
Network Updates
As our client base and membership continues to expand, so does our network. In fact, we’ve recently added a large number of providers. We’re committed to providing access to the providers your clients demand – nationwide. No matter where your clients live, work or travel, we’ve got them covered. Additions last month included:
Medical – Minnesota
Gundersen Lutheran – Houston
Robbinsdale Clinic PA – Minneapolis
Medical – South Dakota
Sanford Clinic – Aberdeen
Dental – Minnesota
A Gentle Dental Center, PA –Robbinsdale
Excelsior Dental – Baxter
S. A. Patel, DDS, PA – Clarkfield
S. A. Patel, DDS, PA – Cottonwood
Dental – Wisconsin
Shaw Family Dental, SC – Ellsworth
Try out our new search function to see just how easy it is to find a network provider quickly and simply. Provider Search
Library: Quick Links to Great Resources
Important Contacts
Our Group Medical Plans
Our Group Dental Plans
Our Individual and Medicare Plans
Our Achieve SM Health Improvement Programs
Our CareSpan SM Disease Management Programs
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