February 11, 2012

Group Supports, Yet Has Questions About Insure Missouri

A group often critical of the Blunt Administration has praise for the governor’s plan to expand health care coverage, at least for the concept.

The Missouri Budget Project still wants to hear details. Executive Director Amy Blouin says Governor Blunt’s Insure Missouri could be very beneficial for Missouri and could help some Missourians who lost Medicaid coverage in 2005 regain health care. Yet Blouin wants some details, especially about how it is to be funded.

Blouin says states which have built upon a Medicaid structure have had some success in programs similar to Insure Missouri. She says states which have chosen to fund the program by providing incentives so that businesses offer health coverage to employees hasn’t worked. Blouin says it appears the Blunt Administration has a good funding structure, but she wants to see more details to determine if it is truly "fiscally sustainable".

Another big concern of the Missouri Budget Project is rural Missouri. Blouin notes the plan relies on HMO coverage, which doesn’t extend very far in rural Missouri. Blouin says that while the St. Louis and Kansas City areas have thorough HMO coverage, that coverage doesn’t extend very far into rural Missouri. 

Download/listen Brent Martin reports (:60 MP3)

Insurance Department Fines Chesterfield HMO $100,000 For Violating Prompt Pay Law

The State Insurance Department has levied its biggest fine ever – more than $100,000 – against an HMO based in Chesterfield. Insurance Director Scott Lakin says Mercy Health Plan violated the state’s prompt pay law by failing to acknowledge receipt of about 20 percent of the claims filed with it. The law requires HMOs to acknowledge claims within ten days. Lakin says Mercy has paid its fine promptly, without objection. He adds several more companies are being examined.

Lawmakers Wrestle with HMO Changes

A proposal to end the need for Missourians to change doctors whenever they change HMOs is under debate in the state Senate. The Senate’s only doctor says cancer patients, pregnant women — and anybody else — should be able to keep their doctor even if their insurance company changes. Senator Marvin Singleton of Seneca favors the “any willing provider” concept, which says any doctor who qualifies to submit insurance claims should be allowed to submit them to whatever HMO insures his patient. Singleton says the priorities are wrong now. Some Senators worry that Singleton’s proposal will drive up health carecosts, especially to large companies or even to stategovernment, which provides coverage to its employees. The Senate will spend more time on his proposal later.

HMO’s Ordered To Stop Dragging Their Feet

Health Maintenance Organizations are being ordered by the Legislature to stop delaying payment of consumers’ bills. A prompt pay bill has been sent to Governor Holden for his signature – a bill requiring payment of claims to start within fifteen days after they are filed – unless the company needs more information. In time, penalties could kick-in for non-compliance. Those supporting the legislation say insurance companies make a lot of money by delaying payments.

Women’s health care focus of bill

Legislation forcing insurance companies to loosen restrictions on common women’s medical care has been filed in both the House and Senate. Representative Joan Barry of St. Louis sponsors the bill that mandates direct access to an OB/GYN. The bill also mandates notification of cancer screenings, provision of bone density testing for elderly women and contraceptive coverage. Barry acknowledges the health insurance lobby will likely resist the legislation and contraceptive coverage might also spark protests among some pro-life lawmakers.