U.S. Cannot Subsidize Health Plans in States With No Marketplace, a Judge Rules – NYTimes.com - October 1, 2014 by zeldalegacy

WASHINGTON — A federal district judge in Oklahoma dealt a blow to the Affordable Care Act on Tuesday, ruling that the federal government could not subsidize health insurance in three dozen states that refused to establish their own marketplaces. This appears to increase the likelihood that the Supreme Court will ultimately resolve the issue.

Federal appeals courts in Washington and in Richmond, Va., split on this question in July.

Judge Ronald A. White of the Federal District Court in Muskogee, Okla., said Tuesday that a rule issued by the Obama administration allowing subsidies in the 36 states was arbitrary and capricious, in excess of statutory authority or simply “an invalid implementation” of the 2010 health care law.

The ruling, if ultimately upheld, could cut off financial assistance for more than 4.5 million people who were found eligible for subsidized insurance in the federal exchange, or marketplace. However, the judge stayed the effect of his decision to allow for an appeal, and Emily Pierce, a Justice Department spokeswoman, said the federal government would file one.

via U.S. Cannot Subsidize Health Plans in States With No Marketplace, a Judge Rules – NYTimes.com.

Filed under: Government, Healthcare

The Role of International Trade Agreements in Fighting Corruption - October 1, 2014 by zeldalegacy

The next year is shaping up to be a big one for multilateral free trade agreements and, by extension, efforts to fight corruption in international commerce.

What do trade agreements have to do with reducing corruption? Historically, not much. But these two agreements break new ground both in their scope and their potential for attacking corruption as a barrier to trade. This fact is often lost…

CIPE Development Blog

Third parties cannot challenge merits of competition settlements - September 30, 2014 by zeldalegacy

Third parties cannot challenge underlying facts Third parties cannot challenge the factual basis underpinning settlements between the Commissioner of Competition and targets of inquiries under the Competition Act, the Competition Tribunal held recently. Challenges by third parties consent agreements are limited to Whether terms of the consent agreement are outside the scope of the type [...]
The Litigator – Affleck Greene McMurtry, LLP

Health care spending trends-watch your wallet‼️ - September 30, 2014 by zeldalegacy

I guess you can look at the following as good news or not so good news (or more likely it’s a good guess for now). A slower growth rate is not bad of course, but health care spending growing at more than twice general inflation is not great.

Clearly your costs are not going down by an average of 00 as the rhetoric once claimed and from a personal point of view you should pay close attention to the few words I underlined below; for employer-based coverage especially that’s what is going to get you in the wallet.

National Health Expenditure Projections, 2013–23: Faster Growth Expected With Expanded Coverage And Improving Economy
Andrea M. Sisko1,*, Sean P. Keehan2, Gigi A. Cuckler3, Andrew J. Madison4, Sheila D. Smith5, Christian J. Wolfe6, Devin A. Stone7, Joseph M. Lizonitz8 and John A. Poisal


In 2013 health spending growth is expected to have remained slow, at 3.6 percent, as a result of the sluggish economic recovery, the effects of sequestration, and continued increases in private health insurance cost-sharing requirements. The combined effects of the Affordable Care Act’s coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth this year and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015–23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990–2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013–23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023.

Filed under: Employee Benefits, Healthcare Tagged: Health care spending, inflation, WPrightnow

Nigeria Elections 2015: Building the Private Sector Voice through Coalitions - September 29, 2014 by zeldalegacy

Nigeria’s upcoming elections have been attracting a lot of international attention because of the country’s population, economy, and political status, which are among the highest on the continent. Over the course of a few weeks in early 2015, Nigerians will elect state and national level leaders, including governors and the president.

While Nigerian civil society and the private sector have had…

CIPE Development Blog

Do you have a health plan using “R&C⁉️ - September 29, 2014 by zeldalegacy

This all looks straight forward. If you use in-network doctors, you pay less than if you go out-of-network. That’s pretty standard stuff these days. The idea is that in-network providers have agreed to lower negotiated fees so both the plan and the patient pay less. They have agreed to that in part to keep you as a patient and in some cases to help add to their patient base.

To provide flexibility most health plans allow you to use a provider of choice; for a price. In this example that price if 30% coinsurance as opposed to a fixed co-payment.

That’s what you think‼️

Look closer, you pay 30% of the R&C charges. R&C stands for reasonable and customary. Now consider that the main reason doctors do not participate in a network is because they won’t accept the negotiated fee. In other words, they charge more than their peers; likely more than what the insurance company determines to be reasonable and customary.

Let’s say out of 100 doctors 80 of them charge ,000 or less for a procedure and 20 will charge more. The R&C fee limit is set at ,000. Now say you use a doctor not in your network and his charge is ,500 for this procedure.

imageYou must pay 30% in our example, right? Wrong‼️

Instead of paying 30% or 0, you will pay 0 (30% of ,000 – the R&C fee) plus 100% of the amount above the R&C or another 0. Going out of network cost you 0; you actually pay 53% of the total cost AND the excess you paid probably does not count toward your out-of-pocket limit.

Now, make sure you read and understand all the information you are provided‼️

Filed under: Healthcare Tagged: coinsurance, R&C, reasonable and customary

$360,000 in the bank may not be enough to pay medical expenses in retirement - September 28, 2014 by zeldalegacy

The hottest trend in health benefits is the high deductible health plan or as optimists like to say, consumer driven health care which translates to; better have 00 lying around to pay your deductible.

Typically accompanying the HDHP is a Health Savings Account or HSA. Here you have yet another way to save on a tax-free basis, this time not for retirement income or college costs, but your health care expenses. Don’t you feel lucky? You can’t have a HSA without having a qualified HDHP because the IRC says so and the IRS won’t like you if you try that.

For 2014 if you have a HSA you can save up to ,300 for an individual and ,550 for a family. If you are age 55 and older you get to save an extra ,000. Contributions are 100% tax-deductible from gross income.

Seriously; serious savings gets you serious money … as long as you can pay all your health care expenses out-of-pocket with after tax out-of-pocket cash you have lying around.

2014 marks the 10-year anniversary of the introduction of health savings accounts (HSAs), created by Congress in 2003. HSAs provide account owners a triple tax preference. Contributions to an HSA reduce taxable income. Earnings on the assets in the HSA build up tax-free, and distributions from the HSA for qualified expenses are not subject to taxation.

A person contributing for 40 years to an HSA could save up to 0,000 if the rate of return was 2.5 percent, 0,000 if the rate of return was 5 percent, and nearly .1 million if the rate of return was 7.5 percent, and if there were no withdrawals.

In order to maximize the savings in an HSA to cover health care expenses in retirement, HSA owners will need to pay the medical expenses they incur prior to retirement on an after-tax basis using money not contributed to their HSA. Many individuals may not have the means to both save in an HSA and pay their out-of-pocket health care expenses. Also, HSA balances may not be sufficient to pay all medical expenses in retirement even if maximum contributions are made for 40 years.

“Lifetime Accumulations and Tax Savings from HSA Contributions” and “IRA Withdrawals in 2012 and Longitudinal Results, 2010–2012” July 2014, Vol. 35, No. 7 Employee Benefit Research Institute, 2014

It appears there are three saving priorities for most Americans; retirement, college expenses and health care expenses. So, where do you place your money first?

Filed under: At Work, Healthcare, Retirement Tagged: health care in retirement, Health savings account, HSA

Heng Huat Resources IPO Oversubscribed by 60.25 times - September 27, 2014 by zeldalegacy

Heng Huat Resources Berhad Initial Public Offering (IPO) received an overwhelming response with its public portion of 7 million shares. It was oversubscribed by 60.25 times. The IPO attract 14,863 applications or 428.7 million shares. Notices of Allotment will be dispatched by post to all successful applicants […]

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Shaping the Post-2015 Development Agenda - September 26, 2014 by zeldalegacy

While the world has made progress on many of the Millennium Development Goals over the past 15 years, the deadline for developing the new set of global development goals is quickly approaching. The current goals will expire on December 31, 2015 and a new set of principles will replace them. The question of what these principles will look like is explored in detail in the latest Economic Reform…

CIPE Development Blog

Reach Energy Berhad IPO (Forth SPAC) - September 26, 2014 by zeldalegacy

Reach Energy Bhd, the forth Special Purpose Acquisition Company (SPAC) after Hibiscus Petroleum, CLIQ Energy and Sona Petroleum is scheduled to be listed in Main Market of Bursa Malaysia on 15th August 2014. Reach Energy will be involved in Exploration and Production activities in Oil & Gas. Upon listing, Reach […]

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