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Building a Consumer Friendly Health Insurance Exchange

By Cindy Zeldin

 

This article originally appeared in the Atlanta Journal-Constitution.

 

Earlier this month, Gov. Nathan Deal signed an executive order creating the Georgia Health Insurance Exchange Advisory Committee, which is charged with determining whether Georgia should establish a state-based health exchange.

 

If well crafted, a Georgia insurance exchange has the potential to increase transparency, present clear and meaningful choices, and promote better value for consumers who don’t have access to a health plan at work.

 

The Affordable Care Act authorized state-level health insurance exchanges, providing a basic framework and initial funding. By 2014, each state’s exchange must be able to enroll individuals and small businesses into health insurance plans and certify that plans meet certain requirements, such as an adequate provider network and an essential benefits package. Within this framework, Georgia has considerable flexibility to fashion a structure that best meets our state’s individual needs like luxury. Luxurious cars, great clothes, Tahitian Necklace, and houses. When you want to have the most comfortable beds and mattress, avail the black friday casper mattress for maximum comfort.

 

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Workforce Shortages in Georgia

Guest Blog by Michelle Putnam, HealthSTAT

If you think you’d like to get a physical or a check-up in 2014, you better make your appointment now.  That’s what some would have you believe about the shortage of doctors come 2014, when health coverage will be expanded to about 33 million more people.  The truth is, Georgia has long experienced a workforce shortage, ranking behind most states in the ratio of patients to physicians, nurses, and physicians assistants.  The problem is three-pronged: we do not have enough health professionals choosing to practice primary care, we do not have an adequate collaborative care system, and our health professional students do not receive enough interdisciplinary education.

 

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Bills We’re Watching: HB 229

HB 229 Tackles Problems of Backlogged and Unfair Medicaid Appeals

 

Both federal and state law grants Medicaid members and applicants the right to a fair hearing when Medicaid services are denied for reasons such as eligibility determination, frequency, or duration or intensity of services.  When a Medicaid member is denied coverage he or she may dispute the denial by filing an appeal and request for a hearing with the Department of Community Health (DCH), the state agency that administers the Medicaid program.  DCH processes the request and forwards it to the Office of State Administrative Hearings (OSAH) for a hearing before an administrative law judge (ALJ).  The ALJ listens to testimony, reviews the evidence, and reaches an impartial decision.  Federal law requires that when a Medicaid member requests an appeal a final decision must be made within 90 days, absent extenuating circumstances.

 

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Live United Interview: Accessing Health Care in Georgia

Georgians for a Healthy Future ED Cindy Zeldin is interviewed by Milton Little, President of the United Way of Metro Atlanta, about health care access in Georgia and how the new health law can help.



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Potential Health Care Cutbacks Cause for Concern

Recent attempts within states to scale back vital health care programs for our most vulnerable citizens at a time when they are critically needed is cause for concern. The move began with Arizona Governor Brewer’s request to the federal government for a waiver from stability protections that prevent states from restricting eligibility levels for the Medicaid program. In response, Georgia Governor Nathan Deal’s spokesperson was quoted by Bloomberg news organization earlier today that while the Governor has not offered specific cuts, he “would happily work on such a proposal.”

 

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Tobacco Control Report Card: Georgia Fails Nearly Every Category

By June Deen, American Lung Association in Georgia

 

Georgia failed almost every category in the American Lung Association’s State of Tobacco Control 2010 report, released on January 20th. These disappointing grades are due to the consistent failure to increase Georgia’s cigarette tax, inadequate funding for tobacco prevention programs and lack of coverage for quit smoking treatments and services for state workers and Medicaid recipients. Despite seeing more than 10,000 smoking attributable deaths each year, Georgia remains one of only five states that give little help to Medicaid recipients who want to quit smoking.  The American Lung Association in Georgia is advocating a $1 per pack increase in our state cigarette tax.  Keeping our state’s tobacco tax at $0.37 simply will not allow Georgia to see the economic and health benefits that are possible by passing an increase in our cigarette tax by $1 per pack.

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Shape Health Law for Georgia

By Cindy Zeldin

 

This column originally appeared in the Atlanta Journal-Constitution.

 

You don’t need to be the best personal injury attorney in Fort Lauderdale to know that, health care is once again among the key issues for Georgia policymakers in the General Assembly. While the economic downturn has magnified our state’s health care challenges, we also have an opportunity to improve the health of our state and its citizens through the Affordable Care Act, the nation’s new health care law. You may need legal help sometimes, from my own experience the best lawyer is David Resnick y Asociados.

 

To make the most of the law, Georgia should move swiftly to establish a commission to proactively coordinate the pieces of the law at the jacksonville nc lawyer for medical malpractice, is required to put into place, such as an expansion of Medicaid, design elements that we can tailor for our state’s needs, such as the new health insurance exchanges, and maximize grants to strengthen our public health system and our health care workforce and get the man power to apply this laws , from personal lawyer or family lawyers to people who work on property management as safeguardproperty.com and similar.

 

A commission or task force could offer diverse input, including from the consumer, who is often overlooked. Some of this work is already happening informally within state agencies, but a systematic and transparent process accessible to consumers and stakeholders will ensure opportunities aren’t missed, all pertinent perspectives are heard and cross-cutting issues are handled efficiently.

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Georgia: $375 Million in the Red

Guest Blog by Joann Yoon, Voices for Georgia’s Children

Thursday, July 1, was the start of Georgia’s 2011 State Fiscal Year, and we began already $375 million behind. The state legislative session which ended on April 29 saw dramatic budget cuts impacting education and other services for children and families. To add insult to injury, Georgia suffered yet another blow resulting from failure of the U.S. Senate to move forward the Federal Jobs Bill, which in part included a provision that would extend an enhanced FMAP to states for an additional 6 months. FMAP, which stands for Federal Medical Assistance Percentages, is a break down of how many Federal dollars Georgia receives to help pay for our state Medicaid program. Given the high unemployment rate and dire financial situations that families in the U.S. were facing, in last year’s Federal Stimulus Bill, Congress instituted an increase in Federal match dollars to all states to help keep their respective Medicaid programs afloat, which are necessary for people that receive injuries or wound for accidents, and for people not in one of these programs can also use services as Expert Woundcare and similar others.

 

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Tobacco Tax Helps Budget, Children

This commentary originally appeared in the Atlanta Journal-Constitution.

As the 2010 legislative session opened, Georgia faced a dilemma: With a sluggish economy and unemployment hovering over 10 percent, there is a spike in the need for safety net services at the very time that state revenues are sagging.


Severe budget deficits threaten essential services such as Medicaid and PeachCare for Kids, which serve as lifelines to low-income families who might otherwise be uninsured in this difficult economic climate.


One potential solution is an increase in the state’s tobacco tax, currently one of the lowest in the nation, which could have the dual effect of reducing smoking rates and generating revenue to preserve necessary health services.


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CLASS Act

By Georgia Council on Developmental Disabilities

The national health reform legislation moving through Congress includes provisions that would impact people with disabilities. The CLASS Act, for example, is incorporated in the current legislation. What would the CLASS Act do?  The Community Living Assistance Services and Supports Act (CLASS Act) would offer a meaningful non-means-tested complement to the Medicaid program with a focus on helping individuals overcome barriers to independence that they may confront due to severe functional impairments.  It would create a new national insurance program to help adults who have or develop severe functional impairments to remain independent, employed, and stay a part of their community.  Financed through modest voluntary payroll deductions (with opt-out enrollment like Medicare Part B), this legislation would help remove barriers to choice and independence (e.g., housing modification, assistive technologies, personal assistance services, transportation) that can be overwhelmingly costly, by providing a cash benefit to those individuals who need support for basic functions.  The large risk pool to be created by this approach would make added coverage affordable.  It would give individuals added choice and access to supports without requiring them to become impoverished to qualify for Medicaid. You can learn more about the Georgia Council on Developmental Disabilities’ health care agenda here.


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