Physician Patient

Archive for November 13th, 2014

MPPA Meeting Thursday, November 13, 2014, 6 PM at the Central Medical Building, St. Paul.

Thursday, November 13th, 2014

1. Those present, Lee Beecher, President, Don Gehrig, Dave Feinwachs, Peter Nelson, Bob Geist, Mike Ainslie, Doug Smith, and Dave Racer

2. MN Provider Coalition bill—Dave Feinwachs, discussed the essential part of the non-discrimination bill, which thanks to a loophole in PPACA could require insurance companies to let patients spend their own money wherever they like and would mandate that such payments be fully credited to their insurance plan deductible. It is neither an AWP bill nor a scope of practice bill.
Action: It was recommended by the Board that the MN Provider Coalition delete other elements of the bill in order to emphasize patient freedom.

3. Blue Print for Health Care—Peter Nelson, discussed at length the competition model for health competition model to make medical care affordable emphasizing reduction in barriers to employer-base defined contribution insurance. It could provide a reasonable way for small businesses to afford employee health insurance. It will be the prime focus of efforts for this Blue Print moving forward. The rest of the points for increasing competition and innovation including multi-state medical insurance consortiums are mostly for discussion upon which future actions could be implemented.
Action: It was moved that MPPA approve the Blue Print. Motion passed unanimously

4. The 6th US circuit ruling in the Hi-Lex case—Dave Feinwachs discussed this case of the MI Blues Corporation, which when acting as an ERISA plan TPA for a small 800 person company making auto parts, was found to be faking provider fees paid and pocketing the discount unknown to the company paying for their employees’ care. The courts called this fraud and award damages to Hi-Lex Company. What was curious is that the defendants expert witness was the Milliman Company, which testified that this is the way al managed care companies do business. As Dave Feinwachs noted, the argument that stealing is ok, because everyone is doing it, lost. He is looking for a local company with an ERISA self-insured insurance plan.
Dave Racer later sent a URL to the US Appeals Court ruling of May 14, 2014: http://www.ca6.uscourts.gov/opinions.pdf/14a0100p-06.pdf

5. The meeting was adjourned at 8PM.

6. The next meeting date will be in early 2015.

Respectfully submitted
Robert W. Geist MD
Secretary pro-tem