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United States: Final Regulations Allow Retirement Plan Payments For Accident, Health And Disability Insurance - McDermott Will & Emery

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On May 9, 2014, the IRS finalized regulations that govern the tax treatment of payments made by retirement plans to pay accident or health insurance premiums. Reported by Mondaq 20 hours ago.

Obama administration overhauls HealthCare.gov

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The Obama administration is in the process of revamping the troubled HealthCare.gov website, and scrapping large parts of the federal health-insurance marketplace in order to dodge the problems that troubled the launch of ObamaCare last year. Reported by FOXNews.com 19 hours ago.

Algos Waiting For Today's Flashing Red NFP Headline To Launch The BTFATH Programs

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If predicting yesterday's EURUSD (and market) reaction to the ECB announcement was easy enough, today's reaction to the latest "most important ever" nonfarm payrolls number (because remember: with the Fed getting out of market manipulation, if only for now, it is imperative that the economy show it can self-sustain growth on its own even without $85 billion in flow per month, which is why just like the ISM data earlier this week, the degree of "seasonal adjustments" are about to blow everyone away) should be just as obvious: since both bad news and good news remain "risk-on catalysts", and since courtesy of Draghi's latest green light to abuse any and every carry trade all risk assets will the bought the second there is a dip, *the "BTFATH mentality" will be alive in well. *It certainly was overnight, when the S&P500 rose to new all time highs despite another 0.5% drop in the Shcomp (now barely holding on above 2000), and a slight decline in the Nikkei (holding on just over 15,000).

But the biggest factor in predicting today's market reaction is that economic news absolutely, positively no longer matter. They haven't mattered for the past 5 years either, with "markets" moving higher only on hope and faith never on actual data, but it really hasn't been this disconnected ever: so much so that even the big banks are mocking how broken the market's discounting mechanism is.

In terms of what expectations are, the Bloomberg consensus estimate is +215k in the headline (DB: 200k) and +210k in the private payrolls. The unemployment rate is expected to tick up by 10bp to 6.4% and average hourly earnings are expected to grow by 0.2% M/M. Indicators have been mixed leading up to today with Wednesday’s ADP report (+179k vs 220k previous) coming in sharply below consensus while the last few weeks of jobless claims have generally been solid.

Regardless, for all those basing their decision what to do with the market, which is now massively, historically overbought, so much so that Goldman's June 30, 2015 S&P price target is less than 10 points away, don't, and simply BTFATH. After all in a market as rigged and manipulated as this one, where this time is different, nobody can ever lose money: Uncle Fed has your back.

Looking at the overnight session, the search for yield is a continuing theme today but its generally a slow session with many waiting on the sidelines ahead of NFP. Asian credit has reacted positively with spreads gapping in 3-5bp in the investment grade space. Asian sovereign CDS is around 3-4bp tighter. JGB yields are about 1bp lower, and while EM rates such as Indonesia yields are down 3bp. Asian equities started the day following its US and European counterparts higher but those gains have been gradually pared back during the Asian trading session. Chinese equities received a small bounce after the vice-Chairman of the country’s bank regulator said that the Government is considering loosening the 75% loan-to-deposit ratio (Bloomberg), but the Shanghai Composite and HSCEI are now both well into negative territory (around -0.5% as we type).

As for Europe, virtually every peripheral bond is trading near or at record low yields, thanks to Draghi's latest carry trade reveal, with both Spain and Italy touching unseen lows overnight, and in fact Spain traded below the UK: yes, that's how broken the market now is (with all due respect, not much, to Mary Jo White claiming the market is actually quite unbrokne).

 

*Bulletin Headline Summary from RanSquawk and Bloomberg*

· Treasuries gain before report forecast to show U.S. economy added 215k jobs in May while unemployment rate rose to 6.4% from 6.3%.
· Rising food prices helped push Japan’s misery index to the highest level since 1981, while wages adjusted for inflation fell the most in more than four years
· With the BOJ looking to drive inflation higher, a squeeze on household budgets threatens consumption as Abe weighs a further boost in the sales levy
· With the ECB’s policy toolbox now virtually exhausted and much hinging on whether banks boost credit themselves, failure to spur consumer prices will leave Draghi with little option but to enter the uncharted terrain of QE; some have more hope than confidence that Draghi’s current plan  will work
· China’s yuan posted the biggest gain in a week in onshore and offshore trading as the People’s Bank of China raised its reference rate by 0.14% to 6.1623 per dollar, the largest increase since Jan. 10
· China’s military is improving its military doctrine, training, weapons and surveillance to be able to conduct more sophisticated attacks against the U.S. and other adversaries, according to the Pentagon
· Russia’s $400m deal to pipe natural gas across the border to China has rekindled hopes that the two nations will finally build a bridge across the frontier to bring a steady stream of Russian customers to Chinese stores
· Denmark kept interest rates unchanged to strengthen the krone after intervening in the currency markets, opting not to follow the European Central  Bank back into negative territory
· New York’s top banking regulator Benjamin Lawsky is pressing BNP Paribas SA to dismiss one of its top executives as part of settlement negotiations with the U.S. over alleged sanctions violations, according to a person familiar with the matter
· Four million people are projected to pay the U.S. penalty for not carrying health insurance next year, about one-third less than previously estimated, after the Obama administration created exemptions from the fine
· Sovereign yields lower. Asian equities mixed, with Japan markets little changed, China lower. European equity markets and U.S. stock futures gain. WTI crude higher, copper falls, gold unchanged

*US Event Calendar*

· 8:30am: Change in Nonfarm Payrolls, May, est. 215k (prior 288k)

· Change in Private Payrolls, May, est. 210k (prior 273k)
· Change in Manufacturing Payrolls, May, est. 10k (prior 12k)
· Unemployment Rate, May, est. 6.4% (prior 6.3%)
· Average Hourly Earnings m/m, May, est. 0.2% (prior 0.0%)
· Average Hourly Earnings y/y, May, est. 2% (prior 1.9%)
· Average Weekly Hours All Employees, May, est. 34.5 (prior 34.5)
· Change in Household Employment, May (prior -73k)
· Underemployment Rate, May (prior 12.3%)
· Labor Force Participation Rate, May (prior 62.8%)

· 3:00pm: Consumer Credit, April, est. $15b (prior $17.529b)

*ASIAN HEADLINES*

Yet another record highs in US stocks, with the DJIA moving above 16,800 for the first time, failed to filter through to Asia markets, with Hang Seng and Shanghai Comp trading lower overnight amid concerns over financial stability in China. Specifically, Chinese regulator (CBRC) said it is considering loosening the 75% loan-to-deposit ratio, although the World Bank warned such reform measures could disrupt growth in the long run.

*FIXED INCOME *

Expansionary monetary policy announcements by the ECB yesterday, which are expected to add approx. EUR 570bln in liquidity, continued to support further yield curve flattening, especially in the short-end. This was particular evidenced in EU peripheral bonds, with Irish, Spanish and Italian 10y bond yields hitting new record lows this morning. The opportunity to enter carry trade also resulted in credit spread tightening.

*EQUITIES *

Financials and telecommunications outperformed on the sector breakdown this morning, while the more defensive sectors underperformed, as market participants sought to capitalise on beta plays that ECB’s latest measures are expected to result in. As a result, despite the somewhat choppy price action, amid risks associated with the upcoming NFP jobs report release later on, major EU equity indices traded broadly higher.

*FX*

Monetary policy divergence between the ECB and the BoE ensured that GBP outperformed EUR this morning, that’s in spite of the fact that Gilts were also dragged higher by Bunds, which therefore prevented curve steepening. Elsewhere, JPY benefited from risks surrounding upcoming NFP and also broad based EUR weakness, with EUR/USD, EUR/GBP and EUR/JPY all trading lower.

*COMMODITIES*

After rising over 1% yesterday, which was also 1st weekly rise in three weeks, on the back of buoyed inflation expectations in Europe following yesterday’s ECB policy announcements, spot prices remained supported this morning, albeit marginally as markets looked forward to the key NFP.

Elsewhere, copper traded near a three-week low and below the 50DMA line amid concerns that a probe into financing transactions at China’s Qingdao Port will dampen collateral related demand. However according to latest press reports, Qingdao Port chairman said that despite the probe, operations are running normally.

In the energy complex, Brent crude futures continue to recover from their lowest levels since early May, with volumes thin ahead of today’s non-farm payrolls release.

* * *

*Jim Reid's concludes the daily summary*

Welcome to P-Day. However payrolls have been overshadowed by the ECB's action yesterday and its fair to say the package of moves will be debated for some time yet. We'll go through the package below but our first reaction is that the move is likely to steadily increase the wedge between financial asset performance and economic fundamentals and prolong the existence of this theme. As we discussed yesterday, its nearly 7 years since the ECB first intervened aggressively to try to free up bank markets. Would anyone have guessed the combination of events that has occurred since? ie extreme global unconventional policy still continuing to this day, 5 years plus of zero interest rates, rampant financial markets, multi-century all time lows in yields and the weakest economic recovery on record bar the Depression. Everybody would had a chance of getting some of this narrative correct but I doubt anybody would have predicted the combination. Its a unique cycle and as such its one where uncertainty/visibility is high even if volatility is low thanks to central bankers. Its amusing to hear central bankers warn about complacency in markets which if present is largely due to the impact of their policies.

Anyway, for markets, what we were looking for from the statement/press conference yesterday was that the ECB wasn't done yet. That's a pretty difficult measure for Draghi to actually deliver given internal politics but he did stress they can still do more which will keep the QE hopes alive and stop markets aggressively shorting Draghi's resolve. Overall I think the measures are more market friendly than economic friendly though. Monetary policy works with long lags and even if these measures were to stimulate activity/inflation (which is still debatable) we might not see it in the data until well into 2015. The clamour for more stimulus is likely to emerge well before that. However Draghi has likely bought himself some time at least.

Our economist's take on the measures is on the cautious side even they think it was a major package. There is some concern that drop in the cost of funding won't find its way to the real economy. They do think that buying time is not a waste though and that the ECB might be hoping that by this winter, a more hawkish sounding Fed – helping to depreciate the euro – and some mechanical re-acceleration in inflation will relieve the pressure and avoid a discussion on Fed-like QE. But they do note that the ECB opened the door to what our economists call “private QE”, referring to “preparatory work on ABS purchases”. They are not convinced its very imminent though. Here

It’s interesting to read their initial thoughts on the new "TLTRO" - the impact of which remains uncertain, for four reasons: First, there is nothing in the documentation which was released yesterday which would prevent banks from using the proceeds to accumulate more government bonds, at least for the first 2 years (they would merely be forced to pay down the TLTRO half way through the operation if they fail to step up their lending to the private sector). This is at odds with Draghi’s statement in the Q&A in which he made it clear that the package is not designed to incentivise further “carry  trades”. Will we get more conditionality down the line to stop this?

Second, substantially reducing banks’ medium term funding cost can be fully passed to final borrowers only if banks consider that they are comfortable with the current level of their interest margins on lending to the private sector. They have been increasing massively since mid-2012. Banks may want to raise them further, either because they consider that lowering the borrowing rate would not properly remunerate their credit risk, adjusted for the capital charge entailed by this type of activity, or because they still need to organically grow their capital ratio. Third, we don’t know the elasticity of the demand for credit to changes in borrowing rates, but in a context of a preference for deleveraging in some segments of the Euro area, this elasticity could well be lower than usual. Fourth, we should not forget that banks need to pay back the ECB EUR 450bn by February 2015, as the two LTROs expire. Even if they were to use the entirety of their EUR 400bn initial allotment in the TLTRO to fund this, there would still be a “net gap” of some EUR50bn. In a cynical view of the targeted LTRO, it could be considered as simply a 4 year extension of the existing LTRO, at a slightly cheaper cost (25 bps against c.65 bps) and with more visibility on the final cost. Seen in this light, it looks less innovative. For more on yesterday's announcement please read their report.

I was at a big DB macro dinner last night and most clients and DB participants felt that the ECB had prolonged the carry trade whatever the scepticism  over the effectiveness of the policy measures for the real economy. So this type of thinking might dominate in the near term. Looking at the reaction of markets following the ECB, the carry trade was indeed favoured with Crossover (- 13.5bp), Main (-3.5bp) and US IG (-2.0bp) credit indices all closing tighter in one of the strongest sessions since February. Carry currencies such as AUD (+0.68%) and MXN (+0.43%) enjoyed strong gains as did the most of the EM rates complex with Hungary (-15bp), Russia (-10bp) and Turkey (-25bp) recording the best of gains.

It was an interesting day for European rates, with core yields closing about 2- 4bp firmer after initially selling off. In terms of the euro, after dropping a point after the ECB announcement EURUSD ended the day sharply higher (+0.45%). DB’s George Saravelos thinks that the squeeze higher in EURUSD can be sustained given his view that the ECB has not surprised in terms of quantity, quality and price of money provided beyond what the rates market had already priced. Indeed looking at the short end, core yields were relatively unchanged and closed the day around 0.5bp to 1bp lower. In the commodity space, gold had a much needed rally (+0.78%) and brent rose 0.36%.

Clearly much also rests on what happens with US rates and today's payrolls is the next big test. The Bloomberg consensus estimate is +215k in the headline (DB: 200k) and +210k in the private payrolls. The unemployment rate is expected to tick up by 10bp to 6.4% and average hourly earnings are expected to grow by 0.2% M/M. Indicators have been mixed leading up to today with Wednesday’s ADP report (+179k vs 220k previous) coming in sharply below consensus while the last few weeks of jobless claims have generally been solid (including yesterday’s jobless claims report, the four-week moving average is now 310k, which is the lowest level since June 2007 according to DB’s Joe Lavorgna). Joe also notes that Continuing claims are down five weeks in a row and have fallen in eight of the last nine weeks—they are now back to levels last seen in October 2007. If we do get a greater-than-200k payroll print today, it will be the fourth consecutive month that this has occured. The last time that payrolls managed to put together such a streak was in January 2000 according to Bloomberg data.

Looking at the overnight session, the search for yield is a continuing theme today but its generally a slow session with many waiting on the sidelines ahead of NFP. Asian credit has reacted positively with spreads gapping in 3-5bp in the investment grade space. Asian sovereign CDS is around 3-4bp tighter. JGB yields are about 1bp lower, and while EM rates such as Indonesia yields are down 3bp. Asian equities started the day following its US and European counterparts higher but those gains have been gradually pared back during the Asian trading session. Chinese equities received a small bounce after the vice-Chairman of the country’s bank regulator said that the Government is considering loosening the 75% loan-to-deposit ratio (Bloomberg), but the Shanghai Composite and HSCEI are now both well into negative territory (around -0.5% as we type).

Turning to the day ahead, German industrial production and trade are the major data releases in Europe. The ECB’s Constancio will be speaking today in London. Later in the day, US payrolls are the main event. The Fed’s consumer credit report rounds out what has been a busy week. Reported by Zero Hedge 19 hours ago.

Money Minute: Busiest U.S. Airport Finally Gets Free Wi-Fi

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Filed under: Market News, Economic Recovery, Internet, Travel Industry, Health Insurance

The busiest airport in the country finally offers free Wi-Fi connections.

The new network at Atlanta's Hartsfield-Jackson Airport can handle up to 15,000 users at a time. More than 94 million travelers pass through the airport each year, and officials say the lack of free Wi-Fi was one of their biggest complaints. Up until now, the airport charged $4.95 to connect.

Of course, you can fly from Atlanta to London, and now your plane can land at Heathrow's new terminal. The $4 billion facility is designed to handle 20 million passengers a year. Queen Elizabeth will be there for an official opening ceremony next week. The terminal is named in her honor.

And one more note for air travelers: airlines are doing a much better job of handling our bags. A new report shows the number of lost bags has been cut in half since 2007. Delta (DAL) and USAirways (AAL) have made the biggest gains.One of the most controversial parts of the Affordable Care Act is the financial penalty imposed on people who don't sign up. Well, we now know 4 million people will be hit with that penalty. The Congressional Budget Office says that's actually about 2 million lower than its earlier estimate, mostly because many people with very low incomes are exempt from the fines.

Here on Wall Street, the Dow Jones industrial average (^DJI) and the Standard & Poor's 500 index (^GPSC) both rose to a record high Thursday. For the S&P, it's the seventh record in the past nine trading days. The Dow gained 98 points, the S&P rose 12, and the Nasdaq composite (^IXIC) rallied 44 points.

Do you feel richer? Many people might so no, but overall, Americans are wealthier than ever before. New figures from the Federal Reserve show the net worth of U.S. households rose by 2 percent in the first quarter to an all time high. Most of the gain was due to rising stock and home prices. That could be good news for the overall economy, if people feel more confident to borrow and to spend.

-Produced by Drew Trachtenberg.
 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 17 hours ago.

Don Allred Insurance Helps Customers Obtain Marketplace Coverage Outside the Open Season

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Although Open Enrollment for purchasing health insurance has ended, the experts at Don Allred Insurance may still be able to help individuals obtain coverage.

Burlington, NC (PRWEB) June 06, 2014

Although the Open Season period (aka Open Enrollment) for purchasing health insurance via the federal Marketplace has ended, the experts at Don Allred Insurance may still be able to help individuals obtain coverage or modify an existing government plan as long as they meet certain conditions known as Qualifying Life Events, or QLEs. Some of the most common QLEs are the following:· Changes in family status due to marriage; birth or adoption of a child; arrival of a foster child; legal separation; divorce; or death of a spouse or dependent
· Loss of coverage due to termination of employment; end of Medicaid or CHIP eligibility; aging out of a parent’s plan; COBRA expiration; divorce; or the expiration of an individual plan in 2014
· Miscellaneous status changes due to return from incarceration; newly acquired American citizenship; membership in a federally recognized Indian tribe; or moving primary legal residences

Furthermore, anyone currently insured under a Marketplace plan may alter his or her coverage upon showing proof of a QLE such as a change in household status or annual income that results in loss of premium tax credits and other cost-sharing reductions.

Not all QLEs are as cut-and-dried as the ones listed above, notes Don Allred Insurance spokesman Scott Allred. “Sometimes a unique combination of circumstances comes into play that tests the bounds of QLE criteria. Our insurance experts can analyze these special situations to help customers determine the best way to obtain adequate coverage in order to comply with federal mandates,” says Mr. Allred.

If you have not voluntarily ended your insurance coverage and believe you meet the criteria for a Qualifying Life Event that entitles you to obtain insurance from the federal Marketplace outside the Open Season, please contact Allred Insurance today to set up a consultation. If none of these QLEs applies to you, the next open enrollment period will begin on November 15, 2014, for coverage starting in 2015.

Visit http://www.allredinsurance.com today for more information. Reported by PRWeb 17 hours ago.

One Blockbuster Drug Explains A Lot About Our Out-Of-Control Healthcare Costs

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One Blockbuster Drug Explains A Lot About Our Out-Of-Control Healthcare Costs Medicare, the federal health insurance program for Americans 65 and older, could save $18 billion over the next 10 years if doctors switch to a less expensive drug to treat blindness. The switch could also save patients $5 billion in insurance copayments, according to a new study in Health Affairs.

Ranibizumab, more commonly known by its brand name Lucentis, is delivered as an injection to the eye and runs about $2,023 per dose. Many patients require up to 12 injections per year. That's why some doctors choose to prescribe the much cheaper drug Avastin (bevacizumab) instead, which costs around $55 per dose.

While Avastin is designed to treat cancer, not blindness, many doctors say it works just as well as Lucentis — with significant potential cost savings to patients, insurers, and the government.

*Battle of the Eye Drugs: Lucentis v. Avastin*

Both drugs were developed by Genentech, a division of the Swiss biotech giant Roche Group. Opthamalogists prescribe both Lucentis and Avastin to treat two of the leading causes of blindness in the U.S. — neovascular age-related macular degeneration and diabetic macular edema. While the names are complicated, both diseases affect the macula, the part of the retina that helps you see objects straight ahead.

Here's the catch: Lucentis has approval from the U.S. Food and Drug Administration (FDA) to treat eye disorders and Avastin doesn't. Avastin was originally manufactured to treat certain cancers, but it is used by many doctors in an "off-label" capacity — meaning not approved by the FDA to treat eye diseases.

It is legal for doctors to prescribe drugs for off-label uses. According to Consumer Reports, about one in five prescriptions are written off-label. However, drug companies are prohibited from promoting off-label uses of their drugs."Lucentis and Avastin are not the same medicine and should not be treated as if they are the same," a Genentech spokesperson said in an email. "Avastin is not manufactured or approved for use in the eye. Genentech does not promote the off-label use of Avastin for disorders of the eye."

Yet according to Medicare data, more than two-thirds of Medicare patients who have macular eye disorders are being treated for those disorders with Avastin, even though it is considered an off-label use. Doctors who use the much more expensive Lucentis are actually in the minority. 

"Lucentis is Avastin — it's the same damn molecule with a few cosmetic changes," J. Gregory Rosenthal, a Toledo ophthalmologist and co-founder of Physicians for Clinical Responsibility, told The Washington Post. "Yet Americans are paying a billion dollars every year for no good reason — unless you count making Genentech rich."

In April of this year, the Centers for Medicare and Medicaid Services released billing data for physician services. And, as we reported, the highest biller, Dr. Salomon Melgen, a South Florida ophthalmologist, received nearly $21 million in Medicare payments in 2012. Melgen billed for more than 37,000 doses of Lucentis.

*More Expensive Drugs Make More Money*

So why doesn't Genentech just get approval from the FDA to use Avastin to treat eye disorders?

Genentech said that findings from randomized clinical trials suggest "the risk of systemic serious adverse events may be higher when injecting Avastin into a person's eye compared to Lucentis." And since Avastin must be repurposed as an eye injection, generally at a compounding pharmacy, there is an additional risk, however small, of contamination.

To be sure, doctors who choose Lucentis over Avastin may do so because they believe it is safer or because the reimbursement rates are higher. For its part, though, Genentech has been accused of promoting Lucentis to make money.

In fact, Bloomberg reports, "Italy is seeking $1.6 billion in damages over allegations that Roche and Novartis AG, which both sell Lucentis, are colluding in directing patients toward more expensive medicines."

Genentech can make even more money from Lucentis in the United States.

In the U.S., the average retail price for Lucentis is more than $2,000. In the United Kingdom, it retails for about $1,100 per dose, according to The Washington Post. One of the main reasons that Lucentis costs more in the United States has to do with the way drug prices are negotiated.

By law, Medicare cannot negotiate drug prices directly with the drug companies. Instead, prices are negotiated between drug companies and health insurers. This basically means that the Centers for Medicare and Medicaid Services, the single largest health insurer in the country, can't negotiate prices. In countries like the U.K., the government health programs directly negotiate prices with drug companies.

When doctors use a drug to treat a Medicare patient, they are directly reimbursed by Medicare for the average sales price of the drug, plus an additional 6%.

That means that when doctors prescribe Lucentis, their profit is $95 per dose. For each dose of Avastin they prescribe, the profit is only $29, according to a report from the Department of Health and Human Services. So there is an economic incentive for doctors to prescribe the more expensive drug. If a patient gets 12 eye injections in a year, the doctor will make $650 more per patient if they use Lucentis over Avastin.

Similarly, there is no financial incentive for Genentech to sell less Lucentis and more Avastin. When Avastin is used to treat cancer patients, it is often delivered at more than 100 times the dose needed for an eye injection, and a full course of Avastin treatment for cancer can cost up to $50,000 per patient. But when doctors use Avastin to treat eye disorders, they buy 100-400 mg vials and then divide them into the 1.25 mg dose needed for the eye injection. That's why a drug that's still under patent ends up seeming like such a bargain — it was never priced to be used in such small doses.

In November 2010, The New York Times reported that Genentech was offering secret rebates to eye doctors to encourage them to use Lucentis.

Under the program [...] medical practices can earn up to tens of thousands of dollars in rebates each quarter if they use a lot of Lucentis and if their usage increases from the previous quarter, according to a confidential document outlining the program that was obtained by The New York Times.

In a response to the Times, Genentech said: "Rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology."

*Bottom Line*

In 2010, the combined cost of using Avastin and Lucentis to treat eye disorders was around $2 billion — or about one-sixth of the entire Medicare Part B drug budget. Because the number of people eligible for Medicare is exploding as our population ages, if prescribing patterns stay the same, that number would increase to $20 billion over the next 10 years, according to the new Health Affairs study.

Phasing out Lucentis and using Avastin instead may be the fastest way to reign in those ballooning costs.

The Health Affairs researchers, led by David Hutton, assistant professor of Health Management and Policy at the University of Michigan, developed a mathematical model to determine the lowest and highest possible spending levels over a 10-year-period if doctors changed their prescribing patterns.

· If all patients switched to Avastin to treat neovascular age-related macular degeneration and diabetic macular edema, Medicare would only spend $2 billion over the next 10 years, compared to the projected $20 billion.
· If all patients switched to Lucentis to treat the same eye disorders, Medicare would spend $47 billion over the next 10 years, an increase of $27 billion from current spending rates.

Given that total spending for all the Medicare program combined was more than $570 billion in 2012, a projected $20 billion may seem like a meager sum. But the amount of money spent on Lucentis and Avastin to treat eye disorders is clearly disproportionate to the rest of Medicare Part B drug spending.

Here is a full statement from Genentech:

We believe doctors should have the ability to prescribe the medicine they think is right for their patients.

However, Lucentis and Avastin are not the same medicine and should not be treated as if they are the same. Lucentis and Avastin were designed for different purposes and may have different safety profiles when used in the eye. We specifically designed Lucentis for use in the eye and to clear quickly from the bloodstream to minimize side effects.

Avastin is not manufactured or approved for use in the eye.  Genentech does not promote the off-label use of Avastin for disorders of the eye.  Avastin is only approved by health authorities for the treatment of certain forms of cancer and is manufactured, formulated and packaged specifically for administration by intravenous infusion to people with cancer.  Patient safety is our primary concern.

Safety findings from prospective randomized clinical trials and large observational studies comparing Lucentis and Avastin intravitreal treatment in wet AMD patients suggest the risk of systemic serious adverse events may be higher when injecting Avastin into a person’s eye compared to Lucentis.  Therefore, uncertainty remains about the safety of Avastin for the treatment of off-label indications in the eye.

Lucentis is FDA-approved for wet age-related macular degeneration (AMD), macular edema after retinal vein occlusion (RVO) and diabetic macular edema (DME). The medicine has prevented blindness and improved vision in countless people who have been diagnosed with these potentially blinding diseases. Lucentis has made a tremendous impact in the lives of patients since its introduction in 2006.

*SEE ALSO: Here's The Controversial Doctor Who Got A Whopping $21 Million From Medicare *

*DON'T MISS: This $55,000 Bill Is The Perfect Example Of Our Broken Hospital System*

Join the conversation about this story » Reported by Business Insider 16 hours ago.

Tax rules for defined-contribution health insurance might need clarification

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Some employers have been giving employees a set contribution each month to purchase health insurance through an exchange, but -More-  Reported by SmartBrief 15 hours ago.

United States: Treasury Issues Final Regulations On Taxability Of Accident And Health Insurance Premiums Paid By Retirement Plans - Day Pitney LLP

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The Department of Treasury issued final regulations on the tax treatment of payments by qualified retirement plans for accident and health insurance. Reported by Mondaq 15 hours ago.

Coverage in jeopardy for 40% of HealthCare.gov enrollees

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*Coverage in jeopardy for 40% of HealthCare.gov enrollees*

Of the 5.5 million people who bought private health insurance plans through HealthCare.gov, 40 percent may end up either having their coverage canceled or their premium subsidies reduced or eliminated, unless they provide missing information about their income or immigration status within the next 90 days. The Department of Health and Human Services says it is now reaching out to those people by phone, e-mail, and regular mail, asking for missing information. If you are one of them, here's what you need to know.  

The missing information falls into two basic categories:

· *How much money you made in 2014. *This is the largest group, affecting 1.2 million people. If you fail to provide documents verifying your 2014 income, you could end up having your premium subsidies cut back or eliminated midway through the year.
· *Your citizenship or immigration status.* About 460,000 people must show documentation verifying they are U.S. citizens, and about 505,000 need to provide information about how long they’ve been in the U.S. and what kind of visa they have. People with missing information about their immigration or citizenship status could see their health plans canceled, because people not “lawfully present” in the U.S. aren’t eligible to purchase coverage from HealthCare.gov.

-How did this happen?-

In order to figure out what applicants were eligible for, HealthCare.gov needed lots of information about their incomes, citizenship, and immigration status. In most cases (as it turned out, about 60 percent of them) the website could automatically double-check and verify the information the applicants supplied against various government databases such as tax and Homeland Security records.

But when HealthCare.gov couldn’t match up applicants with the databases, or found inconsistencies between the government’s records and the information the applicants supplied, the applicants were, in most cases, cleared to go ahead and get health coverage but given 90 days to supply the missing information, such as pay stubs, visas, and citizenship papers. (Here's a complete list of the types of documentation the government wants.)That is where the process broke down almost immediately. When HealthCare.gov opened for business in the fall, among the many missing pieces of planned functionality was a way for applicants to electronically upload copies of requested documents. Instead, they were instructed to mail paper copies to a service center in Kentucky operated by Serco, a government contractor. All those documents had to be manually processed and in many cases, those familiar with the process have told me, documents came in with no identifying information, making it difficult if not impossible to attach them to the correct application.

At some point during open enrollment, HealthCare.gov got its upload feature but, conceded an Health and Human Services Dept. spokeswoman, “In some cases, it was difficult for people to use, or they couldn’t verify the upload once they had done it.” According to Serco documents released recently by the House Energy & Commerce Committee, by the time open enrollment ended on March 31, consumers had managed to upload only about 90,000 documents.

-What to do now
-

If you bought health insurance through HealthCare.gov and received an e-mail, letter, or call asking for additional information, here’s what to do.

· Log in to your HealthCare.gov account and click on “Applications Details.” You should see the screen pictured above. Click on the big green "Verify" button to find out what information the government needs from you.

· Upload copies of the requested documents. Because this is done inside your account, HealthCare.gov will know it’s from you. The Health Department spokeswoman said that the upload function has been "enhanced" and is now working well.

· If you choose to mail in documentation, be sure to include the bar code that came with your notification, which will enable Serco’s clerks to attach your information to the correct application. If you can’t find the bar code, attach complete information about yourself, including your HealthCare.gov application number.

Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.

—Nancy Metcalf

*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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Update your feed preferences Reported by Consumer Reports 13 hours ago.

4 Ways to Evaluate Alternative Health Coverage

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4 ways to evaluate health insurance alternatives before next fall's open enrollment window Reported by ABCNews.com 13 hours ago.

Ambulance Services Industry Market Research Report Now Updated by IBISWorld

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The ageing population has driven growth in the Ambulance Services industry in the past five years. For this reason, industry research firm IBISWorld has updated its report on the Ambulance Services industry in Australia.

Melbourne, Australia (PRWEB) June 07, 2014

Australia's population relies on the Ambulance Services industry for a critical emergency service. The industry's various government-funded operators are at a constant state of readiness to ensure patients that require emergency or urgent ambulance attention can quickly receive such attention. The full costs of ambulance services are generally not covered by ambulance member subscriptions and private health insurance benefits. According to IBISWorld industry analyst David Whytcross, “State government grants typically make up the cost shortfall, with those grants becoming additional industry revenue.” Consequently, increased ambulance costs translate to increased industry revenue. Demand for ambulance services has increased over the past five years. With the average cost of ambulance responses rising and being subsidised by government grants, industry revenue is forecast to rise by a compound annual 5.3% over the five years through 2013-14, reaching $2.8 billion. In the current year, revenue is forecast to rise 5.5%, consistent with the ongoing growth trend.

Growing demand for ambulance services is primarily due to population growth and ageing. Population growth has widened the potential patient pool, while the ageing population has resulted in a greater portion of the population becoming more susceptible to acute incidents requiring ambulance responses. The industry has also become more involved in providing pre-treatment solutions to reduce the cost burden on more expensive general hospitals, resulting in additional costs for the industry. “Growing private health insurance membership with ambulance coverage has taken away from industry revenue, as although paid out private health benefits contribute to the industry, many consumers have replaced singular ambulance membership for private health extras cover,” says Whytcross. Market share concentration in the industry is high, and major companies include the Ministry of Health, Victorian Department of Health, Department of Community Safety, SA Ambulance Service Incorporated and St John Ambulance Australia WA Ambulance Service Inc.

Projected industry growth over the next five years can be attributed to similar trends. Australia's population will continue to expand, while high-risk older patients will continue to grow in number as the population ages significantly. The rising number of older Australians living alone will drive industry demand, particularly for emergency responses. State governments are expected to continue pushing for increased responsibilities for ambulance operators to reduce unnecessary hospital triage responsibilities, which will increase expenses associated with the industry and subsequently government grants provided to the Ambulance Services industry.

For more information, visit IBISWorld’s Ambulance Services in Australia industry report page.

Follow IBISWorld on Twitter: http://twitter.com/#!/ibisworldau

IBISWorld industry Report Key Topics

The industry includes entities that are primarily engaged in providing ambulance services.

Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
International Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Basis of Competition
Barriers to Entry
Industry Globalisation
Major Companies
Operating Conditions
Capital Intensity
Technology & Systems
Revenue Volatility
Regulation & Policy
Industry Assistance
Key Statistics
Industry Data
Annual Change
Key Ratios

About IBISWorld Inc.
Recognised as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every Australian industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Melbourne, IBISWorld serves a range of business, professional service and government organisations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com.au or call (03) 9655 3886. Reported by PRWeb 10 hours ago.

Strategy shift for Blue Cross and Blue Shield of North Carolina

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Blue Cross and Blue Shield of North Carolina shuffled around its organizational structure, consolidating various parts of its business under more defined groupings. The move comes as the state’s largest insurer with $5.5 billion in revenue and $177 million has expanded partnerships outside its core business of providing health insurance. As with many companies connected to health care, BCBSNC has looked to find business in new areas, like partnerships with FastMed Urgent Care, for example, or… Reported by bizjournals 9 hours ago.

Colorado insurance carriers file plans and rates for 2015

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Health insurance carriers had to submit their 2015 plans and rates to state regulators for review Friday. Reported by Denver Post 8 hours ago.

Direct Auto Insurance Finder Added for Public Use at Insurer Website

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Direct auto insurance finder is now included for use by the public at the QuotesPros.com company website. This new finder supplies direct prices from national insurers at http://quotespros.com/auto-insurance.html.

Cincinnati, OH (PRWEB) June 06, 2014

Consumers can now benefit from a direct auto insurance finder capable of offering instant price quotations for car insurance policies on the Internet at the http://quotespros.com website. Public use of this new tool offers any driver comparison options for national coverage plans.

The direct pricing that is immediately viewable upon access to the open system is evaluated by actual companies prior to distribution to owners of motor vehicles. This two-step evaluation process ensures that every distributed quote is accurate for a selected coverage policy.

"The direct car insurance quotes that are offered in our public finder are one method that any person can rely on to explore prices displayed by different agencies," said a Quotes Pros source.

The instant comparison options for vehicle coverage that are immediately viewable through the Quotes Pros tool are based on entered city zip codes of each car owner. This method helps to narrow down exact usage locations for vehicles to help determine crime rates and other statistics normally figured into a car insurance annual price.

"The motor vehicle coverage plans that are offered inside of the public system includes full coverage, liability, SR22 and other top products from companies," said the source.

The Quotes Pros company has developed a method of connecting with multiple agencies this year providing more than vehicle insurance protection policies to the public. Products and prices for life insurance, renters insurance, business insurance and health insurance are searchable at http://quotespros.com/health-insurance.html.

About QuotesPros.com

The QuotesPros.com company continues to support independent research of vehicle insurance agencies through its national portal on the Internet. The company has a dedicated search team to help locate pricing from agencies that the public reviews. The QuotesPros.com company includes automobile, life, health and other protection policies that are underwritten by statewide companies throughout North America. The company search system is publicly updated each weekday with different prices. Reported by PRWeb 7 hours ago.

Cheap Auto Insurance Quotes Now Part of Insurer Website Built for Consumers Online

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Cheap auto insurance quotes are now a part of the Quotes Pros insurer website built for the public to use. Less expensive plans are promoted at http://quotespros.com/car-insurance.html.

San Jose, CA (PRWEB) June 06, 2014

Rising insurance prices for various coverage plans in North America has created more of a need for consumers to explore less expensive plans in the U.S. The Quotes Pros company is now one source to find cheap auto insurance quotes daily at http://quotespros.com/car-insurance.html.

The available plans that can be instantly quoted using the discount auto insurer tool setup this year are presented only by licensed companies. The national and statewide protection policies that are now quotable can help any automobile owner to find cost saving alternatives to their current policy.

"Our tool is a main source to find less expensive vehicle insurance plans privately on the Internet and showcases new and rated companies," said a Quotes Pros source.

One of the options that has been added apart from the affordable car insurance packages this year is the issuance of rates according to zip codes. Because each driver has a unique city zip code, rates are now calculated at a faster pace to dial in the exact savings that agencies are providing for policies.

"The insurer system that any motorist can access on our website provides full resources for liability, SR22 and complex insurer products that are customized with each agency," said the source.

American car owners who are not ready to explore auto insurance pricing using the Quotes Pros company can evaluate different products and prices inside the database of companies. Special rates for life insurance, renters insurance, business insurance and health insurance are now found at http://quotespros.com/renters-insurance.html.

About QuotesPros.com

The QuotesPros.com company has developed one of the first independent portals for locating vehicle insurance pricing on the Internet without contact with actual agencies. The private nature of the Internet quotation tool available provides accuracy during comparisons of annual costs. The QuotesPros.com company has recently added vehicle, health, renters, life and other packages that insurers offer to consumers that can be easily loaded through the company website daily. Reported by PRWeb 5 hours ago.

State Auto Insurance Search Platform Now Finds Average Prices for Coverage at Automotive Website

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State auto insurance search platform is now helping to locate average insurer pricing for car owners at the Quotes Pros company website. New state company prices are found at http://quotespros.com/car-insurance.html.

Jacksonville, FL (PRWEB) June 06, 2014

Consumers most often find different car insurance prices from national and local agencies when exploring rates packages using the Internet. The Quotes Pros company has developed a state auto insurance search platform that now detects average pricing at quotespros.com/car-insurance.html.

The simple tool can locate agency rates at the state level or national level if car owners wish to begin comparing annual or monthly rates. The average prices that are offered are calculated from a number of agencies that are found in the search box on the company website.

"Buying auto insurance at the state level can be cost effective for consumers who search the incentives and price drops that are common with companies specializing in state coverage," said a Quotes Pros source.

The nationwide insurance prices that are also quoted using the Quotes Pros website are instantly calculated by top companies and new agencies that have been entered into the public database since the first of this year. Rates for full coverage, liability, SR22, non owner, antique and broad form insurance are part of the price quotes owners of cars can explore.

"The use of our website can be an effective tool for automobile owners who are ready to purchase a package or continue exploring costs on a monthly or annual basis from numerous agencies," the source added.

The Quotes Pros company has connected its database with more providers this year aside from the companies specializing in car insurance. Quotes for life insurance, quotes for renters insurance and quotes for health insurance are now featured in real time at http://quotespros.com/health-insurance.html.

About QuotesPros.com

The QuotesPros.com company is one national company providing vehicle insurance quotations that are available to any motor vehicle upon request using the open research platform available. The company adds state and national agencies regularly for consumers to quote prices through. The QuotesPros.com company is continuing to supply a resource for vehicle owners to explore monthly and yearly costs for insurance coverage for different plans that agencies offer inside North America. Reported by PRWeb 5 hours ago.

Meet America's Private Health Care Revolution

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Following national focus on Americans signing up for health insurance coverage on public exchanges, a trend also exists in the private sector with similar exchanges for those with coverage. Reported by Motley Fool 13 hours ago.

Employees will pay some health insurance savings

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About a third of the savings identified by a private analyst looking for ways to cut down costs in state government are tied to changes to health insurance used by about 230,000 state workers, retirees and their families. Reported by Miami Herald 8 hours ago.

Car Insurance Rates Database Now Provides Prices to Drivers in Real Time Online

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Car insurance rates database online is now providing quotations to drivers who visit the quotespros.com website. The rates delivered are now good through the remainder of the year.

San Francisco, CA (PRWEB) June 07, 2014

American motorists who are considering switching insurance agencies can now utilize a new car insurance rates database to help analyze costs data. The Quotes Pros company has enacted its tool at http://quotespros.com/auto-insurance.html to provide immediate prices by entering a zip code.

The instant pricing that is available through the company website this year is based on the actual costs received by each insurance agency that exists in the public system. A direct calculation of costs is made when each car owner enters a zip code to find the top rates in a precise location of the country.

"There are many discounts available from local companies that are not accessible to a person living in a different area and our system helps present this data," said a source from the Quotes Pros company.

The vehicle insurance providers that are listed in the public database are licensed throughout the U.S. and provide prices for basic and policies that require customization. Drivers can find liability insurance rates, full coverage insurance rates and other risk based policies that agencies underwrite.

"Our auto insurance quote database is one of the public tools that we've helped introduce this year to average motorists who have few local resources to compare prices," said the source.

The Quotes Pros company has entered more rates data throughout this year that is separate from vehicle insurance providers. Consumers can research life insurance, renters insurance and health insurance by using the optional quotation tool at http://quotespros.com/life-insurance.html.

About QuotesPros.com

The QuotesPros.com company is one American source drivers utilize for researching vehicle insurance policy prices and insurer information using the Internet. The company listings of agencies are instantly viewable using the database programmed this year. The QuotesPros.com company has recently included different packages for protection that are separate from vehicle insurance coverage. Consumers can actively quote life, renters, business and medical insurance pricing using the zip code based search option. Reported by PRWeb 8 hours ago.

Low Cost Car Insurance Prices for U.S. Drivers Added to Public Insurer Quote System Online

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Low cost car insurance prices are now included in the U.S. quotation system built at the Quotes Pros website. All price data is viewable at http://quotespros.com/auto-insurance.html.

Sandusky, OH (PRWEB) June 07, 2014

U.S. motorists can pay more for insurance annually based on agency changes and market fluctuations. One auto resource is now providing access to low cost car insurance prices. The Quotes Pros company has enabled its search platform to find affordable insurer rates free of charge at http://quotespros.com/auto-insurance.html.

New groups of agencies providing less than market prices for standard car coverage policies are among the providers that can be researched using the auto insurance quote tool now open. The drivers using this system when calculating insurance costs receive full privacy and never enter personal contact data.

"Because our system offers private insurance comparisons, vehicle owners who are price shopping for the best rates can review this information without providing their automobile details," said a source from the Quotes Pros website.

The affordable insurance packages that are now quotable while using the Quotes Pros database include multi-level protection options. The pricing for state minimum coverage, SR22, full coverage, non owner, broad form and antique insurance includes all applicable markdowns from national companies this year.

"Consumers using our platform have a direct way to compare national and local prices at the same time before a decision is made to follow through with a locked in purchase," said the source.

The Quote Pros company has also introduced more options for coverage this year that are based on non-automotive policies. Life insurance, renters insurance and health insurance are part of the policies that are available for exploration and price quotes when accessing the tool at http://quotespros.com/life-insurance.html.

About QuotesPros.com

The QuotesPros.com company is positioned as one of the top companies for independently accessing vehicle insurance pricing using the Internet. This company has activated car insurance, life insurance and other policies that are available for quotations. The QuotesPros.com company has grown this year by adding new agencies that prepare exact quotations in policy pricing for the public when comparing different costs before purchasing coverage plans in North America. Reported by PRWeb 7 hours ago.
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