Patch Acworth, GA -- The health insurance company will invest $20 million, open center in Bank of America Plaza. Reported by Patch 13 hours ago.

Patch Acworth, GA -- The health insurance company will invest $20 million, open center in Bank of America Plaza. Reported by Patch 9 hours ago.

Enhancements designed to ensure patients’ informed choice of health insurance plan and prevent inappropriate use of program

(PRWEB) October 26, 2016

The American Kidney Fund (AKF), the nation’s leading charitable organization working on behalf of Americans with kidney disease, today announced a series of measures to protect patients’ autonomy and informed choice when they turn to AKF’s Health Insurance Premium Program (HIPP) for help affording insurance coverage.

AKF currently educates grant recipients about the HIPP program through a number of channels, including a HIPP program guidelines document and a quarterly patient newsletter. The enhanced safeguards announced today—a Provider Code of Conduct, a Patient Bill of Rights, and enhanced educational materials—are directed at providers as well as patients. They clarify the rights and responsibilities of each party to ensure that patients have made an informed choice when selecting health insurance coverage and applying for HIPP grant assistance from AKF.

“For nearly 20 years, AKF’s HIPP program has made it possible for low-income patients dialysis patients to access health insurance coverage even if they need charitable assistance to afford it,” said LaVarne A. Burton, AKF president and CEO. “Our grants have always been issued solely on financial need, without regard to a patient’s insurer or provider, and we have adjusted the program as the health care landscape has evolved over two decades. With the ever-increasing complexity and new health insurance options available in the Marketplace, we are taking additional steps to be sure that patients are well informed and best able to navigate the available choices to select the health plan that best meets their medical and financial needs.”

In August, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Information about health care providers allegedly steering patients to qualified health plans in the exchange, also known as Marketplace plans. CMS cited dialysis providers in particular. Amid the anecdotal allegations, AKF sees an opportunity to further its role as a patient educator and advocate.

“We adamantly oppose any provider efforts to improperly steer patients to private insurance plans, and we equally oppose insurer efforts to steer kidney patients into Medicare or Medicaid plans that may not adequately meet their needs,” Burton said. “In addressing anecdotal reports of provider steering, the Obama Administration must not close off access to the Marketplace for low-income ESRD patients who need charitable help.”

While most ESRD patients can become eligible for Medicare regardless of age, for some patients, a Marketplace plan may provide better coverage at lower out-of-pocket expense. Each patient’s situation is unique, and patients need to carefully evaluate their choices. As one example, about half the states do not require insurance carriers to offer Medigap insurance to ESRD patients under 65. These patients are therefore exposed to a 20 percent out-of-pocket Medicare cost burden with no annual cap; for these patients, a Marketplace plan may have lower out-of-pocket annual costs than would Medicare.

Beginning in 2017, grant applicants will need to demonstrate to AKF why a Marketplace plan is a better option for them personally than Medicare or Medicaid. This mandatory step in the grant approval process will ensure that each patient has carefully evaluated his or her insurance options and has made an informed decision.

The additional safeguards announced today, effective beginning in 2017, are:· A Provider Code of Conduct that each referring dialysis provider must sign. The Code of Conduct requires dialysis providers to keep the best interests of the patient in mind when referring patients to AKF for assistance, and requires providers to give patients comprehensive, accurate, and impartial information enabling them to make informed decisions about their health insurance coverage. Such comprehensive information will include financial and coverage-related implications associated with the choice of a particular coverage option.
· A Patient Bill of Rights that outlines for patients their rights and responsibilities regarding their receipt of HIPP grant assistance. This document explains patients’ freedom to independently choose their health care coverage and providers, to make changes in provider or coverage, to register online to track their AKF grant status, and to report to AKF any concerns about the program, including whether there are concerns that patients’ rights under HIPP have been violated.
· The choice of health insurance can be very complicated for patients with kidney failure, and the options available to them are more limited than those available to Medicare recipients who are over 65 years of age. Medicare requires that all dialysis facilities have sufficient social services staff to meet dialysis patient needs, and AKF is committed to working with providers and with CMS to ensure that dialysis social workers and other dialysis center employees can continue their very important role in educating patients about insurance choice. In this regard, AKF will continue to work in conjunction with patients as well as the kidney care community to develop further solutions to protect patient rights and choices. Additionally, AKF is developing new educational materials to provide patients with objective information about their insurance options.

“We have consistently taken a comprehensive approach to ensuring the integrity of our work, including carrying out the HIPP program in compliance with the federal Advisory Opinion under which the program operates,” Burton said, referring to U.S. Department of Health and Human Services Advisory Opinion 97-01, issued in response to an AKF request in 1997. “The steps we are now taking go well beyond what we are required to do under the Opinion, and will add significant safeguards to ensure HIPP remains a critical part of the nation’s safety net for low-income dialysis patients for decades to come.”

AKF’s HIPP program has provided financial assistance to financially eligible end-stage renal disease (ESRD) patients for nearly 20 years, helping patients afford Medicare Part B, Medigap, employer group health, COBRA and commercial plans. With the advent of the Affordable Care Act, AKF HIPP grants have also provided premium payments for Marketplace plans. About 6,400 of the 80,000 patients who receive premium assistance under HIPP are in Marketplace plans.

For nearly three years, AKF has been providing information to CMS about insurance carriers nationwide that are attempting to steer dialysis patients away from their plans by refusing to accept charitable premium payments, and more recently, insurance carriers that are refusing to insure people who receive charitable assistance. AKF has long urged CMS to promulgate a rule that requires insurers to accept premium payments behalf of low-income patients from independent, publicly supported charitable organizations that meet certain objective criteria.

“Our position has long been that with the proper guardrails in place, nonprofits like AKF can play a critical role in making the promise of the Affordable Care Act come true for chronically ill people who otherwise would not be able to afford Marketplace coverage,” Burton said. “As we take important steps to strengthen our program against improper provider actions, we look forward to continuing to work with CMS to ensure that low-income ESRD patients may continue to receive charitable grant assistance allowing them to afford health coverage. On Monday, we met with CMS and presented the new steps that we are undertaking.”

About the American Kidney Fund
As the nation’s leading nonprofit working on behalf of the 31 million Americans with kidney disease, the American Kidney Fund is dedicated to ensuring that every kidney patient has access to health care, and that every person at risk for kidney disease is empowered to prevent it. AKF provides a complete spectrum of programs and services: prevention outreach, top-rated health educational resources, and direct financial assistance enabling 1 in 5 U.S. dialysis patients to access lifesaving medical care, including dialysis and transplantation.

For more information, please visit KidneyFund.org, or connect with us on Facebook, Twitter and Instagram. Reported by PRWeb 13 hours ago.

Medicare is the federal health insurance program for the elderly and others with certain disabilities. It reimbursed chiropractors $438 million in 2013 for services to more than 17 million beneficiaries. Reported by nola.com 13 hours ago.

By J.B. Silvers, Case Western Reserve University
As we all know by now, The Donald wants to repeal and replace the Affordable Care Act while Hillary wants to fix it. But what does that mean, and how would they do it?The first question is what exactly do they want to repeal or fix. The ACA seems to have evolved into a great political Rorschach test somewhat devoid of real content but relying on projection of underlying beliefs.For Republicans, it is evidence of governmental overreach and excess expenditures, while Dems seem to think of it as the essence of collective action and shared responsibility for those less fortunate. As such, neither informs the specific directions we might take from here.In reality, the ACA consists of four major parts:

2. Expansion of Medicaid for low-income working poor, with mostly federal financing.4. Research on alternative ways to treat conditions to inform physician practice.6. Tests of innovative ways to organize and deliver health care for better value that can be quickly implemented across the system.8. The exchanges, for purchasing subsidized individual policies from private insurance companies.

Of course, it is mainly the exchanges that get public attention and, unfortunately, much of that is misinformed. And even if the candidates were to change or eliminate the exchanges, the other three parts, which may well be the most important and lasting legacy of the legislation, would most likely stand.*Medicaid madness?*The easiest part of the ACA was thought to be the expansion of Medicaid to the working poor, but it became a political battle. Medicaid expansion cuts states' health care costs while providing coverage to millions more people.The expansion required no expenditure of state money for the first three years, only an acceptance of federal dollars. Thus, many considered expansion a done deal and a crucial part of the law. Then the U.S. Supreme Court ruled that states could refuse to expand Medicaid.Many - 26, to be precise - did just that in 2014, as Republican governors and lawmakers in red states voted to not accept the federal money. Some later changed their minds, but as of now, 19 states still have not expanded Medicaid.Even some red state governors who resisted the extra funds from the Feds to expand Medicaid coverage are reconsidering, albeit with some conditions that provide political cover. Only states' rights advocates, for philosophical reasons, and budget hawks, who fear that the Feds will renege on their funding, are holding out for a repeal of this one.*Beyond the exchanges*While the double-digit premium increases have led to calls for repeal, it's important to look at the law more broadly and what can be done to fix it.Two parts of the ACA may have dramatic impact even though they totally avoid public scrutiny. They seek to change the way that health care is delivered at a very fundamental level. Research called for by the ACA is being done by health care systems, insurers, and provider at every level, focusing on alternative ways to treat problems - something that most would assume we already do. Under the law, reimbursements to providers is tied to their doing this.But that's not really the case. For example, the FDA is charged with assuring that a drug or device is effective (efficacious) and safe (not toxic or carcinogenic), not whether it is actually better than the alternative. So we have alternative drugs, devices, surgeries and so forth that all address a problem with little guidance as to which one actually is better.The idea is that scientific findings will guide both physician practice and coverage decisions toward better value and blunt that drive toward more marginal treatment at ever higher cost with limited outcomes.The alternative approach to this kind of cost control is just to cut payments, while allowing volume to expand. It is unlikely that those who support cost control and those who do not will want to proceed down that path. It will lead to bankruptcy and ever declining marginal value - although those who stand to lose money may resist.In a similar way, the Innovation Center called for in the ACA is designed to try new organizational and payment models to see what works better and encourage adoption widely. The goal here is "value," where that is defined as something that meets at least threshold quality metrics (e.g., hospital readmission rates) while meeting or beating actuarial estimates of cost.The only ones who are arguing against these two little known parts of the act are those whose vested interests would be challenged. Drug companies are not wild about the additional standards of value for their products; hospitals argue the quality metrics are faulty, and physicians don't like being forced into new organizations that may limit their autonomy.Big bets have been made on the future of health care, and these cannot be recalled easily. But there are places here that will likely be part of Hillary's "fixing" of the ACA.*And then there are marketplaces*So that leaves us with the "disaster" of the individual insurance markets decried by Trump, who has said he would eliminate the marketplaces in favor of open competition across state lines. Allowing insurance companies to offer insurance in different states, the thinking goes, will increase competition of plans and lower rates for consumers.
Donald Trump embracing an American flag. AP
From the Associated Press

Unfortunately, the companies don't seem interested since they already can do this to some extent but don't. One reason is that premiums are based, in part, on negotiated rates with providers. It is hard to build provider networks in another state, from another state.The level of competition insurers face is secondary and may be a detriment in driving provider rates lower.In any event, cross-border competition hardly is a panacea for rising costs. It is, however, an unspoken attack on the insurers as a way to break their often solid capture of the regulation process which now resides at the state level. Thus, expect industry resistance to this traditional Republican proposal.The problems of the individual insurance exchanges come from many directions. Besides insurance company pricing errors compounded by their natural risk avoidance, the government changed the rules midstream and limited the range of premiums insurers can charge, which forced the young to pay too much or the old too little.This was compounded by a huge failure of Congress to hold up their end of the bargain in supporting the transitional support promised by the law to companies willing to take the plunge into the unknown of the exchanges, as I wrote about in The Conversation in August. When only 12 percent of the support promised to companies with higher than expected costs was paid, the higher risk and big losses drove many out of the markets. Thus, many of the problems of the exchanges lie directly at the feet of Congress.
Bernie Sanders' calls for Medicare for all did not get far. AP.
Jacquelyn Martin/The Associated Press

A Democratic Congress would rectify this as part of the fix. Hillary also would allow people in the 55-64-year-old age group to buy into Medicare early. This is a form of the "public option" that would be popular and probably would enliven the areas where there is no competition on the exchanges.The irony of the Republican opposition to the use of a competitive market with subsidies to make health insurance "affordable" - essentially their long time alternative - might become apparent, allowing them to engage in fixing the ACA if Congress goes blue.Interestingly, Clinton has a number of other positions that one could argue would move us toward lower cost and higher quality as promised by the ACA. One of the most interesting concerns drugs, where she would allow Medicare to bargain for lower prices, permit importation of price-controlled prescription pharmaceuticals from other countries and limit direct-to-consumer advertising.Given that this is the most inflationary of any sector of health care and that many firms seem to have engaged in exploitative pricing, these are likely to get attention from both sides of the aisle although Republicans have said little about their approach.So overall, it is unlikely that we would actually see a full "repeal and replace" from the GOP. There are some signs that Congress is open to fixing the ACA, as evidenced by a few Republicans, such as Rep. Dennis Ross of Florida. Realistically, in their weakened position should Trump lose, compromise is more likely than in any time during the last eight years.The fact that the ACA actually has reduced the deficit, although estimates vary by how much, and extended Medicare solvency by many years may mean that wholesale changes would not be good. It would be important to keep those parts that have saved money. And both sides have pledged their allegiance to both of these politically popular objectives.Going forward, the most likely path is the same difficult one that the U.S. system as a whole must take toward improving access and value. There will be no quick fix.J.B. Silvers, Professor of Health Finance, Case Western Reserve UniversityThis article was originally published on The Conversation. Read the original article.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 11 hours ago.

Employees are spending a larger percentage of their income on health insurance than they did before passage of the Affordable Care Act, according to a newly released report from The Commonwealth Fund. The study describes the development as a general increase in “the share of median family income necessary to cover premium costs and deductibles.” On average, the report says, that family share grew from 6.5 percent in 2006 to 10.1 percent last year. But in many cases, the trend doesn't draw from… Reported by bizjournals 12 hours ago.

Premiums for individual health-insurance plans in Washington will rise an average of 13.6% next year, though rates within the state health exchange will jump about 8% for midlevel plans, far lower than national hikes of 25%. Reported by Seattle Times 11 hours ago.

Employees are spending a larger percentage of their income on health insurance than they did before passage of the Affordable Care Act, according to a newly released report from The Commonwealth Fund. The study describes the development as a general increase in “the share of median family income necessary to cover premium costs and deductibles.” On average, the report says, that family share grew from 6.5 percent in 2006 to 10.1 percent last year. In Missouri, the family coverage share grew… Reported by bizjournals 10 hours ago.

The average price for health insurance policies under the Affordable Care Act will rise by 22 percent next year, though the costs to individual consumers will still vary. A California woman reacts to the new prices and considers her options. Reported by NPR 7 hours ago.

Minnesotans who receive health insurance through their employer pay a share of their insurance costs greater than the national average, according to according to a Commonwealth Fund report released Wednesday. That finding is part of a broader study that examines how employees’ insurance expenses have changed since the Affordable Care Act passed in 2010. About 55 percent of Minnesotans get insurance through an employer. Only 5 percent are covered by the individual plans that are at the center of… Reported by bizjournals 8 hours ago.

Submitted by Joseph Jankowski via PlanetFreeWill.com,

*Massachusetts Institute of Technology Professor and architect of ObamaCare Jonathan Gruber told CNN’s Carol Costello on Wednesday that ObamaCare, which is set to see a sharp increase in premium prices next year, is going just as planned.*

When asked what could be done to the Affordable Care Act in order to drive the prices of premiums down, *Gruber responded by saying “the law is working as designed.”*

*“Look, once again, there is no sense of just what has to be fixed, the law is working as designed,” Gruber told CNN. “However, it could work better and I think the most important thing experts would agree on is that we need a larger mandate penalty.”*

Johnathan Gruber made headlines in 2014 when video surfaced of him saying that the “lack of transparency” and the “stupidity of the American voter” helped ObamaCare become law.

*“Lack of transparency is a huge political advantage,” Gruber said. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”*

Gruber made the comments while discussing how law was “written in a tortured way” to avoid a negative score from the Congressional Budget Office. He suggested that that ObamaCare would have been rejected if the penalties for going without health insurance were interpreted as taxes.



*“If CBO scored the (individual) mandate as taxes, the bill dies,” Gruber said.*

 

*“If you had a law that made it explicit that healthy people are going to pay in and sick people are going to get subsidies, it would not have passed,” he added.*



As the AP reported yesterday, the Obama Administration has confirmed that premiums will sharply rise under the ObamaCare law, with many consumers left with only one insurer to choose from.

Premiums for a midlevel benchmark plan will increase on average 25% across 39 states served by the federally run online market, according to a report from the Department of Health and Human Services.

*“Consumers will be faced this year with not only big premium increases but also with a declining number of insurers participating, and that will lead to a tumultuous open enrollment period,” *Larry Levitt, who tracks the health care law for the nonpartisan Kaiser Family Foundation, told the Associated Press. Reported by Zero Hedge 7 hours ago.

As Obama has learned from his constant threats on new gun regulations, sometimes advertising your intentions for new policies and regulations well in advance of actual implementation simply leads to more of the undesired actions.  According to border patrol officials in Southern Texas, that is exactly what is driving a recent spike in illegal immigration as people are rushing to enter the U.S. ahead of the 2016 election.



Agent Chris Cabrera told CBS News that they’ve been seeing a spike in immigrants crossing the U.S.-Mexico border illegally, thanks in part to the election.

 

*“The smugglers are telling them if Hillary [Clinton] gets elected, that there’ll be some sort of amnesty, that they need to get here by a certain date,” *Cabrera said. *“They’re also being told that if [Donald] Trump gets elected, there’s going to be some magical wall that pops up overnight and once that wall gets up, nobody will ever get in again.”*

 

Cabrera added that they’ve encountered up to 1,000 immigrants along McAllen’s stretch of the border some days.

 

*“We’re getting mass spikes of people crossing and turning themselves in,”* he said.



 

Of course, Trump has been very clear throughout his campaign that illegal immigration would be big focus during his presidency after repeatedly calling for a wall along the southern U.S. border with Mexico and mass deportation of immigrants here illegally.  



Trump has clarified that he *opposes any pathway to legal status for immigrants in the U.S. illegally*. They would have to return to their home countries and apply for legal entry should they wish to come back. He has not said what would happen to those who choose to stay, but said they are subject to deportation. Trump has also called for an end to “birthright citizenship,” currently granted to anyone born in the U.S.



Claims which he recently reiterated at a campaign stop in Gettysburg, PA:

 

Meanwhile, Hillary's website lays out her key policy agenda items relative to immigration which could be further from Trump's.  In addition to promising legislation within her first 100 days to offer a "pathway to full and equal citizenship," Hillary has also supported opening up Obamacare to illegal immigrants. 



*Introduce comprehensive immigration reform.* Hillary will introduce comprehensive immigration reform with a *pathway to full and equal citizenship within her first 100 days in office*. It will treat every person with dignity, fix the family visa backlog, uphold the rule of law, protect our borders and national security, and bring millions of hardworking people into the formal economy.

 

*Do everything possible under the law to protect families.* If Congress keeps failing to act on comprehensive immigration reform, Hillary will enact a simple system for those with sympathetic cases—such as parents of DREAMers, those with a history of service and contribution to their communities, or those who experience extreme labor violations—to make their case and be eligible for deferred action.

 

*Expand access to affordable health care to all families.* *We should let families—regardless of immigration status—buy into the Affordable Care Act exchanges*. Families who want to purchase health insurance should be able to do so.



Ironically, offering Obamacare to illegal immigrants might just be the one immigration deterrent in Hillary's plan. Reported by Zero Hedge 7 hours ago.

Health insurance shoppers beware: Not all of the information on the state's Obamacare exchange is accurate or complete.

Details about health plans offered on the exchange for next year were posted online Monday, giving shoppers a chance to study their options ahead of Nov. 1, when they can start... Reported by ChicagoTribune 6 hours ago.

Seventy-one years ago, recovering Iwo Jima solider, Bill Madden, turned down free tickets see the Cubs play in the World Series because of the unique strings attached. This time around, he's not missing his opportunity.

Mishawaka, IN (PRWEB) October 26, 2016

Seventy-one years ago, recovering Iwo Jima soldier Bill Madden turned down free tickets see the Cubs play in the World Series. It wasn’t lack of desire that kept Madden from going, but the unrealistic work requirements that stopped him. As a resident of Saint Joseph Health System St. Paul’s, and a lifelong Cubs fan, Madden is getting that second chance to see the Cubs play in the World Series, thanks to the Coalition to Salute America’s Heroes. The Coalition provides emergency financial assistance to America’s combat-wounded veterans. St. Paul’s will host a celebration event prior to Madden’s departure for the game.

In 1945 Madden fought and was wounded in Iwo Jima during WWII, earning a Purple Heart for his sacrifice. In fact, he recalls seeing the flag being raised from the historic scene known today from the famous photograph.

Madden was then sent to a military hospital in Chicago to recover from his injuries the same year the Chicago Cubs last earned a spot in the World Series. As a gesture of thanks, the Cubs organization offered Naval hospital patients tickets to the game. The Naval hospital that held the tickets, however, had a few conditions of their own.

"The chance to go was exciting,” Madden said. “But they (Navy) put strings on getting those tickets for a Marine like me. They told us we had to work, including scrubbing and mopping floors if we wanted to go." So Madden took his chances and turned down the tickets, thinking he lived a mere 90 minutes from Wrigley Field and was sure to see the Cubs in another World Series.

Madden waited and waited for his chance to see the Cubs in the World Series again. A patient man, he wasn’t sure he’d ever see his favorite team play in the series. Last year, the coalition took Madden to his first league championship game when the Cubs were in contention against the New York Mets. The Cubs lost and failed to advance. This Friday, however, Madden will finally get that second chance at seeing his favorite team play when the coalition takes him to Game 3 of the series.

Last summer, Madden got to know the Cubs organization a little better when three South Bend Cubs players lived at St. Paul’s during the season. He, along with his fellow residents, will continue their Cubs baseball fever with a celebration event before Madden departs for Chicago.

St. Paul's Cubs Celebration (St. Paul's resident-only event)
Friday, Oct. 28, 10:30 a.m.
Saint Joseph Health System St. Paul's
3602 S. Ironwood Dr., South Bend, IN
Speakers: Bill Madden, WWII veteran; David Walker, president of the Coalition to Salute America's Heroes; Shari Binkley, executive director of St. Paul’s

About Bill Madden
As a 19-year-old-Marine, Bill watched many of his buddies die around him on the Pacific island of Iwo Jima. But, out of the smoke came a familiar face, his brother Bob. "I really thought I was hallucinating," Bill noted. But it really was his brother and fellow Marine, and a strange place to be reunited.

The battle of Iwo Jima took more than 25,000 American lives, but he and his brother had survived. During the battle Bill was shot in the arm and wrist, which left his ulnar nerve partially paralyzed. Bill recovered from his injuries and went on to become an English teacher for 35 years at both the high school and college levels. He married his high-school sweetheart, Phyllis, and had four children. Now a widower, Bill resides in South Bend, Indiana, at St. Paul's senior living community.

About St. Paul's
Saint Joseph Health System St. Paul’s offers seniors a wellness lifestyle and residences. It serves seniors with independent living apartments, assisted living apartments, memory care apartments and rehabilitation and wellness services. Last summer, it housed three South Bend Cubs players as guests in an effort to bridge generational gaps.

About the Coalition to Salute America’s Heroes
The Coalition to Salute America’s Heroes, based in Leesburg, Virginia, has provided an immediate, invaluable lifeline to thousands of America’s wounded veterans since its establishment in 2004. The Coalition is distinguished from other veteran-focused organizations by its direct financial assistance to America’s combat-wounded heroes. Its Emergency Financial Aid program has stopped foreclosure proceedings on veterans’ homes and kept their vehicles from being repossessed. The organization regularly provides gift checks to cover meals, medical and utility bills, clothing, car repairs and even baby diapers.

About Saint Joseph Health System
Saint Joseph Health System (SJHS) is a not-for-profit healthcare system located in North Central Indiana that offers acute-based hospital care and post-acute services including: community wellness, physical rehabilitation, home care, physician clinics, outpatient services, independent and assisted senior living, memory care and affordable senior apartments. SJHS includes: Mishawaka Medical Center; Plymouth Medical Center; Rehabilitation Institute; Outpatient services of the Elm Road Medical Campus; Health Insurance Services; Saint Joseph Physician Network; VNA Home Care; the Senior Living Communities at St. Paul's, Holy Cross and Trinity Tower; and Saint Joseph PACE. SJHS serves more than 200,000 members of the Michiana community annually. SJHS is a Regional Health Ministry of Trinity Health in Livonia, Michigan.

### Reported by PRWeb 6 hours ago.

Kazakhstan’s adoption of the Singaporean governance and economic model is a fascinating subject worth exploration. Focusing on the Samruk-Kazyna National Welfare Fund, the civil service structure, and healthcare services in Kazakhstan, this article delves into examining how the Kazakh government has attempted to reform its economy and bureaucracy to build a highly functional state.

By Boh Ze Kai*

Singapore and Kazakhstan may have little in common. Singapore is the 19^th smallest country in the world – a tiny, yet densely-populated English-speaking island with one of the world’s highest GDP per capita, and a developed economy based on maritime shipping routes, financial services, knowledge economy, and high-tech manufacturing of semi-finished value-added goods. Kazakhstan is the 9^th largest country in the world – a sparsely-populated, landlocked Russian-speaking expanse of steppes, with an economy based on fortuitous reserves of crude oil and petroleum gas (60 percent of GDP) and large reserves of ores and rare minerals (22 percent of GDP), while wheat-centred agriculture and a small manufacturing industry account for the remainder.

Singapore, not known to many, however, has served a model for Kazakhstan’s economic development since May 1991, when the legendary then-Senior Minister Lee Kuan Yew visited Almaty and delivered a lecture to the economists of the Council of Ministers. Mr Lee convinced President Nursultan Nazarbayev of the importance of adopting a suite of long-term economic policies intended to drive the nascent state into the modern capitalist world economy. In his book ‘The Kazakhstan Way’, Nazarbayev names Lee Kuan Yew alongside Charles de Gaulle as the two greatest statesmen in history (Nazarbayev, The Kazakhstan Way, 2006). On the occasion of the 20^th anniversary of Kazakh-Singaporean relations, the Ambassador to Singapore laid out a series of Kazakh policies influenced by the city state (Baudarbek-Kozhatayev, 2013). Much of these policies are pursued as part of Strategy Kazakhstan 2050, a wide-ranging effort put into force in 2011 to modernise and professionalise national institutions across the country.

This article aims to explore recent development policies pursued by Kazakhstan, how they were influenced by Singaporean policies, and comment on their efficacy and differences. In particular, the article focuses on the Samruk-Kazyna National Welfare Fund, the civil service structure, and healthcare services in Kazakhstan.

In 1974, Temasek Holdings was incorporated under the Singapore Companies Act, with the intention of allowing it to manage assets previously owned by the Government of Singapore. Temasek has never been a government agency or a statutory board, but functions like a normal company with directors, shareholders, management, and fiduciary and tax obligations, albeit with Presidential safeguards and only one shareholder: the Ministry of Finance. The firm initially acquired a portfolio comprising some of Singapore’s largest state-affiliated companies across a wide swathe of industries, household names like Singapore Airlines, the Development Bank of Singapore, Keppel Corporation, and ST Engineering. It later acquired extensive equity investments worldwide, including Alibaba, Paypal, Dell, and the Industrial and Commercial Bank of China.  Beginning with an initial portfolio value of S$354 million, the company is now worth S$242 billion with a revenue of S$101 billion (24 percent of Singapore’s GDP for 2016), and six percent 10-year annual returns (Temasek Holdings, 2016).

In 2008, the Samruk-Kazyna National Welfare Fund was formed by Presidential decree, merging the Samruk and Kazyna funds in order to provide long-term maximisation of value in national assets. Modelled after Temasek, its sole shareholder is the Government of Kazakhstan, and its initial holdings were state-owned companies in key industries like national carrier Air Astana, state oil and gas company KazMunayGas and state uranium company Kazatomprom. The company boasted a revenue of 3,091 billion KZT in 2015 (23 percent of Kazakhstan’s GDP), and received acclaim for its role in stabilising the effects of the 2008-2009 recession by acquiring three of Kazakhstan’s worst-hit banks (BTA, TemirBank, Alliance) and providing them with the necessary credit to survive the recession. Samruk-Kazyna’s restructuring of BTA’s US$9 billion external debt into US$650 million was also lauded by the international community.Figure 1: Percentage breakdown of portfolios of Temasek Holdings & Samruk-Kazyna, 2015

Unlike Temasek, Samruk-Kazyna has mostly committed to developing national assets rather than investing in international acquisitions. Temasek’s portfolio is notably centred around telecommunications, financial services, logistics, and real estate; while Samruk-Kazyna’s portfolio strongly features oil, transportation, energy, and chemicals (see Figure 1).This has left it vulnerable to Kazakhstan’s domestic economic issues, particularly the falling price of oil. Kazakhstan’s national budget for 2015, originally accounting for the price of oil at US$80 a barrel, was revised in January 2015 to account for the price of oil at US$50 a barrel(Urazova D. , 2015), as of 2016, it is now US$30 a barrel. The immediate effect of declining oil prices is to shrink the revenue of oil companies like KazMunayGas and related industries, generating a ripple effect that is reflected in lower revenues for Samruk-Kazyna and diminished GDP growth for Kazakhstan (Table 2), with a clearly visible correlation between Brent crude price, and key economic and financial indicators (Figure 3). The practical effect is that unlike Temasek, Samruk-Kazyna has been stagnating since oil prices began falling in 2014.

–

*Year* *Brent Crude Price (USD per barrel)* *Kazakhstan GDP Growth (per annum)* *Samruk-Kazyna Annual Revenue (billion KZT)* *KazMunayGas Annual Revenue (billion KZT)*
2007 60.00 8.90% 487
2008 102.95 3.30% 2874 605
2009 46.86 1.20% 2912 485
2010 79.70 7.30% 3609 609
2011 98.00 7.50% 4204 834
2012 102.99 5.00% 4731 899
2013 100.58 5.80% 5031 817
2014 103.90 4.10% 2971 846
2015 48.50 1.20% 3091 530
2016 28.50 0.10% 487

Table 2: Comparison of year-on-year GDP growth and annual revenue of Samruk-Kazyna & KazMunayGas vis-à-vis Brent crude price from 2007-2016 (Agency of Statistics of the Republic of Kazakhstan, 2016)(Samruk-Kazyna National Welfare Fund, 2015)(KazMunayGas, 2015)

Figure 3: Graph of indices of GDP growth, Brent crude price, and revenue of Samruk-Kazyna and KazMunayGas from 2007-2016 (data obtained from Table 1)

Yet, falling oil prices can only partially explain Samruk-Kazyna’s stagnation – the organisation is plagued with bureaucracy, nepotism and inefficiency. Low salaries and poor employee welfare created a gulf between management and employees, triggering a riot and massacre in the KazMunayGas-controlled town of Zhanozen in December 2011. In 2013, the organisation and its subsidiaries reportedly engaged 350,000 employees with 650,000 more affiliated employees (Samruk-Kazyna Press Centre, 2013), indicating a bloated and inefficient human resource policy. This led to the firm announcing its decision in 2013 to replace 30% of its management staff across all subsidiaries, enlisting foreign experts to pass on best practices in order to remedy the rampant inefficiency(Konyrov, 2013).In 2015, it emerged that the 6 members of the executive body of Samruk-Kazyna received combined bonuses totalling US$1.9mln in 2014 alone (Urazova, 2015), in a country where median annual salaries are approximately US$5,000.In contrast, Temasek Holdings maintains lean operations – it has a payroll of only 582 employees, and commits to leaving day-to-day management to the subsidiary companies; involving itself only to ensure sound corporate governance (Temasek Holdings, 2016).

In 2013, Samruk-Kazyna conducted a benchmark exercise headed by McKinsey & Company, which revealed that the return on equity and assets of the company was significantly lower than that of other similar sovereign wealth funds(Shukuyev, 2015). This prompted the launch of a large-scale transformation of the subsidiary operations based on best practices from Temasek Holdings and Malaysian sovereign wealth fund Khazanah Nasional Berhad, focussing on restructuring the portfolio to maximise value, and process-flow maximisation programs to improve human resource conditions. In 2014, Nazarbayev openly ordered Samruk-Kazyna to privatise half of its assets, and in April 2014, Samruk-Kazyna released a statement that it would release 209 of its 599 companies for private ownership(Jafarova, 2014). By 2015, the fund had sold off 36 assets totalling 49bn KZT, with a comprehensive privatisation plan aiming to sell another 783 public assets, including 217 assets owned directly by the Samruk-Kazyna group by 2020(Samruk-Kazyna National Welfare Fund, 2015). Crucially, the fund encouraged foreign acquisition of its assets, and announced its own desire to accelerate acquisition of foreign assets, and engage in joint ventures with foreign firms. The company announced there would be ‘no sacred cows’ in the privatisation drive – downstream, logistics, mining, transportation and even energy industries would be available for external acquisition(Gizitdinov, 2015).

Unfortunately, encouraging investors to acquire nationally critical industries has proved to be an uphill struggle. In 2013, Samruk-Kazyna began calling for buyers for the three banks it had acquired in 2009, drawing a lukewarm response. The banks were eventually sold to two individual businessmen, (rather than being acquired by larger, better-connected banks like Halyk Bank) for approximately 200bn KZT, compared to the nearly 332bn KZT injections made by Samruk Kazyna into the same banks(Interfax-Kazakhstan, 2014).Rumours have also surfaced that the government of Kazakhstan had already begun buying back minority shareholdings in privatised companies in an effort to curtail the influence of independent directors(Bisenov, 2016). The veracity of these rumours is irrelevant, only that the reputation of the privatisation programme has reached a point where investors perceive significant risks, and mistrust both government interference and the firm’s own corporate governance record.

This is not to say that Samruk-Kazyna is poisonous. In fact, while Standard & Poor lowered the credit rating of the firm to ‘BBB-/A-3′ from ‘BBB/A-2′ with a negative outlook, it remains a reputable investor, and a medium-grade investment. Samruk-Kazyna continues to cooperate actively with the Government of Kazakhstan, owning substantial assets in industries capable of fuelling the growing global demand for ores, oil, and other commodities. The continued enactment of the Kazakhstan 2050 plan to correct Kazakhstan’s macroeconomic deficiencies, coupled with the leviathan, ambitious One Belt-One Road plan launched by China and partnered by Kazakhstan’s own Nurly Zhol plan provides Samruk-Kazyna with unprecedented opportunities to become profitable once again.

*Effective Governance*

Singapore can claim to possess the best civil service in the world, ranked 1^st in the 2014 World Bank’s Government Effectiveness and Regulatory Quality Indices. It comprises of a corps of 80,000 civil service officers acting independently from elected officials, many headhunted at the age of 18 by the technocratic Public Service Commission (PSC) and exposed to rigorous interviews and meritocratic selection processes before being sent on government scholarships to prestigious universities in Singapore and abroad. Of these, an elite cadre of approximately 200 officers form the Administrative Service, focussing on the formulation and evaluation of policy rather than its execution. Singapore’s civil service is a human resource pipe-dream – high salaries tagged to top positions in the private sector discourage corruption and attract the brightest talents, a Civil Service College builds strategic capacity, while staff-training opportunities are abound both locally and abroad. Civil services from Abu Dhabi to China have professed intentions to emulate the island-state, but Kazakhstan’s dedication to pursuing the Singapore model of civil service is perhaps the most notable.

On 22 May 2015, Nazarbayev announced a momentuous document: 100 Concrete Steps for Five Institutional Reforms (summarised in Table 4). The document is a highly specific set of government policies, which has been described by the former Russian finance minister and head of Russia’s Sberbank, Herman Gref, as “the Singapore government program”(Sputnik News, 2015). Yet, the contents of the program itself are nothing new, and Kazakhstan has been consistently attempting to emulate Singaporean policy for some time.

*Institutional Reform* *Summary of Steps*
Development of a Professional Civil Service *Creation of a meritocratic recruitment and evaluation system*
Transition to performance-based renumeration
Restrictions on the accumulation of wealth for civil servants
Creation of anti-corruption legislation and institutions

Ensuring the Rule of Law *Creation of strict recruitment and evaluation system for judiciary*
Expansion of legal statutes
Encouragement of transparency in judicial proceedings
Creation of new Councils and boards to oversee specific proceedings
*Electronification of legal proceedings*

Industrialisation and Economic Growth Implementation of land use reforms
Restructuring of tax regimes
Attraction of international investors into strategic sectors
Reorganisation of education to focus on strategic sectors
Liberalisation of labour relations
Drawing down of welfare policies to focus on skills upgrading

Identity and Unity Development of tourist industry
*Establishment of information society and e-government *

Establishing an Accountable State Creation of an accounts committee to audit and assess public service
Integration of all public services into online portal
Creating results-oriented state culture
*Empowerment of local government to formulate policy*

Table 4:          Summary of 100 Concrete Steps for Five Institutional Reforms (most relevant sections in bold letters)

Kazakhstan inherited the legendarily unwieldy bureaucracy of the Soviet Union, and is plagued by corruption (126/175 on Corruption Perceptions Index) and inefficiency (96/209 on World Bank Government Effectiveness Index). To combat this and under issues, Kazakh officials, including the Prime Minister, have studied Singapore’s public policy under the auspices of the Lee Kuan Yew School of Public Policy in Singapore(Mahbubani, 2015). Under Strategy Kazakhstan 2050, the Government committed to the establishment of a professional and meritocratic civil service. It began by reducing the number of political appointments by 80 percent to encourage transparency and discourage the rampant nepotism that had pervaded the political and social culture of Kazakhstan (Organisation of Economically Developed Countries, 2014). On 23 November 2015, the Government ratified the Law on Civil Service, mandating, inter alia, that government employees would only be hired at entry-level positions and work their way up meritocratically (О государственной службе Республики Казахстан, 2015). This and other initiatives represent concrete steps taken by Kazakhstan to bring the country in line with best practices of the best civil services in the world.

In 2004, the Government of Kazakhstan launched its e-government portal, which remained mostly stagnant such that it ranked 98^th on the World Bank’s e-Participation Index in 2008. Then it exploded all at once, launching platforms to access electronic databases for everything from real estate to birth records, payment portals for taxes and school fees, and even creating APIs for mobile access to the e-government services. By 2012, Kazakhstan was ranked 2^nd in the world, on par with Singapore. Apart from reducing bureaucracy, the e-government service has also been hailed for its role in reducing corruption, reducing the available avenues for illegal renumeration and bribery. However, in displacing the vertical hierarchy of Kazakh bureaucracy and placing limits on the traditional patronage system, the e-government system’s greatest challenge comes from the embattled public service infrastructure(Janenova, 2016). After an eight-year opposition from the traffic police, drivers’ licenses were electronified in 2012; and the launch of the electronic filing system (mirroring Singapore’s ubiquitous e-Litigation system) in 2015 is still limited to statements of claims and appeals.

In 2013, the Government of Kazakhstan launched Administrative Corps A, a cadre of managerial positions at the highest levels of regional and state government, including city mayors, executive secretaries and chiefs of staff, intended to mirror Singapore’s Administrative Service. Unlike Singapore, Kazakhstan’s strong tribalism and regionalism make local government necessary, and members of Administrative Corps A are expected to formulate semi-autonomous policy decisions. The selection process is rigorous – candidates are subjected to multiple examinations and interviews, and are expected to bear personal recommendations from leading members of the public and private sector(Central Communications Service of the Ministry of Information and Communications of the Republic of Kazakhstan, 2013). This initiative will displace the traditional client-patron networks which used to determine local and national officials, though the personal recommendations stipulation continues to provide a barrier to systemic equality.

Since 1993, the Government of Kazakhstan has funded the Bolashak Scholarship, an all-expenses paid scholarship to top universities locally and abroad with a five-year bond upon return. Unlike Singapore’s PSC Scholarships, Bolashak scholars are preponderantly bonded to private companies rather than the civil service. In this aspect, the Bolashak is more similar to the Singapore-Industry Scholarship (SGIS), a government supported initiative to provide talent to strategic sectors. The Bolashak scholarships has boasted over 12,000 scholars since its inception mostly sent to the UK or the USA, much like Singapore. In recent years, the program has seen a descaling effort, with undergraduate scholarships cut in 2011, and massive slashes to overseas scholarships in favour of encouraging scholars at the nascent Nazarbayev University (Wikileaks, 2008).

Kazakhstan’s challenges to the implementation of a professional civil service and tenets of effective governance are primarily systemic. A culture of nepotism and corruption within the government has created an undercurrent of indolence that provides inertia to any efforts aimed at improving the situation. To break the impasse created by entrenched members of the bureaucracy, Kazakhstan must look elsewhere, as Singapore has not faced the same issue in recent years. It is fortunate that Nazarbayev is a political juggernaut capable of dictating and enforcing government direction by virtue of his unchallenged personal and political influence.

*Healthcare*

Singapore’s healthcare system is known for its affordability and refusal to provide free healthcare across all income groups. Instead, Singapore relies on compulsory savings, means-tested subsidised healthcare rates and price controls. In the 2015 Health Outcomes Ranking by The Economist Intelligence Unit, Singapore placed 2^nd in the world, remarkable since government spending only accounted for 41.7% of average healthcare expenditure, making it the 33^rd smallest spender, with an average government healthcare expenditure of US$1,100 per capita, or 1.9 percent of GDP. A major part of Singapore’s success can be attributed to the Central Provident Fund (CPF), a compulsory savings plan where 37 percent of employer salaries (20 percent by employee, 17 percent by employer; 2016 rates) are assigned into accounts from which only authorised payments for housing and education (Ordinary account), medical expenses (Medisave), or retirement (Special account) may be used. 8-10.5 percent of monthly salaries are deposited into the Medisave account.Indeed, the median CPF balance upon retirement is S$126,000, a number which has been growing consistently (see Figure 5), with a median Medisave account of S$24,000 in 2016.CPF savings are invested into Special Singapore Government Securities, which has the two-fold effect of being a highly secure triple-A government bond, and also effectively constituting a massive public loan to Singapore’s reserves (sums raised from sale of government securities may not be used as government expenditure but are instead managed as long-term investments by the Government of Singapore Investment Corporation (GIC)).

Figure 5: Graph of mean annual deposits and withdrawals per capita into CPF account (Central Provident Fund, 2015)

Kazakhstan faces an aging population issue, with 7.1 percent of its population aged 65 and above; compared to Singapore with 10.5 percent bringing with it the associated problems of rising per capita healthcare costs and increasing dependency ratios. In light of this, retirement planning is managed by a 10 percent wage payment to the Single Pension Fund (SPF), which pays out a fixed-rate upon retirement. In 2015, Kazakhstan announced the creation of a Social Health Insurance Fund (SHIF). Employees would be required to contribute two percent of wages, and employers five percent, creating a centralised system for the utility of public healthcare services. This would provide a much-needed injection of funds into Kazakhstan’s creaking national healthcare system, and hopefully improve the quality and availability of medical services. The SHIF has already attracted the support of the World Bank, which extended a US$80 million loan to Kazakhstan through the International Bank of Reconstruction and Development (IBRD) in 2016 for its implementation (World Bank, 2016).

Table 6: Key similarities and differences between the Social Health Insurance and Medisave programmes

SHIF suffers from the ill-reputation surrounding its predecessor, the Mandatory Health Insurance (MHI) Fund, which was launched in 1996 and collapsed under heaving bureaucracy and inefficiency in 1998. The World Bank report on the SHIF specified population fatigue for government-led health insurance policies, which may lead to mistrust and low levels of adoption.

Kazakhstan’s macroeconomic indicators provide some cause for concern regarding the programme. Firstly, Kazakhstan’s interest rates of 13 percent are significantly higher than Singapore’s interest rates of 1.5 percent, which will require similar levels of interest rates on sums in the SHIF. Secondly, Kazakhstan has faced steadily declining growth rates since 2010 on the back of falling oil prices, and the increase in labour costs to employers comes at a time when investors are already debating their options in other parts of Central Asia. Nonetheless, Kazakhstan’s low unemployment rates of 5.10 percent in 2016 suggest that it still has the capacity to absorb higher labour costs without significant impact to the economy.

*Conclusion*

While Kazakhstan has openly stated that many of its policies are influenced by Singaporean policies, the details of how policymakers adapted Singaporean policies for Kazakh society is understandably not in public domain. However, by assessing the similarities and differences, it is clear that Singapore policies have been of use to Kazakhstan’s development, particularly in recent years.

Due to a shared background of conservative Asian values and (generally agreed though controversial) benevolent authoritarian governments, both countries have the enviable ability to enact long-term, Whole-of-Government policies. It is this capacity to absorb political costs in order to pursue development goals that gives Kazakhstan the ability to emulate Singapore.

However, Singapore has some key advantages that Kazakhstan undoubtedly does not enjoy. Chief among them is Singapore’s diversified economy that is not reliant on any particular sector or commodity, but rather on international trade as a whole. Kazakhstan’s vulnerability to oil shocks undermines its ability to support sustained policies in the manner of Singapore. In addition, Singapore’s compact and highly urbanised population responds to policies with significantly less lag time, while Kazakhstan still has rural and even tribal populations across its wide expanse. On top of this, an established culture of entrepreneurship and business provides the basis for a productive business culture, compared to the Soviet legacies entrenched in Kazakhstan.

As a result of the significant differences, Kazakhstan has recognised that Singapore does not hold the answers for all its problems. At the VIII Astana Economic Forum in May 2015, Nazarbayev announced that Astana would be rebuilt as a “new Dubai”, leveraging on Dubai’s legislative and economic experiences to mould Astana into an international hub for petrochemical-related finance. Dubai’s successful transition from an almost exclusively oil-producing economy into a service-based economy may prove to be a better role model for Kazakhstan in some domains.

**Boh Ze Kai* is a Project Intern with Mantraya. This Special Report is published as part of Mantraya.org’s “Borderlands”  and “Regional Economic Cooperation and Connectivity in South Asia” projects.)

*References:*
Agency of Statistics of the Republic of Kazakhstan. (2016). The official statistical information. Retrieved from Ministry of National Economy of the Republic of Kazakhstan Committee on Statistics: http://www.stat.gov.kz/faces/publicationsPage/publicationsOper?_adf.ctrl-state=c9x5a2tz3_34&lang=en&_afrLoop=3753629369057408&visiblescreen=no&page_id=publicationsOper

Baker & McKenzie. (2009, February 4). Baker & McKenzie – CIS, Limited. Retrieved from Baker & McKenzie: http://www.bakermckenzie.co.jp/e/material/dl/supportingyourbusiness/newsletter/emi/Feb4.pdf

Baudarbek-Kozhatayev, Y. (2013, April 22). 20th Anniversay of Diplomatic Relations Between Kazakhstan and Singapore. The Business Times, p. 20.

Bisenov, N. (2016, May 30). Kazakhstan’s privatisation programme faces “strategic” challenge. Intellinews.

Central Communications Service of the Ministry of Information and Communications of the Republic of Kazakhstan. (2013, April 3). SELECTION OF CANDIDATES TO CORPS A BEGINS IN KAZAKHSTAN. Retrieved from Ortcom.kz: http://ortcom.kz/en/news/selection-of-candidates-to-corps-a-begins-in-kazakhstan.1069

Central Provident Fund. (2015). CPF Annual Report 2015. Singapore: Central Provident Fund.

Gizitdinov, N. (2015, October 30). Kazakh Sovereign Fund Sees No `Sacred Cows’ for Privatization. Bloomberg News.

Interfax-Kazakhstan. (2014, February 27). Samruk-Kazyna sells its stakes in four banks at a loss. Interfax-Kazakhstan.

Jafarova, A. (2014, April 17). Kazakh Samruk-Kazyna to sell over 200 companies. Azernews. Retrieved from http://www.azernews.az/region/66168.html

Janenova, S. (2016). PUBLIC SERVICE INNOVATIONS IN KAZAKHSTAN. Astana.

KazMunayGas. (2015). Annual Report 2015. KazMunayGas Annual Report.

Konyrov, B. (2013, May 22). Samruk-Kazyna to replace 30% of its managing directors. Tengrinews.

Mahbubani, K. (2015, July 25). The unusual partnership of Singapore, Kazakhstan. The Straits Times.

Nazarbayev, N. (2006). The Kazakhstan Way. (Russian, Trans.) Karaganda: Stacey International. Retrieved September 22, 2016, from http://personal.akorda.kz/images/file/36fe1739f2c39ca6d78b31f6e40d0a9c.pdf

Nazarbayev, N. (2015). The 100 concrete steps set out by President Nursultan Nazarbayev to implement the five institutional reforms. Astana: Government of Kazakhstan.

Organisation of Economically Developed Countries. (2014). OECD Public Governance Reviews Kazakhstan: Review of the Central Administration. Paris: OECD Publishing.

Samruk-Kazyna National Welfare Fund. (2010). Annual Report 2010. Samruk-Kazyna Annual Reports.

Samruk-Kazyna National Welfare Fund. (2012). Annual Report 2012. Samruk-Kazyna Annual Reports.

Samruk-Kazyna National Welfare Fund. (2015). Annual Report 2015. Samruk-Kazyna Annual Reports.

Samruk-Kazyna Press Centre. (2013). Глава АО «Самрук-Қазына» Умирзак Шукеев вручил государственные награды сотрудникам группы компаний Фонда. Astana: Samruk-Kazyna Press Centre.

Shukuyev, U. (2015). Umirzak Shukuyev. Retrieved from Invest in Kazakhstan 2015: http://kazakhstan.newsdeskmedia.com/Images/Upload/Kazakhstan_2015/PDFs/Umirzak_Shukeyev.pdf

Sputnik News. (2015, May 22). Kazakhstan Unveils ‘Singapore’-Like Government Reform Plan. Sputnik News.

Temasek Holdings. (2016). Temasek Review 2016. Temasek Review. Retrieved September 22, 2016, from http://www.temasek.com.sg/documents/download/downloads/20160706235822/TR2016_Singles.pdf

Temirbank. (2015). Financial Statements 2015 (Russian). Temirbank Financial Statements. Retrieved from http://www.kase.kz/files/emitters/TEBN/tebnf6_2012_rus.PDF

Urazova, D. (2015, January 19). Kazakh budget revised amidst dropping oil prices. Tengrinews.

Urazova, D. (2015, September 4). What are Samruk Kazyna board members paid. Tengrinews.

Wikileaks. (2008). 08ASTANA2263_a. Astana: Wikileaks.

World Bank. (2016). Social Health Insurance Project: Improving Access, Quality, Efficiency and Financial Protection. Paris: World Bank.

World Bank. (2016, April 27). World Bank to Support the Improvement of Health Service Delivery in Kazakhstan. Retrieved from World Bank: http://www.worldbank.org/en/news/press-release/2016/04/27/world-bank-to-support-the-improvement-of-health-service-delivery-in-kazakhstan

О государственной службе Республики Казахстан. (2015). О государственной службе Республики Казахстан.Astana. Reported by Eurasia Review 2 hours ago.

SAN JUAN, Puerto Rico (AP) — Wanda Serrano arrived at Puerto Rico's largest public hospital before dawn to take her 17-year-old son to an appointment. Doctors have gradually left Puerto Rico during a decade-long recession that has gripped the island and driven more than 200,000 people to the U.S. mainland seeking better opportunities. [...] the steady departure of pediatricians, surgeons, orthopedists, neurologists and others has become a stampede as the economy shows no sign of improving and financial problems in the territorial health insurance program make it nearly impossible for doctors to stay in business. The island of 3.5 million people now has only two pediatric urologists, one orthopedist specializing in ankle and feet, one pediatric cardiologist, and a handful of geneticists and endocrinologists. Doctors not only struggle with delayed reimbursements for services but receive less money through the government's Medicare and Medicaid programs as well as private health insurance than they would for the same services on the U.S. mainland. The great majority of patients like Serrano's son now seek specialists at Puerto Rico's largest public hospital, lining up as early as 1 a.m. daily for medical care. The hospital is buckling under a surge of patients as it operates with a dwindling budget, unable to buy certain medical supplies like it used to when the government could still borrow money. Reported by SeattlePI.com 49 minutes ago.

Health Care Services Corporation Operates Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma and Texas

*IRVINE, CA, and HERSTAL, BELGIUM* - October 27, 2016 - MDxHealth SA (Euronext: MDXH.BR) today announced that Health Care Services Corporation (HCSC) has issued coverage for patients meeting the eligibility criteria established under the positive medical policy on the ConfirmMDx ^® for Prostate Cancer test.  

HCSC, a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association, is the largest customer-owned health insurer in the United States and fourth largest overall, operating through HCSC's Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma and Texas. The company, founded in 1936, serves more than 15 million members across five states and employs more than 22,000 people in over 60 local offices.

MDxHealth continues to gain positive medical policies and coverage with PPO, commercial payors and other specialized networks; facilitating timely reimbursement for ConfirmMDx testing.  

"This is the third Blue Cross Blue Shield (BCBS) Association licensee to establish a positive coverage policy and adds five more BCBS plans to the growing list of payers covering ConfirmMDx for Prostate Cancer," *stated Dr. Jan Groen, CEO of MDxHealth* . "We believe HCSC's decision is a significant step in providing national access to ConfirmMDx for Prostate Cancer, further expanding the impact on patient outcomes and reduction in cost to the US healthcare system. "

About ConfirmMDx for Prostate Cancer

ConfirmMDx for Prostate Cancer is the first epigenetic, and only tissue-based test in the 2016 NCCN Guidelines for early detection of prostate cancer which addresses false negative biopsy concerns. It is the only molecular diagnostic test that provides a very high negative predictive value (NPV) of 96% for clinically significant prostate cancers, and 90% NPV for all prostate cancers, as well as prostate mapping of the test results to help guide repeat biopsies. Each year, more than 1 million American men undergo an invasive prostate biopsy with a negative result, however approximately 30% of those men actually have prostate cancer. The current standard of care for prostate biopsy procedures samples less than 1% of the prostate, leaving men at risk for undetected cancer and leading to a high rate of repeat biopsies, even on cancer-free men. ConfirmMDx for Prostate Cancer helps urologists identify low-risk men who may forego an unnecessary repeat biopsy and high-risk men who may benefit from intervention. To date more than 3,000 urologists have ordered ConfirmMDx on more than 45,000 patients. ConfirmMDx has qualified for Medicare reimbursement and covered by numerous private health insurance plans.

About MDxHealth

MDxHealth is a multinational healthcare company that provides actionable molecular diagnostic information to personalize the diagnosis and treatment of cancer. The company's tests are based on proprietary gene methylation (epigenetic) and other molecular technologies and assist physicians with the diagnosis of cancer, prognosis of recurrence risk, and prediction of response to a specific therapy. For more information, visit mdxhealth.com and follow us on Twitter at: twitter.com/mdxhealth .

*For more information:*

* *

Dr. Jan Groen, CEO
MDxHealth
US: +1 949 812 6979
BE: +32 4 364 20 70
info@mdxhealth.com    

 

   

 

Jonathan Birt, Chris Welsh, Hendrik Thys (PR & IR)
Consilium Strategic Communications
UK: +44 20 3709 5701
US: + 1 917 322 2571 (Rx Communications Group LLC)
mdxhealth@consilium-comms.com

 

This press release contains forward-looking statements and estimates with respect to the anticipated future performance of MDxHealth and the market in which it operates. Such statements and estimates are based on assumptions and assessments of known and unknown risks, uncertainties and other factors, which were deemed reasonable but may not prove to be correct. Actual events are difficult to predict, may depend upon factors that are beyond the company's control, and may turn out to be materially different. MDxHealth expressly disclaims any obligation to update any such forward-looking statements in this release to reflect any change in its expectations with regard thereto or any change in events, conditions or circumstances on which any such statement is based unless required by law or regulation.  This press release does not constitute an offer or invitation for the sale or purchase of securities or assets of MDxHealth in any jurisdiction. No securities of MDxHealth may be offered or sold within the United States without registration under the U.S. Securities Act of 1933, as amended, or in compliance with an exemption therefrom, and in accordance with any applicable U.S. securities laws.

* NOTE: * The MDxHealth logo, MDxHealth, ConfirmMDx, SelectMDx , AssureMDx and PredictMDx are trademarks or registered trademarks of MDxHealth SA. All other trademarks and service marks are the property of their respective owners.

To access the PDF version, click here
--------------------This announcement is distributed by NASDAQ OMX Corporate Solutions on behalf of NASDAQ OMX Corporate Solutions clients.

The issuer of this announcement warrants that they are solely responsible for the content, accuracy and originality of the information contained therein.

Source: MDxHealth (R) via GlobeNewswire

HUG#2051574 Reported by GlobeNewswire 7 minutes ago.

The Democratic presidential candidate failed in her 1990s effort to steer her husband's universal coverage program through Congress, as the complex plan collapsed for lack of political support. [...] she has tacked sometimes to the right on health care, and sometimes to the left. The government's premier health insurance program covers about 57 million people, including 48 million seniors and 9 million disabled people under age 65. [...] it remains unclear how Trump's proposed repeal of "Obamacare" would affect its improvements to Medicare benefits, including closing the prescription drug coverage gap known as the "doughnut hole." Earlier, Trump spoke approvingly of giving Medicare legal authority to negotiate prescription drug prices, but that idea currently is not mentioned in his health care plan. The federal-state program for low-income individuals covers more than 70 million people, from pregnant women and children to elderly nursing home residents. Clinton would also require insurers to cover three sick visits to the doctor each year without patients needing first to meet their plan's deductible, the annual amount patients pay before their insurance kicks in. He has no similar proposals on out-of-pocket expenses but has called for requiring hospitals, clinics and doctors to disclose prices so patients can shop around to reduce costs. [...] he would expand the use of tax-sheltered health savings accounts, used to pay for medical expenses not covered by insurance. The 2010 Affordable Care Act expanded coverage for the uninsured and made carrying health insurance a legal obligation for most people. About 11 million people are covered through the law's private insurance markets, while the Medicaid expansion has added at least 9 million to that program. Clinton would resolve a "family glitch" that denies health insurance subsidies to some dependents, sweeten subsidies for people buying coverage on the hea Reported by SeattlePI.com 21 hours ago.

Employees are spending a larger percentage of their income on health insurance than they did before passage of the Affordable Care Act, according to a newly released report from The Commonwealth Fund. The study describes the development as a general increase in “the share of median family income necessary to cover premium costs and deductibles.” On average, the report says, that family share grew from 6.5 percent in 2006 to 10.1 percent last year. See Florida specific information embedded below. But… Reported by bizjournals 19 hours ago.

AudioEducator will host a live audio conference presented by expert speaker Thomas J. Force, Esq., on the Latest Update on Federal Litigation Affecting out-of-Network Providers on Thursday, November 03, 2016.

Durham, NC (PRWEB) October 27, 2016

AudioEducator will host a Live Webinar presented by noted expert Thomas J. Force, Esq. titled “Update on Federal Litigation Affecting out of Network Providers” on Thursday, Nov 03, 2016, which will assist in defending from fraud audits such as fee forgiveness audits and get a list of patient forms essential to the appeals process.

A provider that has not contracted with an insurance company for reimbursement at a negotiated rate is an out-of-network (OON) provider. There are some health plans, like HMOs, which do not reimburse out-of-network providers at all. In such cases, the patient would be solely responsible for the entire amount charged by the doctor. There are some other health plans which would offer coverage for out-of-network providers; however, the patient responsibility would be more than what it would be if one was visiting an in-network provider.

In order to get an idea of the strategies concerning various health plan insurers, monitoring of federal cases needs to be done as there are memoranda and motions within them that outlines the different positions of the health plans concerned to topics like, fee forgiveness, fraud audits, balance billings and recoupments. OON providers cannot possibly obtain proper reimbursement and keep themselves compliant in the current climate without understanding relevant federal laws and cases interpreting these laws.

There have been various types of litigation concerning payment for OON services in recent years, which includes – provider and patient class action suits alleging that health plan benefit payments for OON services are unreasonably low or not consistent with the benefit descriptions included in members’ health benefit brochures, hospital-based physician suits in which physicians are looking for billed charges from health plans for emergency care or other provided services. Then there are class action suits against hospitals which are filed by patients challenging the reasons of hospital-billed charges being billed to uninsured patients or patients for whom the hospital is OON.

For cases like these and of similar nature, a central issue often concerns the reasonableness of prices for OON services. Therefore, it is crucial to have a clear distinction between market transaction prices and billed charges, and for the court to know the health insurance affordability implications and the health care expense, if the health plan is needed to pay above-market price for OON services.

In this session, the focus will be on recent federal litigation by and against health plans by and against Out-of-Network (OON) Providers. This session will also provide strategies and techniques to assist in appealing out-of-network denied and under-reimbursed claims.

For more information visit: https://www.AudioEducator.com/medical-coding-billing/federal-litigation-affecting-oons-10-27-2016.html

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About AudioEducator

AudioEducator is the country’s leading source of knowledge and training for professionals in Medical Coding and Billing. Our healthcare conferences and webinars are conducted by nationally renowned experts, consultants and legal experts who provide a fresh perspective on healthcare issues and trends. AudioEducator offers important updates, regulatory knowledge and com information on the latest coding and billing news in various medical specialties. It has provided thousands of healthcare professionals the opportunity to get answers to their most complex questions directly from experts. To know more visit: https://www.AudioEducator.com Reported by PRWeb 18 hours ago.