Ergonomics Rule Voted Out.

Payments to Medicare+Choice HMOs have increased, the medical privacy debate persists and tax deductions are considered for people who buy long-term-care insurance.

The U.S. House has repealed the ergonomics standard, following the lead of the U.S. Senate, leaving only a presidential signature to make it official.

If President Bush signs the repeal, as expected, it means the end of lawsuits by insurers against the Occupational Safety and Health Administration, but not the end of ergonomics. Another, but very different, OSHA standard is expected to be developed.

Because controversy no longer exists, "there is no reason to sue," said Barbara Levering, spokeswoman for the American Insurance Association. The AIA coordinated a lawsuit on behalf of 12 insurers that's narrower in scope than other lawsuits against OSHA because it takes issue only with OSHA's authority to issue regulations that set up compensation for work-related injuries.

Insurers had worked hard to comply with a 1,500plus page repetitive-motion ergonomics rule, signed into law by then-President Clinton in November. It took effect Jan. 16, and those covered by it were scheduled to be in full compliance by October, with small businesses getting an extra year to be in compliance.

Reimbursements Increased for Medicare HMOs

Higher reimbursements for health maintenance organizations that care for Medicare recipients took effect March 1 .And the U.S. government might increase reimbursements again in 2002.

In December, Congress approved an increase in the minimum reimbursement to health plans participating in the Medicare+Choice program. The move provided some relief for rural communities and small urban areas that have seen several HMOs pull out of the program, in part because of low reimbursement rates.

A two-tiered reimbursement system was created to replace the previous system in which all health plans received a minimum monthly reimbursement of $405.01 per person. Under the new system, health plans in counties with 250,000 or more people are guaranteed a minimum monthly payment of $525 per person, and HMOs in all other areas will receive at least $475 per person per month.

Reimbursements for 2002 could rise to $552.92 for any metro area within the 50 states and the District of Columbia with a population of more than 250,000, and to $500.26 in all other areas, according to a Health Care Financing Administration statement.

Phil Blando, spokesman for the American Association of Health Plans, said the increases will help, but more needs to be done for areas that will see only a 2% increase in 2002. "Historically, these 2% counties have included Los Angeles, Chicago, Miami, Philadelphia, Detroit-where nearly half of all Medicare+Choice seniors live."

'Oversight' Leads to Extension of Privacy Discussion

An "oversight" by the Clinton administration has opened the door for extending the effective date of the Department of Health and Human Services' medical privacy regulation until April 14, including a 30-day comment period, according to Health and Human Services Secretary Tommy G.Thompson.

On Dec. 28, HHS published "Standards for Privacy of Individually Identifiable Health Information" in the Federal Register, a final rule creating new federal privacy rights for personal health information.

HHS was legally required to submit this regulation for consideration by Congress for a 60-day period. "Due to an oversight under the prior administration, this requirement was not met," Thompson said in a statement. "As a result of this oversight, the 60-day period of congressional review did not begin until Feb. 13, and, therefore, the effective date of the regulation has been delayed until April 14, 2001."

Those covered under the regulation have to be in full compliance by April 14, 2003.

The privacy regulation covers health information created or maintained by health-care providers that engage in certain electronic transactions, health plans and healthcare clearinghouses.

Bill Proposes Tax Deduction for LTC Premiums

Long-term-care insurance premiums would be tax deductible under a bill recently introduced in the U.S. House.

Medicaid pays for much of the long-term care now. Encouraging individuals to buy long-term-care insurance by allowing them to deduct the premiums from their taxable income, similar to the way contributions to a 401(k) plan are deductible, would save the government money, proponents say, as well as increase business for providers of that line of insurance.

H.R. 831 includes a tax credit for individuals with long-term-care needs.

"As long-term-care costs for individuals rise, so too will Medicaid expenditures for nursing home care if changes are not made. ACLI research shows they'll increase from about $30 billion a year to about $134 billion--an unsustainable level for tomorrow's taxpayers," Carroll A. Campbell Jr., president and chief executive officer of the American Council of Life Insurers, said in a statement.

Dennis Kelly is Washington Bureau manager.