Tag Archives: New York

New Contraceptive Regulations Announced by Governor Cuomo

“Governor Andrew M. Cuomo today announced a series of actions to firmly secure access to reproductive rights in New York State. Through regulatory action, the State will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles regardless of the future of the Affordable Care Act; contraceptives are available in amounts exceeding one month’s supply at a time; and all medically necessary abortion services are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles.”

Links to the circular letter and regulations can be found below.  High Deductible Health Plan deductions will apply to abortion services.




Jeffrey R. Ungvary President

Jeffrey R. Ungvary

You Have Extra Time to Sign Up for Obamacare Plans

Americans who couldn’t enroll in federal Obamacare insurance plans over the weekend because of computer glitches or long waits will now have until next Sunday to sign up, federal officials announced early Monday.

“We are pleased that the vast majority of consumers were able to apply and pick a plan through HealthCare.gov or its call center without a problem,” said Aaron Albright, spokesman for the U.S. Centers for Medicare and Medicaid Services.

“For those consumers who were unable to complete their enrollment because of longer than normal wait times at the call center in the last three days or because of a technical issue such as being unable to submit an application because their income could not be verified, we will provide them with a time-limited special enrollment period for March 1 coverage.”

The special enrollment period begins Monday and ends Feb. 22.

The extension was prompted by the Saturday outage of an Internal Revenue Service function for Obamacare enrollment, which could have prevented about 500,000 people from enrolling. The glitch prevented some people from getting their income verified so they could enroll on HealthCare.gov and at least some state exchanges by the Sunday deadline.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Health Insurance and Medicaid Enrollments High

About two million New Yorkers have signed up for insurance under the Affordable Care Act, with three out of every four of them poor enough to qualify for Medicaid, according to figures released Wednesday by the Cuomo administration.

While Gov. Andrew M. Cuomo heralded the overall numbers as a sign of the success of the program, having such a large proportion on Medicaid, which is funded by the government, could impose a heavy new burden on public finances.

But insurance experts said they expected the impact of the new Medicaid enrollment to be mitigated by the greater access to health care. In other words, they said, having Medicaid coverage would give people access to primary care that could keep them from developing a chronic disease or becoming catastrophically sick and ultimately costing the system even more.

“Theoretically, could these numbers of people eventually push that Medicaid number up higher? Yes,” James R. Tallon Jr., president of the United Hospital Fund, said on Wednesday.

But, he added: “Having most people insured is the key to controlling long-term cost growth because it means you can manage care in a more effective way.”

By and large, experts said, those signing up for private insurance on the state’s Affordable Care Act health exchange are people who were priced out of the market before. The law raised the income ceiling for Medicaid eligibility in New York and other states that accepted the expansion of the program; a family of four can now earn about $33,000 and still qualify. Many people who earn too much for Medicaid can get subsidies to help them buy private insurance.

Though Republicans in Congress have criticized the public costs and tried several times to repeal the law, which was passed in 2010, President Obama has vowed to veto any attempt to overturn it.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Governor Cuomo’s New Tax on Health-Insurance Policies

Gov. Andrew Cuomo’s new budget includes a nearly $69 million tax on health-insurance policies to pay for the administrative costs of continuing New York’s ObamaCare health exchange, The Post has learned.

The levy is intended to make up for federal funds no longer available to the states as of this year. Adding up to about $25 per person insured under the plan, the cost is almost certainly going to be passed on to consumers.

The tax is being called a bait-and-switch by opponents of Cuomo’s decision to start a state-run ObamaCare health exchange in New York. Had he not done so, they argue, there would have been no need for the tax.

“There was no indication that there would be a new tax to pay for this. We had plenty of debate on ObamaCare. I never heard this mentioned,” said Assemblyman Steve McLaughlin (R-Troy).

The Affordable Care Act requires that state-based health benefit exchanges be self-sustainable beginning this year after they got federal seed money to launch.

Cuomo created NY State of Health, an online marketplace to shop for health plans, in 2013.

The move was controversial, as Cuomo made it by executive order rather than with legislation.

A majority of states — almost all with Republican governors — refused to set up exchanges because they opposed ObamaCare. The federal government runs the program in those states.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Alert: Winter Storm Juno Safety Tips

With winter storm Juno quickly approaching, take note of the following Red Cross Safety Tips for the inclement weather.

•Winterize your vehicle and keep the gas tank full. A full tank will keep the fuel line from freezing

•Water: Have on hand at least a 3-day supply; one gallon per person per day

•Food: Have on hand at least a 3-day supply of non-perishable, easy-to-prepare food


•Battery-powered or hand-crank radio (NOAA Weather Radio, if possible)

•Extra batteries

•First aid kit

•Medications (7-day supply) and medical items (hearing aids with extra batteries, glasses, contact lenses, syringes, etc.)

•Multi-purpose tool

•Sanitation and personal hygiene items

•Copies of personal documents (medication list and pertinent medical information, proof of address, deed/lease to home, passports, birth certificates, insurance policies)

•Cell phone with chargers

•Family and emergency contact information

•Extra cash

•Baby supplies (bottles, formula, baby food, diapers)

•Pet supplies (collar, leash, ID, food, carrier, bowl)

•Tools/supplies for securing your home

•Sand, rock salt or non-clumping kitty litter to make walkways and steps less slippery

•Warm coats, gloves or mittens, hats, boots and extra blankets and warm clothing for all household members

•Ample alternate heating methods such as fireplaces or wood- or coal-burning stoves

Stay up-to-date with weather conditions here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Premium Increases on Plans Have Slowed, But Employees’ Are Paying More

In New York, premiums for employer-sponsored family plans have slowed since the passage of the Affordable Care Act, but premiums and deductibles now eat up a larger share of employees’ incomes, according to a Commonwealth Fund report released Thursday.

Premiums for family coverage in the state grew 6% annually from 2010 to 2013, down from 7% in the seven years preceding the law. The average premium for a family, including an employer’s share, was $17,530 in 2013—an 86% increase from a decade earlier. New York data from the report are online here.

For single plans in New York, the annual growth rate of premiums rose slightly after the ACA’s passage, to 5.7% from 2010 to 2013, versus 5.5% from 2003 to 2010.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Small Businesses See Boom in 2015

Like other local business execs involved in construction, Andrew Musci expects the city’s ongoing building boom to continue to be a positive for him in 2015.

“We are seeing more opportunities for work,” said Mr. Musci, CEO of Altel Systems Inc., a Brewster, N.Y.-based commercial integrator of audio and video systems that has worked on renovations at Lincoln Center as well as the World Trade Center Transportation Hub. “The city has been a bright spot that has continued, despite the rugged economy.”

With the new year approaching, it’s not only firms in the construction industry and related trades that are seeing potential growth. An October survey of 300 business owners in the metropolitan area by Bank of America found that 76% were confident they would hit their year-end revenue goal, and 60% believe their revenue will grow in 2015. Some 48% said they planned to hire in 2015.

And some local owners say they are pleased by the city’s effort to reduce the fines and bureaucracy that plague small businesses. Department of Consumer Affairs Commissioner Julie Menin in July announced a program to, among other things, increase outreach and training, issue warnings in some cases instead of violations, and allow businesses to “cure” problems and avoid a fine. Also, in a last minute vote this month, the House extended a host of tax breaks at least for 2014, including allowing businesses to expense up to $500,000 in capital costs, a provision that has a big impact on small business purchasing decisions.

Nonetheless, many of the city’s small-business owners are adjusting to higher costs on many fronts, ranging from Affordable Care Act mandates to increased compliance requirements in certain industries. Meanwhile, some restaurateurs are worried about a hike in the minimum wage for tipped workers that Albany is pondering.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

No Fines for Sick-Leave Complaints

In the nine months since Mayor Bill de Blasio approved an expansion of the paid-sick-leave law, the city has received 289 complaints of violations. But so far, the city is on track to fine only seven of those potential violators, though probably not until 2015.

Of the 289 complaints, 204 are still being investigated or mediated by the Department of Consumer Affairs, according to a spreadsheet provided by the agency. Seventy-eight complaints have been closed, while seven have either resulted in a hearing at DCA’s adjudication tribunal or are currently awaiting a hearing. That’s up from five businesses that were facing fines in October.

Fines for violating the law, which requires businesses with as few as five employees to provide paid time off for workers who are ill or have ill family members, start at $500 and can rise to $750 and $1,000 for repeat offenders. The amount of money the city is spending to investigate and adjudicate the paid-sick-leave law is unclear, although it seems likely to far exceed what it collects in fines. DCA hired 13 employees this year to help with enforcement.

Of the 78 closed complaints, 59 were resolved with the complaining employee recorded as satisfied. Nine complaints were deemed invalid, while another nine were withdrawn by the employee or because the employee was not located. The 289 complaints do not include others deemed irrelevant to the law.

A majority of the complaints—191—were for employers’ failure to notify workers of the paid-sick-leave law. Ninety-three employees complained of not receiving pay for their time off; 49 complained that their employers did not accrue sick time accurately; 38 claimed retaliation by their employers for taking sick time; and 13 said their employers requested a doctor’s note, which the law does not require.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

New York Fighting Over Medical Billing

Surprise medical bills have long been a battleground issue for Andrew Cuomo, both before and after he became governor. This year’s budget includes consumer protections against surprise bills from out-of-network providers. The new law takes effect in April.

But four months before implementation, the law still is a work in progress. Two of the health care industry’s most influential playersphysicians and insurersdisagree on final rules, which have yet to be issued by state insurance regulators. The state Department of Financial Services declined to comment for this story.

Providers and insurers are still exerting influence over how the new law will be implemented, with concerns over who has responsibility to disclose what providers charge, and how to benchmark reasonable fees. Fighting among providers and insurers has derailed similar legislation in Maryland and Colorado, said Jack Hoadley, a research professor at Georgetown University’s Health Policy Institute. Policy experts hope New York won’t be next.

“New York has a chance to try something and make it work, and that really hasn’t happened before,” said Mr. Hoadley.

The challenge with out-of-network fee legislation, he added, “is to make sure that you’re not left with either the provider or the insurance company completely holding the bag.”

Pressure for a law in New York intensified in 2012 after the state Department of Financial Services issued a report that examined the issues underlying some 2,000 annual complaints about medical billing.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

The Rise of Urgent Care Centers in New York City

The new urgent care center on Broadway between 102nd and 103rd doesn’t look like a doctor’s office and definitely doesn’t look like a hospital.

With its open floor plan, plush chairs and oddly placed modern art, it looks like a upmarket lobby, in part because the designer has a background in hotels.

The waiting room at Cure Urgent Care is meant to provide a sense of calm, as is the logo out front—a green medical cross with a smile underneath.

“It’s supposed to convey the idea that it’s not supposed to hurt to get better,” said the company’s C.E.O., Jake Deutsch.

The center is open until 10 p.m. on weekdays and 9 p.m. on weekends, far later than the typical physician’s office, because, according to the sign outside, “life doesn’t wait for you to feel better.”

This is the public-facing part of New York’s recent boom in urgent care centers, as they compete for patients who once might have spent hours waiting to be X-rayed in an emergency room, or days for an appointment at a doctor’s office. Most anyone can stitch your finger, so clinics have to offer a little something extra, a certain ambiance, shorter wait times, if they are to change consumer behavior and lure patients away from traditional care.

This is, in many ways, a very positive development—as the centers compete to provide convenience and value, they’re also keeping people out of the emergency room, potentially saving hospitals and patients thousands of dollars on each case, and allowing E.R. personnel to focus on true emergencies.

But the flood of urgent-care entrepreneurs into New York’s wide-open market brings with it a new level of public risk.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary