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Posts Tagged ‘HIPPA’

Health_CareAs a motorcycle enthusiasts should we care about the Healthcare debate?  In a word, YES!

Looking in our rear view mirror, there is precedent for all of us to be concerned with in regards to any health care legislation coming out of Washington. For example in 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) that was intended to ensure non-discrimination in health coverage in the group market. However, when it came to implementing the law, the Department of Labor, the Internal Revenue Service and the Health Care Financing Administration – now the Centers for Medicare and Medicaid Services – issued a rule allowing insurers to deny health benefits for an otherwise covered injury that results from certain types of recreational activities, such as skiing, horseback riding, snowmobiling or motorcycling. Even though many motorcycle friendly organizations (ABATE, AMA, etc.,) have fought this discriminatory rule with legislation, it’s a clear indicator of what can happen if a new health care bill is implemented by bureaucrats in Washington using biased data.

More information can be obtained HERE on injury exclusions as each state has unique implementations.  In some cases state law compliments HIPAA.

Generically speaking, the most simple answer is for motorcycle enthusiasts to oppose any legislation that may come from the new healthcare debate which restricts the freedoms of riders who enjoy an active lifestyle.  We cannot allow our elected officials to abdicate the rights of the insured to an unelected commission or board, which will render final decisions regarding appropriate medical coverage for individuals who ride motorcycles as a mode of transportation or for recreation (e.g., denial of a procedure).

If this issue resonates with you, below is a form letter to mail to your state reps for reference:

[Your Name]
[Street Address]
[City, State, Zip Code]

August 27, 2009

Note: In Oregon write to all three:

The Honorable Jeff Merkley
United States Senate
107 Russell Senate Office Building
Washington, DC 20510-3704

The Honorable Ron Wyden
United States Senate
223 Dirksen Senate Office Building
Washington, DC 20510-3703

The Honorable Kurt Schrader
House of Representatives
1419 Longworth House Office Building
Washington, DC 20515-3705

Re: Motorcyclists Express Concern with Health Care Debate

Dear Senator [NAME]:

As a constituent and riding enthusiast, I urge you not to include anything in the various health care bills that may adversely affect my ability to ride a motorcycle.  I am opposed to any legislation that may inhibit the freedoms of riders, including myself, from enjoying an active lifestyle.

I value personal freedom and responsibility when it comes to enjoying my passion for riding. As you continue your deliberations on health care reform, please do not abdicate the rights of the insured to an unelected commission or board which will render final decisions regarding medical coverage for those of us who ride as a mode of transportation or for recreation. Please ensure that I will continue to be able to pursue my chosen recreational pursuit without the addition of unneeded prohibitions, limitations or mandates stemming from the health care legislation under consideration.

Again, I urge you to protect my freedoms from being dictated to by an unelected commission or board in determining medical coverage for individuals who ride.

Thank you for your time and consideration of this important issue.

Sincerely,
[Your Name]

We need to write our government representatives and voice our concerns regarding the various health care bills to ensure that motorcyclists can chose a recreational pursuit without the addition of unneeded limitations or mandates stemming from any health care legislation being considered.

Photo courtesy of Masscare.org

All Rights Reserved © Northwest Harley Blog

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er1Trip and fall breaking your arm at home – no problem.  Slip out of your saddle and break your arm while enjoying your motorcycle hobby – you may get slapped with a major medical bill!

Why?  Health plans do not have to notify individuals and employers of any exclusions or limitations on their health benefits at the point of sale.  Many employers or individual “consumers” shopping for health care coverage are led to believe that care for the broken arm, for example, is the same regardless of how the injury happened – but this is not the case.

But, it looks like help is on the way.  Congressman Michael Burgess, MD (R-Texas), introduced the Burgess Bill (HR1253) requiring more transparency in health insurance.  The bill would make a technical correction to HIPPA (Health Insurance Portability and Accountability Act) and would instruct health plans to notify individuals and employers of any exclusions in health benefits.  The bill recently passed the house and will:

  1. Require that any limitations and restrictions on health plan benefits be explicit and clear;
  2. Require that the health plan be disclosed to the sponsor of the group health plan in advance of sale and,
  3. Require that the issuer, in an easy to understand way, provide participants and beneficiaries a description of the limitations and restrictions as soon as they enroll.

Important to note is the Burgess Bill, originally submitted in September 2008 to the house as HR6908 was received, but no action was taken by the Senate.  Mr. Burgess reintroduced the bill (video HERE) with Congressman Bart Stupak (D-Michigan) as HR1253 (Health Insurance Source of Injury Clarification Act), but it’s identical to HR6908.

Health care transparency is good.  Punishing riders for enjoying their hobby with exceptions buried deep within an insurance plan only to be caught off guard is plain wrong!

UPDATE: April 10, 2009 – Received feedback from experts (thx Kitty!) in the field.  Although the post is accurate, making blanket statements is difficult since each state has different provisions and rules.  However, in the state of Oregon, Individuals (people who are interested in buying their own private policy) are provided with a carrier brochure/application by their broker or the insurance carrier which includes the covered services and exclusions.  With Group Insurance , the employer makes the decision on the plan purchased and is given a copy of the carrier proposal which would include the benefits and exclusions.  All insurance carriers must provide employees with a copy of the employee insurance handbook at time of enrollment.  The book includes covered services and exclusions.  Handbooks are mailed to home addresses by the insurance carrier to be sure employees receive this important information.

Photo courtesy of NBC/ER.

All Rights Reserved © Northwest Harley Blog.

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Like many “Average Joes” on the street, if you ask them to name a well-known motorcyclists I suspect most would connect-a-dot with actors who have played bikers in movies (Brando, Fonda, McQueen, Travolta), but if you ask them to name something relevant about the AMA (American Motorcyclist Association) or what they have done for motorcyclists — I believe you’d get the perverbial deer-in-the-headlight look.

In the early days (circa: 1920’s) only members of AMA chartered motorcycle clubs were permitted to race, and professional racing with its world-class competition was a prime factor in the formation of motorcycle clubs. The AMA imposed strict rules on its members in the interests of racing safety as well as for public image, specifically to promote an image of a family-friendly and wholesome sport.  This was especially true after an organizational rift within the AMA apparently occurred in reaction to media coverage of the 1947 incident in Hollister, CA.  

So what is AMA today?  Basically they promote and protect the motorcycling lifestyle and freedom on two wheels. AMA advocates for motorcyclists’ interests in the halls of local, state and federal government, the committees of international governing organizations and the court of public opinion. Through its member clubs, promoters and partners, the AMA sanctions many motorsports competition events around the world.

It’s the AMA promotion of motorcyclist interest and the HIPPA Recreational Injury Technical Correction Act that brings me to blog today.  There is a rule making it possible for health care benefits to be denied to those who are injured while participating in motorcycling.  That’s not right and I’m soliciting your help.  Write your Congressman.  I’ve supplied a form letter below or you can go HERE and leverage the easy to use form at AMA.

 

Subject:  Cosponsor S. 616, “The HIPAA Recreational Injury Technical Correction Act!”

Dear,  [Congressmen Name HERE] Oregon is: Senator Gordon Smith (R-OR) and Senator Ron Wyden (D-OR)

I live, ride and work in your district and I am urging you to support motorcyclists by co-sponsoring S. 616, “The HIPAA Recreational Injury Technical Correction Act.”  

U.S. Senator Susan Collins (R-ME) and U.S. Senator Russ Feingold (D-WI) recently introduced S. 616, “The HIPAA Recreational Injury Technical Correction Act.” Identical legislation passed the full Senate in the 108th Congress and obtained 177 bipartisan cosponsors in the House. 

S. 616 aims at ending health care discrimination for individuals participating in legal transportation and recreational activities-activities like motorcycling, snowmobiling, skiing, horseback riding, and all-terrain vehicle riding. 

This legislation addresses a loophole caused by a Department of Health and Human Services’ rule making it possible for health care benefits to be denied to those who are injured while participating in these activities. 

On August 21, 1996 an important opportunity arose when President Clinton signed the Health Insurance Portability and Accountability Act (HIPAA), prohibiting employers from denying health care coverage based on a worker’s pre-existing medical conditions or participation in legal activities, such as motorcycling. 

In 2001, the Department of Health and Human Services released the final rules that would govern the HIPAA law.  The rules recognize that employers cannot refuse health care coverage to an employee on the basis of their participation in a recognized legal activity.  However, the benefits can be denied for injuries sustained in connection with those activities!  Therefore, you were guaranteed the right to health care coverage but not guaranteed any benefits in return for your monthly payments.   

This legislation will fix the loophole for people like me in your district!  Please cosponsor and support S. 616.  Thank you very much.

Your [Name/Signature]

Whether you agree or not with the AMA charter to promote a motorcycle image of a family-friendly and wholesome sport…I think reasonable minded motorcyclists will all agree that your health provider should NOT be able to deny you medical coverage just because you are a biker.

Thanks for supporting!

Full disclosure: I don’t work for the AMA or am I a member.

Photo courtesy AMA advertisement.

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