MANAGED CARE February 2009. ©MediMedia USA
The burden of diabetes just got bigger, according to epidemiologists at the National Institutes of Health and the Centers for Disease Control and Prevention. Nearly 13 percent of adults age 20 and older have diabetes, but 40 percent of them have not been diagnosed. An additional 30 percent of adults have pre-diabetes, a condition marked by elevated blood sugar that is not yet in the diabetic range. Researchers used newly available data from an oral glucose tolerance test, which gives more information about blood glucose abnormalities than the traditional fasting blood glucose test. Findings are reported in the February issue of Diabetes Care… The California Supreme Court has barred the practice of balance billing that hospitals and emergency department physicians use to charge patients directly when their HMOs refuse to pay. The practice occurs when insured people seek emergency care from out-of-network physicians and hospitals… New data-reporting guidelines became effective on Jan. 1. The Centers for Medicare and Medicaid Services has issued guidance documents for group health plans and their insurers and third-party administrators (TPAs). The guidelines should facilitate coordination of benefits with Medicare. Insurers, TPAs, and plan administrators are required to collect data, including Social Security numbers or health insurance claim numbers, and file these data electronically with Medicare.