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Insurance commissioner steps out to support state-run exchange

UPDATED: Democratic Insurance Commissioner Wayne Goodwin broke his silence on the legislative debate surrounding the health insurance exchanges, arguing that a state-based exchange is better for the state's consumers.

"I believe that North Carolinians know what’s best for North Carolina," he said in a prepared statement released Tuesday. "State-based regulation best protects our consumers and promotes a healthy insurance marketplace."

Goodwin sat on the sidelines (at least publicly) for the past week as the Republicans pushed a bill to let the federal government run the online marketplace for insurance policies and require Goodwin to send back any federal money he received to help get a state-sponsored exchange.

State receives $74 million federal grant for health insurance exchange

The state has received a $74 million federal grant to set up an online marketplace for health insurance, a key component of the new federal health care law.

The internet insurance mall would be for small businesses or individuals not insured through their jobs. The money would be used for getting guts of the system ready.

According to the grant application the state Department of Insurance submitted last year, more than half the money would be used by the state Department of Health and Human Services to link the software that creates the website to an existing software program called NC FAST, which is used by DHHS and county social services departments.

Gov. Pat McCrory has not said how he wants the state to approach the health care law - whether he wants the state to run its own exchange, whether the state will run it with the federal government, or if North Carolina will tell the U.S. government to do all the work.

Senate leader Phil Berger said Wednesday he did not want a state or state-federal exchange.

DOI plan to raise fees likely to face industry opposition

The state Department of Insurance's proposal to raise fees it collects from insurers and other businesses it regulates won't win many fans among companies or consumers.

In response to Gov. Bev Perdue's recent request for suggested budget cuts, agency officials instead recommended increasing various fees that it collects from insurers, agents, adjusters and others licensed to do business in North Carolina. Other state agencies also have resisted proposing cuts (Read the full N&O report here).

But insurers would oppose any effort to raise their costs. If the DOI wants to raise fees that are passed along to consumers, it would need to fully disclose that intention, said Jennifer Cohen, executive director of the Insurance Federation of North Carolina.

"We wouldn't want consumers to think insurance companies were simply jacking up their rates to make more profit," Cohen said. "People are struggling with job issues and debt issues. Consumers will be very much opposed to letting the state balance the budget on their backs."

New Medicaid law to spare patient assets

The state has a new law designed to reduce its future Medicaid costs while allowing elderly people to protect some of their assets if they enroll in the insurance program.

The law sets up what's called a long-term care partnership, where people who buy long-term care insurance will have the amount of insurance benefits they use shielded from Medicaid "spend-down" provisions that require medical bills to be subtracted from income before some applicants can qualify for the government insurance program.

The law takes effect Jan. 1.

According to the state Department of Insurance, here's how the partnership works: A private partnership’s policy pays for services such as in-home care, community-based services or nursing home care.

When the partnership policy’s insurance benefits are used, Medicaid disregards the exact dollar amount paid by the insurance company when determining qualification of long-term care Medicaid benefits. Medicaid does not recover this money even after the insured person's death.

For example, if a partnership policy is $200,000, and the insured person uses that amount of benefits but still needs care, the person can apply for Medicaid coverage. In the application, $200,000 of the person's personal assets — such as savings, family-owned businesses or farms — would be exempted.

North Carolina joins 33 other states who have implemented long-term care partnership programs, according to the state Department of Insurance.

Dome Memo: New friends

RIVALS NO MORE: Ken Lewis, the Chapel Hill lawyer who finished third in the Senate primary, endorsed his former opponent, Elaine Marshall, perhaps delivering African-American votes to her for the June 22 runoff with Cal Cunningham.

INSURANCE SMACKDOWN: Insurance Commissioner Wayne Goodwin called an emergency news conference to fight a special provision in the Senate budget proposal that would strip him of his rate-making authority. The provision was shocking, he said, and happened "in the cover of darkness." Senate leader Marc Basnight said the idea came from his office but ended up in the budget legislation by mistake. The item was later removed.

WISE TO PRIVITIZE?  Two circulating proposals would outsource parts of the state's troubled mental health and probation systems. Lobbyists are pushing privatization, and legislators and state officials are listening. Skeptics say it's a bad idea.

IN OTHER NEWS: Former Department of Transportation Secretary Lyndo Tippett was issued a subpoena in the federal investigation into former Gov. Mike Easley's administration. The Senate budget proposal allows local school systems to furlough teachers. Odd couple: Former Gov. Jim Hunt and "American Idol" finalist Anoop Desai teamed up on a YouTube video to ask people to oppose cuts to the Smart Start early childhood education program.

Goodwin slams move to strip his authority over rates

N.C. Insurance Commissioner Wayne Goodwin called an emergency press conference this afternoon to decry an addition to the state budget bill that would abolish the rate-making authority of his office.

The addition, Goodwin said, was made Monday, and his office was alerted Monday evening, Sue Stock reports on the .biz blog. There could be a vote on the bill as early as today.

Using phrases like "shocking" and "irresponsible government," Goodwin said that if passed, the bill would surely cause insurance rates for homes, vehicles and workers compensation to rise throughout the state.

"Working people do not need this piled on them," he said.

The motion to abolish the commissioner's authority and place the duties of regulating insurance rates in the hands of a seven-member panel is reminiscent of a bill introduced in 2007 that would have also relieved the commissioner of his rate-setting duties. That bill was eventually shelved.

This time around, Goodwin said he did not know who exactly was behind the addition to the bill.

"This happened so fast, in the cover of darkness, that I don't know who is behind it," he said. "I have my suspicions, but I don't know. ... We had this fight three years ago, and we fought it then. It's even more dangerous now."

UPDATE: Sen. Katie Dorsett, a Guildford County Democrat, said she anticipates an amendment to the budget to come forward today to remove the provision stripping the commissioner of his rate-making authorities. The amendment passed and the language was stripped from the bill. 

Medicare provider suspension could be problem for 24,000 in state

As many as 24,000 North Carolina Medicare recipients may be affected by the suspension of a New York-based drug plan.

Federal Medicare regulators have ordered Fox Insurance Company of New York to suspended new enrollments and marketing for its Medicare Part D drug plan because the company was not providing drugs to customers quickly, according to the federal Centers for Medicare & Medicaid Services.

The company, without permission from Medicare, was suggesting patients use cheaper drugs than those prescribed by doctors. Given the drugs for treating cancer, diabetes and HIV/AIDS, delays in medications could have had serious implications.

More than 24,000 Medicare recipients in North Carolina were enrolled with the company, said Kristin Milam, a spokeswoman for the N.C. Department of Insurance. Mecklenburg County had more than 1,400 enrollees and Wake County had about 1,000.

Many of those enrolled were also enrolled in Medicaid and should be able to change drug providers on a monthly basis, she said. Others may have to follow special procedures. Milam said anyone with questions is encouraged to contact the state's free Seniors' Health Insurance Information Program, which provides unbiased, expert advice and information. 

"If you've got a question about it and you think you're affected by this, go ahead and call," Milam said. "You will get a live person when you call that 1-800 number."

Individual, in person appointments are also available in every county. For more information visit or call 1-800-443-9354.

Goodwin builds 'suggestion box'

Insurance Commissioner Wayne Goodwin has launched an online "suggestion box."

As he explains on his Wayne's World blog, the feature is the next step in a series of moves meant to make the N.C. Department of Insurance more accessible. In Goodwin's first year in office, the department added a YouTube channel, a Facebook page, and an RSS feed.

Government transparency is very important to me. Throughout my administration I have greatly improved public participation by North Carolina consumers, families and businesses in the work of the Department of Insurance. In addition to public comment periods and greater emphasis on public hearings and a revamped website and social networking by the NCDOI, I'm very pleased to introduce the Suggestion Box.

The "box" is actually a form to fill in on the Web, but you get the idea. 

Can we build it...faster?

This has been a horrible year for contractors and architects because of the building slow down. But state government has at least tried to cut down the red tape to make it easier for the public building jobs that are available.

Starting this fall, the State Construction office and the section of the Insurance Department that inspects new construction for fire code compliance were merged into one office. The merger, which was approved by the legislature earlier this year, means that for new state construction, contractors and architects only have to deal with one state agency and one set of inspectors, not two.

State Insurance Commissioner Wayne Goodwin agreed to transfer eight of his employees over to the state construction office to make it happen. Britt Cobb, the secretary of administration who oversees the construction office, said the change has speeded up the building approval process by 30 days.

Harrison wants BCBS investigation

Rep. Pricey Harrison has asked for an investigation into Blue Cross and Blue Shield's campaign against the public option health care proposal.

Harrison, a Greensboro Democrat, has asked the Attorney General and N.C. Department of Insurance to look into whether the insurer violated the state's do-not-call registry with a robocall and whether it is proper for the insurer to use premiums to pay for mailers, reports Mark Binker of the Greensboro News & Record.

"We are a fully taxed medical services and hospital corporation," Borman said, adding that the company paid $162 million in federal, state and local taxes last year.

However, the fact the company paid taxes does not make it a for-profit company, said Adam Searing, a health policy expert with liberal-leaning advocacy group The North Carolina Justice Center.

"They are a nonprofit organization," Searing said. "They are organized under a special part of the nonprofit corporation law in North Carolina. They have a nonprofit board."

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