Kentucky Real Estate Business

Posts Tagged ‘Care’

Article by jekky

(7380, ‘Living environment br Worldwide horses and other equids usually live outside with access to shelter from the elements In some cases animals are kept in a barn or stable or may have access to a shed or shelter Horses require both shelter from wind and precipitation as well as room to exercise and run They must have access to clean fresh water at all times and access to adequate forage such as grass or hay In the winter horses grow a heavy hair coat to keep warm and usually stay warm if well fed and allowed access to shelter But if kept artificially clipped for show or if under stress from age sickness or injury a horse blanket may need to be added to protect the horse from cold weather In the summer access to shade is well advised For horse owners who do not own their own land fields and barns can be rented from a private land owner or space for an individual horse may be rented from a boarding farm Unless an animal can be fully maintained on pasture with a natural open water source horses must be fed daily preferably at least twice a day If a horse cannot be fed by its owner every day it is usually kept at a boarding stable where the staff will care for the horse for a fee As equines are herd animals most have better mental behavior when in proximity to other equine company However this is not always possible and it has been known for companionship bonds to develop between horses and cats goats and other species There are exceptions Some horses particularly stallions may need to live on their own as they may fight with other animals Horses that are not on full time turnout in a field or pasture normally require some form of regular exercise whether it is being ridden longed or turned out for free time However if a horse is ill or injured it may need to be confined to a stable kept in a box stall br Pastures br Horses require room to exercise br If a horse is kept in a pasture the amount of land needed for basic maintenance varies with climate an animal needs more land for grazing in a dry climate than in a moist one However an average of between one and 3 160 acres 12 000 160 m2 of land per horse will provide adequate forage in much of the world though feed may have to be supplemented in winter or during periods of drought To lower the risk of laminitis horses also may need to be removed from lush rapidly changing grass for short periods in the spring and fall autumn when the grass is particularly high in non structural carbohydrates such as fructans If the terrain does not provide natural shelter in the form of heavy trees or other windbreaks an artificial shelter must be provided a horse s insulating hair coat works less efficiently when wet or when subjected to wind horses that cannot get away from wind and precipitation put unnecessary energy into maintaining core body warmth and may become susceptible to illness Some horses are turned out in a natural setting during the winter or when retired from work However even in these cases animals need to be checked frequently for evidence of injury parasites sickness or weight loss Horses cannot live for more than a few days without water Therefore even in a natural semi feral setting a check every day is recommended a stream or irrigation source can dry up ponds may become stagnant or develop toxic blue green algae a fence can break and allow escape poisonous plants can take root and grow windstorms precipitation or even human vandalism can create unsafe conditions br Fences and pens br Wood and wood like synthetics are classic and attractive forms of fencing br Horses evolved to live on prairie grasslands and to cover long distances unfettered by artificial barriers Therefore when fenced in accident potential must be considered Horses will put their heads and legs through fences in an attempt to reach forage on the other side They may run into fences if chased by another animal or even when running at play if the fence such as a wire fence is not particularly visible The smaller the area the more visible and substantial a fence needs to be For exercise alone a pen run corral or dry lot without forage can be much smaller than a pasture and this is a common way that many horses are managed kept in a barn with a turnout run or in a dry lot with a shelter feeding hay allowing either no pasture access or grazing for only a few hours per day Outdoor turnout pens range greatly in size but 12 160 feet 4 160 m by 20 to 30 160 feet 9 160 m is a bare minimum for a horse that does not get ridden daily To gallop for short stretches a horse needs a run of at least 50 to 100 160 feet 30 160 m When kept in a dry lot a barn or shelter is a must If kept in a small pen a horse needs to be worked regularly or turned out in a larger area for free exercise br A sturdy and well made wooden post and rail fence that is suitable for horses br Fences in pens must be sturdy In close quarters a horse may contact the fence frequently Wire is very dangerous in any small pen Pens are often made of metal pipe or wood Larger pens are sometimes enclosed in closely woven mesh sometimes called no climb fencing However if a wire mesh is used in a small pen the openings must be too small for a horse hoof to pass through br Types of fencing br See also Agricultural fencing br One danger of a wire fence is that as shown in this photo it is practically invisible a running animal may not see the fence until it is too late to avoid running into it br Over vast areas barbed wire is often seen in some parts of the world but it is the most dangerous fencing material that can be used around horses even in a large pasture If a horse is caught in barbed wire it can quickly become severely hurt often leaving lasting scars or even permanent injuries Horse management books and periodicals are nearly universal in stating that barbed wire should never be used to contain horses However this advice is widely ignored particularly in the western United States Various types of smooth wire fencing particularly when supported by a strand of electric fence can be used to enclose a large pasture of several acres and is one of the least expensive fencing options A wire fence should have at least four preferably five strands to provide adequate security However even without sharp barbs wire has the highest potential for horses to become tangled in the fence and injured If used it must be properly installed and kept tight through regular maintenance Visibility is also an issue a horse galloping in an unfamiliar pasture may not see a wire fence until it is too late to stop br A heavy woven mesh with closely spaced strands is relatively safe for horses as they cannot easily break the fence nor put a foot through it br Woven mesh wire is safer but more expensive than strands of smooth wire It is more difficult to install and has some visibility issues but horses are less likely to become tangled in it or be injured if they run into it Adding a top rail of wood or synthetic material increases visibility of the fence and prevents it from being bent by horses reaching over it A strand of electric fence may also keep horses from pushing on a mesh fence Mesh fencing needs to be heavy gauge wire woven not welded and the squares of the mesh should be too small for a horse to put a foot through Field fence or no climb fence are safer designs than more widely woven sheep fence Chain link fence is occasionally seen but horses can bend chain link almost as easily as a thinner gauge wire so the additional expense is often not justified by any gain over good quality woven wire br Electric fencing made of modern synthetic materials with fine wire interwoven throughout make a visible and inexpensive fence Use of plastic posts allows a temporary fence to be set up and moved easily as needed An electric fence such as this is good for dividing up a grazing area but should not be used as a boundary fence or in areas where animals will put a lot of pressure on the fence br Electric fence comes in many styles of wire rope and webbing and is particularly useful for internal division of pastures It carries only a mild charge that causes a noticeable shock but no permanent injury to animals or people It is relatively inexpensive and is easy to install but if electricity fails it is easily broken It is excellent both as a temporary fence and in single strands as a top or middle barrier to keep horses away from conventional fencing There is some danger that horses can become tangled in an electric fence though because the materials are finer it usually breaks stopping the current though injuries are still possible Because electricity can fail it should not be the sole fencing used on property boundaries particularly next to roads though a strand on top may be used to keep a horse from leaning over a fence made of other materials Nor should it be used alone in small pens where horses may accidentally bump into it on a regular basis However small single horse enclosures are sometimes seen at endurance riding competition where temporary fencing must be set up in remote areas In residential areas warning signs should be posted on any boundary fences with electrified sections to keep people from touching the fence and accidentally being shocked Wood is the classic form of horse fencing either painted planks or natural round rails It is one of the safest materials for containing horses Wood or a synthetic material with similar properties is the best option for small paddocks pens and corrals It can be used to fence pastures and has some ability to give or break if a horse collides with it However wood is expensive high maintenance and not completely without safety concerns boards can splinter nails can stick out and cause lacerations Wood like synthetics are even more expensive but are often safer and lower maintenance br A pipe fence will not break br Cable of various sorts is sometimes used for horse fencing and especially if combined with a top rail or pipe or wood can be reasonably safe However if cable is not kept tight like wire horses can be tangled in it However it not only cannot break but unlike wire it also cannot easily be cut by humans Its advantage over wire is that it poses less of a risk of entanglement It is often less expensive than wood or pipe has some give if a horse runs into it and requires relatively little maintenance Metal pipe is often used for fences instead of wood and if properly installed can be fairly safe in the right circumstances Pipe is often the most expensive fencing option but is low maintenance and is very strong Pipe will generally not give or break if it is run into or if the horse puts a foot through it which can itself be a potential injury risk horse owners debate the relative merits and dangers of pipe versus wood for horse fencing Usually pipe is most suitable for very small areas such as pens where a horse may often bump or test the fence but will not be at risk of colliding with the fence at full speed br A Kentucky limestone fence br Solid wall masonry fences typically either brick or fieldstone are a type of horse fencing with an ancient tradition Advantages of stone fences are high visibility durability strength and safety Horses cannot get caught or tangled in them put legs through and if a horse runs into one the impact is spread over much of the body rather than concentrated on a single spot They will last for decades with only minor repairs The major disadvantage is the cost the materials are expensive fences require skilled labor for proper construction and take longer to build br Barns and stables br See also barn 160 and stable br A large horse stable in Poland br Horses are sometimes kept indoors in buildings called either barns or stables The terms are often used interchangeably a barn is the more general term for a rural building that houses livestock the term stable is more often used in urban areas and can be used as a noun to refer to the building that houses horses or the collection of horses themselves or as a verb to describe the act of keeping horses in a stable These buildings are usually unheated and well ventilated horses may develop respiratory problems when kept in damp or stuffy conditions Most horse barns have a number of box stalls inside that allow many horses to be safely stabled together in separate quarters There are also separate areas or even rooms for feed equipment and tack storage and in some large stables there may be additional facilities such as a veterinary treatment area or a washing area in the building Barns may be designed to hold one horse in the backyard of a family home or be a commercial operation capable of holding dozens of animals br Box stalls in a barn or stable should be of sturdy construction and cleaned daily br The standard dimensions for a box stall called a box in the UK and a stall in the USA vary from 10 by 12 to 14 by 14 depending on local cultural traditions the breed of horse gender and any special needs Mares with foals often are kept in double stalls Stallions kept’)

http://goarticles.com/article/Horse-care/3892926/

Article by Donald Dubay

http://goarticles.com/article/Lawn-Care-Can-Involve-Cutting-Your-Grass-Responsibly/4339831/

As an aid to the residents’ growing demand in long term care, the Kentucky Long-Term Care Partnership Insurance Program was established,  a partnership between the Department for Medicaid Services and the Department of Insurance, which mainly provide incentives for an individual to insure against the cost of providing for his or her LTC needs in the future.

It also offers a means for individuals to qualify for Medicaid services for costs of LTC without exhausting all of their assets and resources. Aside from these, this partnership program aids in lessening the financial burden of Kentucky’s Medicaid program through encouraging the use of private insurance and increase consumption of LTC insurance policies.

Every LTC insurance policy made available in the state are required to offer: (a) coverage for expenses for at least twelve months for each covered person on an expense-incurred, indemnity, or prepaid basis for one or more long-term care services provided in a setting other than an acute care unit of a hospital, and, (b) coverage for long-term care services for a policyholder who is a resident of a state with a qualified long-term care partnership program when coverage first became effective.

To guarantee every policy made available within the state meet the set of requirements and standards, the Department of Insurance shall have responsibility to approve any long-term care partnership insurance policy available meets and continues to meet all applicable federal and state laws and regulations.

The state shall not impose any requirement affecting the terms or benefits of such a policy unless it imposes such requirement on long-term care insurance policies without regard to whether the policy is covered under the partnership or is offered in connection with the partnership.

Also, the department shall ensure that any agent who sells a long-term care partnership insurance policy can demonstrate an understanding of the LTC partnership insurance and how it relates to other public and private coverage of LTC expenses.

While, the Department for Medicaid Services on the other hand, shall provide consultation, materials, and other information to the Department of Insurance to enable it to facilitate the development and issuance of uniform training materials for agents who sell LTC insurance policies. It may contract with another entity to conduct agent training and testing but the training and certification may be conducted at the expense of the insurance agent.

Moreover, the state also set reciprocity standards which only apply to the asset disregard wherein applicants may only be qualified for it if the state wherein they purchased their LTC policy and the state where they apply for Medicaid both participate with the reciprocal standards.

http://business.ezinemark.com/kentucky-long-term-care-partnership-program-17107c4f421.html

Week of March 15, 2010

The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie.

Federal

With a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill — requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess.

The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March.) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March.) Aetna urged Congress to apply the “doc fix” to next year’s reimbursement as well, since insurers’ Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond.

States

ARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the 0 million deficit this year and reduce the anticipated .6 billion deficit in 2011. Righting the state’s fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language.

CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers’ agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem.

COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees.

CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature’s Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance.

GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks.

KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial – a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on “most favored nation” clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of “eligible employee” to include part-time workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital’s highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers.

KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber.

SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor’s signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U.S. Senate and House.

Yes. It can seem to happen at the most inopportune time at your apartment. Whether you are trying to study for a final exam, have an important work related phone call, or even just trying to sleep in on your only day off…you suddenly hear the annoying sound.

Its a constant buzz of lawn mowers, weed eaters, and edgers making your apartment grounds look really really nice. You often wonder why they have to do it right at that time, but I want to remind you that it always could be worse.

It could be YOU out there having to mow that lawn. YOU could have to take time out of your busy schedule or on that day off to cut the grass and pull the weeds. If you were a home owner rather than an Apartmentite, you would have to do it all yourself.

That is just another one of the HUNDREDS OF MILLIONS of reasons that living in an apartment rocks! At least they aren’t making all that noise in the middle of the night and although it seems like it lasts a long time, the sound will end before too long anyway. So don’t stress.

If they weren’t doing this, you’d have a lot harder time looking for “landmines” through tall grass as you walk through the apartment grounds and it might be embarrassing to bring guests to an apartment that isn’t groomed well. The noise is nothing that earplugs can’t handle.

So the next time you hear the buzz of the lawn machines start going off at 8 AM on a Saturday, don’t throw your pillow across the room in frustration, just put it over your head to drown out the sign. Drift back to sleep knowing that you, yourself don’t have to go out there and smell like sweat and grass because it is AWESOME living in an apartment.

(PLUS…YOU NEVER HAVE TO CLEAN THE POOL EITHER)

For more apartment information, check out ApartmentHomeLiving.com

Week of March 15, 2010The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie.FederalWith a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill — requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess.The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March.) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March.) Aetna urged Congress to apply the “doc fix” to next year’s reimbursement as well, since insurers’ Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond.StatesARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the $700 million deficit this year and reduce the anticipated $2.6 billion deficit in 2011. Righting the state’s fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language.CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers’ agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem.COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees.CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature’s Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance.GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks.KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial – a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on “most favored nation” clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of “eligible employee” to include part-time workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital’s highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers.KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber.SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor’s signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U.S. Senate and House.

Yes. It can seem to happen at the most inopportune time at your apartment. Whether you are trying to study for a final exam, have an important work related phone call, or even just trying to sleep in on your only day off…you suddenly hear the annoying sound.

Its a constant buzz of lawn mowers, weed eaters, and edgers making your apartment grounds look really really nice. You often wonder why they have to do it right at that time, but I want to remind you that it always could be worse.

It could be YOU out there having to mow that lawn. YOU could have to take time out of your busy schedule or on that day off to cut the grass and pull the weeds. If you were a home owner rather than an Apartmentite, you would have to do it all yourself.

That is just another one of the HUNDREDS OF MILLIONS of reasons that living in an apartment rocks! At least they aren’t making all that noise in the middle of the night and although it seems like it lasts a long time, the sound will end before too long anyway. So don’t stress.

If they weren’t doing this, you’d have a lot harder time looking for “landmines” through tall grass as you walk through the apartment grounds and it might be embarrassing to bring guests to an apartment that isn’t groomed well. The noise is nothing that earplugs can’t handle.

So the next time you hear the buzz of the lawn machines start going off at 8 AM on a Saturday, don’t throw your pillow across the room in frustration, just put it over your head to drown out the sign. Drift back to sleep knowing that you, yourself don’t have to go out there and smell like sweat and grass because it is AWESOME living in an apartment.

(PLUS…YOU NEVER HAVE TO CLEAN THE POOL EITHER)

For more apartment information, check out ApartmentHomeLiving.com