Health Care Law Blog: February 2006

Tuesday, February 28, 2006

Bloglines Adds Drag and Drop Feature

Bloglines has added a new drag and drop feature making it much easier to manage your feeds. Following is the news item from Bloglines on the new features.

Bloglines | News: "Drag 'n' Drop - Just in Time for Spring Cleaning

If you are like most Bloglines users, you've found that it's too easy to subscribe to a ton of feeds but way too hard to keep them organized. While modern medicine has yet to invent a pill to cure Bloglines addiction, the feed management improvements we released yesterday will at least help you, our users, cope with the symptoms.

Feed Management

The features previously separated in Edit and Reorder/Sort modes are now consolidated into a single Edit mode found at the top of My Feeds and Clippings.

1. Create a new Folder by clicking on the New Folder icon.
2. Rename inline. Click once to select the item and click a second time to edit the name.
3. Double click on any item to edit details for feeds, folders and clippings.
4. Unsubscribe or delete a folder by dragging it to the trash can. (Tip: To cancel a drag, tap the Esc key.)
5. To manually sort, simply drag and drop into place; use the arrow keys or mouse wheel to scroll.
6. To sort automatically, make your selection and then choose from the dropdown menu. You can sort alphabetically, reverse alpha, by oldest or newest first, or by the number of unread items.
7. If you use Bloglines Mobile, you may want to exclude feeds from your mobile view to avoid wasting valuable minutes downloading feeds you don't need.
8. Do you have a handful of feeds that you read more often than others? Turn off the Notifier for the other feeds so that little 'ding-dong' only interrupts you when it's important.
9. Maybe you're a tattoo artist and don't want to share your Blogroll for fear your clients will find out you read knitting blogs. Have no fear, you can keep it secret. Just mark them as private and those feeds won't be listed.
10. We've made it easier to choose multiple items. You can now use shift-click to select ranges or ctrl-click (command-click on Mac) for separate items."

Monday, February 27, 2006

The Politics of RSS in West Virginia

How powerful is RSS? Powerful enough to overcome traditional political boundaries in West Virginia. Although many readers of Phil Kabler's Febuary 20, 2006, edition of the Statehouse Beat likely skimmed over the item below, it was quite interesting to those fascinated by the growth and power of RSS technology.

West Virginia has a Democratic controlled executive and legislative branch and is well known nationally as being a Democratic state. However, the current Democratic administration is using a largely Republican owned and controlled media group, West Virginia Media Holdings owned by Bray Cary, to distribute news via the states official website at "wv.gov." The reason? RSS technology and the fact that only one media group in West Virginia has incorporated RSS technology.

I suspect that the Charleston Gazette, the states Democratic focused newspaper, took note of this item in Mr. Kabler's column and will begin incorporating RSS technology news feeds. The Gazette staff has been experimenting over the last year with a number of blogs in its entertainment section called The Gazz, however, most of the blogs don't have easily accessible RSS feeds allowing easy syndication and reading via an RSS reader.

Below is the excerpt from Mr. Kabler's Statehouse Beat column:

A reader notes that if Internet users click on the “WV News” icon on the homepage of wv.gov, the official Internet portal for the state of West Virginia, it takes them to news updates broken down by regions of the state — all from Bray Cary’s West Virginia Media affiliates.

Manchin spokeswoman Lara Ramsburg said that’s not because of any arrangement between the state and West Virginia Media, but because the news sites are the only ones in the state using RSS XML technology.

While it was beyond her ability to explain, and mine to comprehend, that technology apparently allows the news feeds to be updated on the site automatically.

BlogHer Survey Says?

Should you include personal items on your professional blog? What about including business items on your personal blog? What are others doing? If you are a blogger and interested in these questions take a few moments to share your thoughts at the BlogHer survey mentioned by Denise Howell at Between Lawyers.

WVHCA Statistics on Health Care Cost Shifting in West Virginia

The West Virginia Health Care Authority has posted interesting charts showing the cost shifting of heath care costs in West Virginia. The presentation was given by the Chair of the Health Care Authority, Sonia Chambers, to the West Virginia House of Delegates Health and Human Resources Committee on February 14th, 2005.

The charts show a reasons why West Virginia needs to work hard to attract more businesses to West Virginia. As the non-governmental payor pool shrinks those left will take on a greater burden of the cost shift. At some point the breaking point will occur where business will no longer be able to make up the difference and West Virginia hospitals will no longer be able to cover the cost of health care based on the rates paid by governmental payors.

Check out the following charts:

Sunday, February 26, 2006

Law Firm Strategy

Adam Smith, Esq. looks at the interesting concept of having a law firm Chief Strategy Officer. I've watched the explosive growth of Reed Smith from its days when I graduated from law school. At that time Reed Smith was basically a Pittsburgh based law firm. Under the leadership of Greg Jordan (a fellow Bethany College grad) the law firm moved into the upper ranks of the AmLaw 100.

To create a vision for your company or law firm you have to have a strategy and work toward reaching goals everyday. So often law firms and other businesses are too concerned with the present to think about the future, developing a strategy and doing something everyday to implement the strategy. The same applies to successful hospitals and health care providers.

How's Your HIPAA?

The HIPAA Blog has a summary of the winter 2005-2006 quarterly survey sponsored by Phoenix Health Systems and HIMSS on HIPAA compliance by health care providers. Be sure the check out the survey to see where your hospital, physician office, health insurance payor or other health facility ranks.

Friday, February 24, 2006

Something Everyone Should Consider: The Opportunity Wedge

Consider the Opportunity Wedge and the great catch phrases posted by Tom Collins, law blogger at morepartnerincome. Great advice for everyone -- not just law firm associates.

Wednesday, February 22, 2006

Blawg Review and Grand Rounds

Don't forget to check out this weeks edition of Blawg Review and Grand Rounds. Patrick Lamb hosts Blawg Review #45 at In Search of Perfect Client Service and Dr. Andy hosts a great edition of Grand Rounds 2:22.

Sunday, February 19, 2006

I Heart Tech: A New Legal Technology Tips & Tricks Blog

I'm constantly trying to improve technology skills to make my law practice more efficient and effective for my clients. Ask my staff and you will find that I am constantly trying to teach them tips and tricks to save them time and effort in the everyday world of a law practice.

A big proponent of the practical use of technology and software, I was glad to run across a new blog called I Heart Tech hosted by Adriana Linares. Can't recall where I first saw her new blog announced but it now has been added to my RSS Bloglines reader. It was probably through inter alia's Blawg of the Day posts -- a great resource of new legal blogs. Although we haven't met I look forward to watching Adriana's posts.

Saturday, February 18, 2006

Subcontracts on Nationwide Privacy and Security Health Information Project

iHealthBeat reports on a nationwide effort to identify state privacy and security laws, policies and practices that could negatively impact health care data sharing. HHS has awarded a contract to The Research Triangle Institute International who will organize subcontrators in up to 40 different states to help identify the state related issues. The Request for Proposal outlines the details and deadlines for those interested in becoming a subcontractor under the project.

The RTI International press release states:

As part of a contract with the U.S. Department of Health and Human Services, RTI International and the National Governors Association (NGA) Center for Best Practices released a request for proposals inviting U.S. states and territories to participate in a collaborative effort to examine privacy and security laws and business practices that affect the ability of states and territories to exchange interoperable electronic health information.

Working collaboratively through a stakeholder process, the team members will work with representatives from up to 40 state governments and territories to identify, assess and develop plans to address variations in organization-level business policies and state laws that affect privacy and security practices that may pose challenges to interoperable health information exchange.

The request for proposals provides detailed information on the requirements for each state and/or territorial project, guidelines for submitting a proposal and information on the support provided by RTI and the NGA. States and territories receiving an award will be required to complete the work within one year.

Award recipients will examine the state or territory's privacy and security policies and business practices regarding electronic health information exchange; convene and work closely with a wide range of stakeholders within the state or territory; and develop an implementation plan to address organization-level business practices and state laws that affect privacy and security practices and impede interoperable health information exchange.

Thanks For Supporting Blawg Review #44

Thanks to all the ~~blawgers/bloggers~~bobbers who linked this week's Blawg Review #44. It was a fun blogosphere adventure. Hosting Blawg Review reminded me a little like my first marathon -- it was fun, but I don't want to do it again next weekend.

Following is a list of the bobbers who supported and publicized Blawg Review #44:

Nick Jacobs at Nick's Blog.
Law.com at Inside Opinions: Legal Blogs.
Evan Schaeffer at Evan Schaeffer's Legal Underground.
Colin Samuels at Infamy or Praise.
Sean Sirrine at Objective Justice.
Sheryl Schelin at The Airport Lawyer.
Bill Gardner at Law Firm IT and Oncee@Blogger.
Denise Howell at Bag and ~~Baggage~~Bobbage.
Kevin Heller at Tech Law Advisor.
Glenn Reynolds at Instapundit.com.
Dan Hull at What About Clients?

Now, on to Blawg Review #45 which will be hosted by Patrick Lamb at In Search of Perfect Client Service.

Should Consumers of Health Care Have More Rights to Protect Their Medical Information?

This in from the HIPAA Blog and Alan Goldberg. Consumer Reports notes the benefits that having a national system of medical records in electronic format, but also warns of the privacy issues.

The Consumer Reports article has an interesting discussion and advice of what rights you (as a consumer) are signing away when you sign a Notice of Privacy Practices at your local hospital or physician. The article goes back to the age old discussion privacy advocates and health care industy experts had during the drafting of the original HIPAA privacy standards.

Thursday, February 16, 2006

Jim Calloway's Law Practice Tips Blog: More lessons in what not to e-mail

Jim Calloway's Law Practic Tips Blog has a great post on the reason for being cautious with your email. Although his particular post deals with a snippy exchange between a young lawyer and her would-be employer - the lesson applies for any industry. The lesson use to be -- don't say anything that you wouldn't want to see in the newspaper. Today, its don't say anything in an email that you don't want to see jet around the world via "email forwards" or on a blog.

HHS Issues Final Rule on HIPAA Enforcement

Today the Office of Secretary, Health and Human Services (HHS) issued the Final Rule on HIPAA Administrative Simplification Enforcement. The Final Rule can be viewed in the Federal Register February 16, 2006).

According to a email received from Stanley Nachimson, Senior Technical Advisor with the Office of E-Health Standards and Services, the Final Rule adopts the complete regulatory structure for implementing the civil money penalty authority of the Administrative Simplification part of HIPAA (SSA, section 1176), completing the structure begun when the Privacy Rule was issued in 2000 and expanded by the interim final procedural enforcement rules issued in 2003.

The Final Rule covers the enforcement process from its beginning, which will usually be a complaint or a compliance review, through its conclusion. A complaint or compliance review may result in informal resolution, a finding of no violation, or a finding of violation. If a finding of violation is made, a civil money penalty will be sought for the violation, which can be challenged by the covered entity through a formal hearing and appellate review process.

Tuesday, February 14, 2006

Brrreeeport: Scccoooble

Gotta brrreeeport says Scccoooble.

Proposed Modifications to WV Rules of Professional Conduct

The Committee of the Lawyer Disciplinary Board and the Board of Governors of the West Virginia State Bar reviewed the newly amended American Bar Association Model Rules of Professional Conduct and has submitted a proposed revised version of the West Virginia Rules for public comment.

Comments to proposed modifications should be submitted before May 30, 2006, to the New Rules Committee, Office of Disciplinary Counsel, 2008 Kanawha Blvd East, Charleston, WV 25311.

Valentine Day Grand Rounds (Vol. 2, No. 21).

Grand Rounds Vol. 2 No. 21 is now creatively up as a Valentine Day personal ad at intueri: to contemplate, Musings. Miracles. Medicine. Madness.

Monday, February 13, 2006

Blawg Review #44

Welcome to Blawg Review #44 coming to you from "Wild and Wonderful" West Virginia. Although the traditional Mountaineer slogan of Wild and Wonderful is being changed to "Open for Business," (which has come under attack) it still rings true for most West Virginians. If a state economic makeover is in order, why not consider thinking outside the blog and go with "Open for Wild and Wonderful Blogging." Consider the fact that Capitol Insiders went high tech without anyone knowing about it.

West Virginia is often negatively portrayed in the national media, most recently due to the coal mining disasters at Sago and Aracoma. However, take a look at Rick Lee's On Location with Rick Lee, who promotes a better image of West Virginia and what it offers. If you enjoy photo bloggers be sure to check out Rick's fun "Thursday Night Is Grocery Night" posts.

Whether by intention or by Freudian slip, the Blawg Review editor in his introductory post referred to my health care blog or blawg as "Health Care Law Bob." In the interest of mediating the ongoing dispute and discussion of blog vs. blawg -- all blawgs, blogs or other online web logs written by lawyers shall now be referred to as "bobs." Personally, I like the ring of Bob Review, Real Lawyers Have Bobs, Bag and Bobbage and f/k/a . . . blog d/b/a bob. (As an aside, I just want credit for coining the term dogger.)

So . . . on with "Who Let the Bob's Out?"

efore getting to the rest of the posts submitted to this week's edition of Bob Review, following are some interesting health care related blog posts.

Sean Sirrine at Objective Justice posted Hospital Requires Patient to Sue to Receive her Medical Records, discussing a bizarre medical malpractice case in which a Florida woman has been required by Orlando Regional Healthcare Systems to sue them in order to find out why all her limbs were amputated when she went to a hospital to give birth to her son.

Hurricane Katrina and its aftermath have shown the vulnerability of the health care system in America. Concerned for Charity Hospital, a new blog about Charity Hospital in New Orleans, issues a warning to those headed to Mardi Gras who might need medical treatment.

Nick Jacobs, the CEO at Windber Medical Center and regular blogger at Nick's Blog, guest posts at Hospital Impact. His End-of-Life Care Healthcare will end the life of healthcare indicates why we all need to discuss with each other, our families and our nation end of life care issues and the impact on the health care system. Nick's Blog, the first known hospital CEO blog, is an excellent example of how blogs can be used by a CEO to communicate to staff, employees, customers (or in this case patients) and the community.

While mentioning end of life care issues, Dennis Kennedy points out the importance of end of life IT planning in What Happens to Blogs, Email and the Rest of Your Online Presence When You Die?

Walter Olson at Overlawyered posts that No One Is Being Force Fed Soda, where he quotes sources against regulating food advertising aimed at children. Olson also mentions in his post the Mountain Mama syndrome and the CDC's investigation of why West Virginian adults rank 3rd nationally in adult obesity. My suggestion, start playing Dance, Dance Revolution with the kids.

If you like "blawg," then you'll love "consolidoperability." As the health care industry moves toward the national and state mandates for interoperability of electronic health care systems, there is likely to be more IT health vendor consolidation. iHealthBeat doesn't have a blog or an RSS feed, but they do have a weekly newsletter that is a great source for the Internet's impact on health care. For example, are you interested in the future of Google and health care? Read Jane Sarasohn-Kahn's thought provoking commentary titled "Paging Dr. Google."

In This Judge Knows How Our Students Feel, the HealthLawProf Blog highlights how many in the health care industry feel about the Medicare regulations. U.S. District Judge Sam Crow called Medicare regulations "complex, confusing and arguably incoherent at times" while sentencing three individuals who overbilled Medicare for more expensive motorized wheelchairs and seat cushions.

For more on the complexity of our health care system read Balkinization's post, When is a Bill Signed by the President, Not a Law, dealing with the Deficit Reduction Act of 2005 and a snafu related to language in the bill involving the Medicare payment for DME equipment.

eisure time for lawyers? Check out Bruce MacEwen's post Can't I Trade Some Of This Money For A Week Off? at Adam Smith, Esq., discussing the negative impact the billable hour system has on productivity and what he refers to as the "plasticity" of legal services. For the original perspective on the article that appeared in the Economist, read ProfessorBainbridge's perspective.

Are you tired of receiving junk faxes about that cruise that you can't take because you have to bill more hours? J. Craig Williams at May It Please The Court reports, "after receiving over 1,000 faxes in a three-year period, Travel Agent Sherman Gottlieb was, and he decided to do something about it." Gottlieb sued Carnival Cruise Lines under the Telephone Consumer Protection Act and seeks to recover in excess of $500,000.

ver at the Richmond IP Blog there is discussion of Dual Copyright Approach Protects Directors and Playwrights and an article appearing in the New York Times tackling the issue of whether directors are entitled to copyright protection for their staging of dramatic works.

The Insurance Scrawl by Marc Mayerson presents analysis and commentary on the insurer's duty to defend, a policy holder's right to select counsel and the inherent conflict issues arising between insurer and insured. The post titled Fettering the Insurer's Privilege to Control the Defense It is Duty Bound to Provide analyzes a recent 4th Circuit case, Twin City Fire Ins. Co. v. Ben Arnold-Sunbelt Beverage Co., where the court "rejected the argument that an insurer’s reservation of the right to deny coverage called for prophylactic protection of the interest of the insured by allowing it to select counsel of it's choice to defend at the insurer’s expense."

Mail, instant messaging, wikis, blogs, social networking, online news aggregators, social bookmarking and other hosted means of communication and knowledge management are being used more and more by professionals and business employees. Denise Howell of Bag & Baggage raises some excellent points over at Between Lawyers about the practical impact the growing use of hosted communication and knowledge management systems will have on businesses faced with litigation and e-discovery. The post mentions the proactive approach being taken by some larger companies to manage e-discovery and speculates whether Web 2.0 companies are ready for the onslaught of subpoenas duces tecum that are bound to come their direction.

In from the Wall Street Journal Blog, the Flying Shrimp Verdict has made its way ashore. If this case had been tried in West Virginia, the plaintiff might have had a chance.

ig Law Bobbing conference set for April. Kevin Heller talks about Big Law Laying Claim to Blawging at the Blog Law and Blogging for Lawyers Conference, scheduled for April 20 & 21 in San Francisco and co-chaired by Dennis Crouch of Patently-O: Patent Law Blog. Kevin O'Keefe mentions the conference as the "first comprehensive CLE to look at blogging both as a legal marketing tool for attorneys and as a legal area." It will be interesting to see how large law firms and institutional blogs evolve over the next couple of years.

Bill Gardner, who hosts Law Firm IT: "The View From the Server Room," follows up on a post by Robert Ambrogi and links to Got Shells, warning law firms about Google's new desktop search features. Bill also has an excellent instructions for those wanting to incorporate Technorati tag features into Blogger using a Grease Monkey script.

esson #1 for demand letters in the age of email and the blogosphere -- take a cautious and thoughtful approach to what you write. Marty Schwimmer at the Trademark Blog has been following the developing story of Jason Calacanis' blogs at Weblogs, Inc. Network using the "For Dummies" trademark. Schwimmer posts a followup comment to his Trademark Attribution For Dummies post, noting that BuzzMachine is now organizing a protest encouraging bloggers to end their posts with FOR DUMMIES.

Ray Ward demonstrates why the CAP LOCKS KEY IS THE MOST OBNOXIOUS KEY ON YOUR KEYBOARD in his post IF YOU WRITE IN ALL CAPS, STOP IT! at Minor Wisdom.

Focus on Marketing DNA. Larry Bodine at the Legal Marketing Blog provides some practical advice to analyze your firm's marketing DNA.

lthough all of us are probably considered "edge cases" among our non-blogging lawyer peers, the mass marketing and commodization of blogging is coming. Kevin O'Keefe at Real Lawyers Have Blogs reports on the phenomenal growth of blog s from 2003 through 2006 and looks to the past to try to stay ahead in the future.

Jim Calloway provides a link to some great common sense tips for appellate lawyers at his Law Practice Tips Blog.

ork Bobs. Are your employees bobbing? In Employment Lawyers' Poll on Employee Blogging, Denise Howell looks at a recent survey by employment lawyers on employee blogging. Howell details the results of a poll by the Employment Law Alliance on "Blogging and the American Workplace." The survey revealed that work related blogs proliferate with at least 5% of U.S. workers blogging and 15% of U.S. employers having "specific policies addressing work-related blogging." Howell identifies potential pitfalls to the survey. For example, it may not address the vast gray area between "purely personal blogging" and "officially sanctioned blogging."

Opinionistas provides the perspective of an experienced executive legal secretary who anonymously blogs as Ramblings of a Green Yogurt.

lib lawyer life? You betcha. Evan Schaeffer's Legal Underground shows us our true colors by uploading a copy of the Coloring Book for Lawyers in Coloring Book Satirizes Lawyer's Glib Life.

For those of you practicing (or driving) in California be sure to stop by Declarations and Exclusions post, Dangling Propositions, looking at automobile insurance rate regulation under California Proposition 103.

Letter photos courtesy of Spell it with Flickr.

Next week's Bob Review will be hosted by Patrick Lamb over at In Search of Perfect Client Service, who recently discussed the personal approach to law firm branding. Patrick, next week inquiring minds will want to know? Where are you sporting the Butler Rubin Saltarelli & Boyd LLP logo?

Bob Review f/k/a
Blawg Review has information about next week's host, and instructions how to get your blawg posts reviewed in upcoming issues.

Monday, February 06, 2006

In The Round: Blawg Review #43

Blawg Review #43 is now in the round from prologue to epilogue at the Online Guide to Mediation. Diane Levine, this week's host of Blawg Review, has beautifully written, directed and staged this weeks edition of the legal blogging news for lawyers, law students, law professors and others.

Next week I will be hosting the weekly law blog carnival at the Health Care Law Blog. Already submissions have started to hit my in box. I'm looking forward to reading and weaving together all the submissions from legal bloggers and blawgers from around the world.

I'll depart with on of my favorite quotes from Hamlet:

"Words without thoughts never to heaven go."

Friday, February 03, 2006

Outsourcing West Virginia's Health Care

The Charleston Gazette reported on House Bill 4359 introduced yesterday by Delegate Canterbury (R-Greenbrier County). House Bill 4359 would allow state employees covered by the West Virginia Public Employes Insurance Agency (PEIA) to go to foreign hospitals for health care services, including surgery. Delegate Canturbury's proposed bill would allow the outsourcing of West Virginia health care in an attempt to introduce more competition into West Virginia's health care system. For more indepth info check out Del. Canturbury's website called www.competitionishealthy.com.

The Charleston Gazette article gave some interesting cost comparisons. For example, the article states that Bumrungrad International in Bangkok, Thailand, a resort-like foreign hospital, performs open heart surgery for under $8,000. The article also cites hospitals in India and Singapore.

The bill takes a unique approach in trying to increase the health care competition in the state of West Virginia and it will be interesting to watch the response by other health care industry groups in West Virginia. I'm especially intrigued by the provision that allows for a rebate of part of the savings directly to the patient/state employee. This type of provision provides a direct incentive for the patient/state employee to be involved in understanding the costs of their own health care.

This trend of overseas outsourcing continues to grow -- whether it be product manufacturing, medical dictation services, radiology services, engineering services, legal services - just to give a few examples. I've read a number of articles over the last year about the coming changes in the legal industry regarding lawyers services continuing to move overseas. It is a challenge that everyone in the service industry better start looking at and preparing for in the future. As Thomas Friedman would say, the world is becoming more flat and connected.

I'm interested to know whether any other state legislatures have introduced similar legislation and the impact the legislation has had on the health care system.

Below is a complete copy of HB 4359 as introduced:

(By Delegates Canterbury, Walters and Eldridge)
[Introduced February 2, 2006; referred to the
Committee on Banking and Insurance then Finance.]

A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-28, relating to establishing a system to reduce the cost of medical care paid by the Public Employees Insurance Agency by providing incentives to covered employees to obtain treatment in low cost foreign health care facilities accredited by the Joint Commission International .

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §5-16-28, to read as follows:

ARTICLE 16. WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.

§5-16-28. Authorization for treatment in foreign health care facilities accredited by the Joint Commission International (JCI); Incentives for covered employees; rebate of savings.

(a) Not later than the first day of July, 2006, the director shall establish a program of incentives for covered employees who elect to obtain medical care or medical procedures in health care facilities accredited by the Joint Commission International (JCI) when the cost of the medical care or medical procedure in the foreign health care facility is less than the cost of the medical care or medical procedure available in a health care facility in this country: Provided, That the difference in the cost of the foreign health care is equal to or greater than the total cost of the incentives.
The incentives shall include:
1. Waiver of all co-payments and deductible payments;
2. Payment of cost of round trip air fares for the covered employee and one companion;
3. Lodging expenses in the foreign country for the companion for the length of the treatment or procedure;
4. Lodging expenses in the foreign country for the covered employee and the companion for not more than seven days of convalescence after the treatment or procedure;
5. Payment to the covered employees hiring agency for seven days of paid sick leave which are not counted against the employees accrued sick leave; and
6. Rebate not more than twenty percent of the cost savings directly to the covered employee.

(b) The director shall establish a fund within the agency for the deposit of the remaining eighty percent cost savings. Not later than the first day of July of each fiscal year, the director shall rebate the moneys in the fund in equal amounts to each covered employee.

NOTE: The purpose of this bill is to provide a system to reduce the cost of medical care paid for by the Public Employees Insurance Agency by providing incentives to covered employees to obtain treatment in foreign health care facilities accredited by the Joint Commission International. Under the bill, if there are sufficient savings to do so, covered employees may choose to travel to foreign countries for medical care and treatment with the cost of travel, lodging and the treatment paid for by PEIA. In addition, PEIA would reimburse the employee twenty percent of any savings, pay for the lodging and travel cost of a companion, pay for the cost of lodging for seven days of convalescence and pay the employer for seven days of paid sick leave for the employee.

This section is new; therefore, strike-throughs and underscoring have been omitted.