Taking a Look at ACA Non-Discrimination Rules: When Does Medical Management Cross the Line?

The ACA prohibits benefit limits and cost sharing that discriminate against individuals based on health status and other factors, but federal rules also stress that insurers can continue to use reasonable medical management, which would allow benefit limits based on certain circumstances. JoAnn Volk looks at what this may mean for regulators and consumers trying to tell the difference.
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Big Data and Baby Steps: Two Very Different Approaches to Data Collection

Most Americans see the need for more data about health insurance and how it’s working for consumers, and the insurance industry itself seems to recognize the importance of collecting and analyzing data. But it’s not clear that our government regulators do. JoAnn Volk looks at the mismatch between what insurers are undertaking and what federal rules will require for data collection. Continue reading

The NAIC’s Summer Meeting: Updating Network adequacy and ACA Transparency Requirements

The National Association of Insurance Commissioners (NAIC) has been hard at work updating a model state law governing the adequacy of health plan provider networks and revising the ACA-mandated summary of benefits of coverage for consumers. JoAnn Volk serves as a consumer representative to the NAIC and shares details from their recent national meeting as well as upcoming activities. Continue reading