Parity in Practice? Examining Requirements and Enforcement of the Mental Health Parity and Addiction Equity Act

Last fall, the Pennsylvania Department of Insurance documented that the UnitedHealthcare Insurance Company had committed several violations of the Mental Health Parity and Addiction Equity Act (MHPAEA). Other states are also increasing their oversight efforts. However, over ten years after the law was enacted, federal and state insurance regulators are still working to insure consumers have the protections promised under the law. CHIR’s Madeline O’Brien explains what MHPAEA is, how it is enforced, and recent CHIR efforts to support effective oversight. Continue reading

New Resource for Consumer Advocates on Out-of-Network Payment Disputes in Balance Billing Legislation

State lawmakers across the country are are gearing up for a new legislative session. Many will be considering state-level protections for consumers to prevent surprise out-of-network medical bills. Just as with the federal legislation, however, one of the key sticking points for state policymakers will be how to approach out-of-network provider reimbursement. To aid stakeholders in these efforts, Community Catalyst teamed up with CHIR experts to create a guide for its health insurance reform toolkit: The Advocate’s Guide to Addressing Out-Of-Network Payment in Surprise Balance Billing Legislation. Continue reading

5th Circuit Decision in Texas v. U.S. Prolongs Uncertainty for Health Care Consumers, Markets

Perhaps knowing their decision would sow consumer confusion and market uncertainty, the 5th Circuit Court of Appeals delayed its decision in the Texas v. U.S. litigation until after the close of open enrollment for Affordable Care Act (ACA) insurance coverage. CHIR’s Sabrina Corlette delves into the consequences of the long-awaited December 18, 2019 decision. Continue reading

Updates from the MEWA Files: The Good, the Bad, and the Ugly of Federal Enforcement Efforts

Last week, CHIR alumna Christine Monahan walked through common types of misconduct documented in the U.S. Department of Labor’s (DOL) investigative reports and case files relating to multiple employer welfare arrangements (MEWAs), including association health plans (AHPs). In this third post in our series, she shares what these records show about DOL’s enforcement efforts and the harms that can result from lax MEWA regulations. Continue reading

Insurers Report on Their Q3 Financial Earnings: Marketplace Profitability, Retail Partnerships, and More

Last month, health insurers reported on their third-quarter (Q3) financial earnings, offering insights on their yearly performance to date and commenting on the market and regulatory challenges they see ahead. CHIR reviewed the quarterly filings and earnings call transcripts for seven publicly traded health insurers, and found that many continue to experience financial stability in the individual market and are closely monitoring major policy changes that could have an impact on their businesses moving forward. Continue reading

Protecting Patients from Air Ambulance Surprise Balance Bills – Where Are We Now?

A recently released report by the Health Care Cost Institute finds that the average price of an air ambulance trip has increased significantly from 2008 to 2017, a Department of Transportation advisory commission is studying the industry’s billing practices, and legislation is pending in Congress to protect patients from surprise bills sent by air ambulance companies. CHIR’s Maanasa Kona and Sabrina Corlette provide an update on the recent activity. Continue reading