Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations. Continue reading

Translating Coverage into Care: Answers to Common Post-Enrollment Questions

Open Enrollment has ended in the majority of states, and almost 8.5 million people signed up for coverage through HealthCare.gov. As consumers begin to use their 2019 plans, a host of questions about covered services, cost sharing, provider networks and more are sure to crop up. Luckily, CHIR has answers to frequently asked post-enrollment questions in our recently updated Navigator Resource Guide. Continue reading

Responding to the Opioid Crisis: Insurers Balance Stepped up Monitoring, Restrictions with Need for Appropriate Pain Treatment

The United States has an opioid epidemic, with an unprecedented number of opioid-related deaths in recent years. The rise in opioid addiction and overdose is further complicated by the need to effectively treat the approximately 100 million people living with chronic pain. In their latest issue brief for the Robert Wood Johnson Foundation, CHIR experts report on how insurers are responding to the opioid crisis while also meeting the needs of members living with chronic pain. Continue reading

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is. Continue reading

The ACA in 2014: Helping Consumers Transition to New Coverage

The start of 2014 marks the transition to new health plans that must meet ACA standards for adequacy and affordability. But, as with any transition, there can be disruptions, particularly for people who are in the middle of treatment or need drugs that may not be on a new plan’s formulary. HHS has recently released fact sheets and an interim final rule to help consumers and health plans make a smooth transition. JoAnn Volk has this overview – and answers some common consumer questions. Continue reading