Tag: medical management

COVID “Long Haulers” Can Carry Additional Burden of Getting Insurers to Cover Care

COVID-19 survivors may experience new symptoms well after their initial infection. Health systems offer these patients help with managing their conditions, but COVID-19 is a novel disease, and research demonstrating effectiveness of treatments for many post-COVID conditions is sparse. Karen Davenport takes a look at some of insurance implications of the dearth of information on “long COVID.”

This Tax Filing Season, Many Will Spend their Refunds on Health Care

As tax filing season comes to a close, CHIR’s Emily Curran discusses recent findings by the JPMorgan Chase Institute showing that many will spend their tax refunds on health care. The findings are consistent with other trends showing that as out-of-pocket costs increase, individuals defer medical care, which can lead to serious health and financial consequences.

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.

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.

New Federal Guidance Helps Protect People from Discrimination in Benefit Design

In response to actions by some health plans to impose benefit-specific waiting periods for coverage of serious health conditions, such as organ transplants, the Obama Administration recently issued guidance to prohibit the practice and protect consumers from discriminatory benefit design. Georgetown Law Center’s Sandy Ahn reviews the new guidance and the impact for consumers in this guest post.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.