Category: Health reform

I’ve been calling for greater private insurance coverage of COVID-19 testing. I’ve been wrong

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As the nation combats the biggest threat to its public health and economy that any of us have seen in our lifetimes, the key to recovery will lie in widespread, universally accessible testing for COVID-19. In a recent blog post for Health Affairs, CHIR’s Sabrina Corlette argues that our traditional, insurance-based model of financing health care services won’t work if we want to use testing to help us get back to work, schools, and community life.

The Provider Relief Fund: How Well Does it Protect Patients from Surprise Medical Bills for COVID-19 Related Services?

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The $175 billion Provider Relief Fund prohibits participating providers from balance billing COVID-19 patients, regardless of their source of coverage. While this could help many patients avoid surprise medical bills, there remain several questions about the scope of protection this will provide. In an update to his April 30, 2020 post, Georgetown expert Jack Hoadley takes a look at the fine print of the program as well as new guidance from HHS.

When Things Fall Apart: A Roadmap for State Regulators Managing Fallout from Provider-Payer Contract Disputes

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High profile contract disputes between insurers and providers appear to be on the rise, raising the risks of disruptions for patients and unexpected out-of-network billing. In a new report for the Robert Wood Johnson Foundation, CHIR experts examine best practices among state regulators and insurers to protect consumers and provide recommended policies and procedures to mitigate risks when a provider leaves a health plan network.

Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?

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The cost of medical care associated with the novel coronavirus can be a barrier for many people who should get tested, raising a public health risk. Given our patchwork quilt system of health insurance coverage and the lack of a timely and comprehensive federal response, CHIR’s Sabrina Corlette and Kevin Lucia consider actions states can take to encourage people to get the care they need.

How States Are Using Independent Dispute Resolution to Resolve Out-of-Network Payments in Surprise Billing

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As Congress and a number of states craft legislation to protect consumers from surprise out-of-network billing, a critical issue is resolving how insurers will pay out-of-network providers for their services. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley and Maanasa Kona assess the experience of states that use an independent dispute resolution process to determine these payments.

Addressing Surprise Billing by Setting Payment Standards for Out-of-Network Providers

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The thorniest issue in pending legislation to protect consumers from surprise medical billing is how to resolve disputes between payers and providers over appropriate payment. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR experts Maanasa Kona, Jack Hoadley, and Katie Keith examine the seven states that have adopted a payment standard for out-of-network bills.

Update on Federal Surprise Billing Legislation: New Bills Contain Key Differences

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Congressional leaders are racing to meet a self-imposed May deadline for passing legislation to protect consumers from surprise medical billing. In their latest post for the Commonwealth Fund’s To the Point blog, Jack Hoadley, Beth Fuchs, and Kevin Lucia identify key similarities and differences among competing proposals, and provide a comprehensive side-by-side guide to the key committee bills.

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.