By Patricia Boozang, Sabrina Corlette, Ashley Traube, and JoAnn Volk, Manatt Health and Georgetown University’s Center on Health Insurance Reforms Behavioral health challenges have grown considerably during the COVID-19 pandemic. At the same time, federal, state, and local policymakers increasingly recognize the need for alternatives to law enforcement-driven responses to behavioral health crises. While the American Rescue Plan Act of…
…patients from receiving surprise medical bills. These bills can occur when individuals receive emergency care from an out-of-network facility or provider, or when an individual gets non-emergency care at an in-network facility but receives some services during their stay from an out-of-network provider. For example, an individual may schedule surgery with an in-network surgeon at an in-network hospital, but the…
…try to seek care, when it may be too late to enroll. Additionally, because people of color are more likely to experience employment or housing volatility due to structural racism, these individuals are more likely to suffer coverage losses resulting from any data shortfalls. Automating enrollment. To reduce the number of people who start but do not complete the transition…
…14 percent incidence rate of post-COVID conditions to the CDC’s current data on reported COVID-19 cases by age, approximately 3.5 million non-elderly adults—can experience fatigue and physical weakness, chest pain, cough or shortness of breath, difficulty concentrating and memory problems, anxiety or depression, and other physical, cognitive, emotional, and neurological complications. Patients who are older or have pre-existing conditions are…
…providers. However, as of July 2021, only 6 percent of hospitals had fully complied; another study found that, as of March 2021, only 33 of 100 randomly sampled hospitals had reported their payer-specific negotiated rates. Bipartisan committee leaders on the Hill have urged the Centers for Medicare and Medicaid Services (CMS) to do more to enforce the transparency requirements. CMS…
…also plans to increase its call center capacity, will invest in more support for the processing and resolution of data-matching issues (DMI) as well as getting call center representatives up to speed on the impact of the ARP. Oregon’s marketplace also plans to develop new training materials related to the ARP for call center staff. Takeaway The ARP’s subsidy expansions…
…percent of respondents who were not aware of opportunities for marketplace coverage and report speaking Spanish at home, some state-based marketplaces like California are expanding communications and outreach to Latino communities by increasing funding for multilingual marketing campaigns. At the federal level, the new Champions for Coverage program harnesses the organizing power of trusted community advocates to build awareness and…
By Dania Palanker and Kevin Lucia When people shop for health insurance online, internet searches often direct them to websites using misleading or deceptive practices to steer consumers to plans that are not compliant with the Affordable Care Act (ACA). These include plans lacking key ACA protections, such as coverage of pre-existing conditions. While research has called attention to the…
…the data on air ambulance services that must be reported to HHS and the Department of Transportation (DOT) and discusses the departments’ proposed approach to NSA enforcement. Beyond the NSA provisions, the proposed rule also provide guidance on new federal requirements that individual market and short-term plan insurers disclose broker compensation to current and potential enrollees as well as to…
…and in a format that can be analyzed. However, many hospitals have yet to comply with the new transparency requirements, and the data they have posted has in some cases been hidden from web search engines or provided in a format that makes analysis difficult. We wanted to gain insights into the potential for this data and generate ideas for…
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