…the approach favored by hospitals and physician advocates. The Senate Health Education, Labor & Pensions, House Energy & Commerce, and Education & Labor Committee bills all create a payment standard with a back up IDR process. The post identifies other key similarities and differences among the bills, and includes a comprehensive side-by-side comparison. You can read the full post here….
…the Public Charge Rule? (Disponible en español) Protect Immigrant Families: Specialized Resources for Advocates and Service Providers Protect Immigrant Families: Know Your Rights (Disponsible en español) The U.S. State Department applies different rules if you have your interview outside of the U.S. If this is the case for you, please talk to a qualified immigration lawyer, or visit https://www.protectingimmigrantfamilies.org/ for…
…with significant implications for state insurance regulation and the operation of the state-based marketplaces. Comments from the public, including state officials, are due by March 2. A detailed overview, identifying areas where states may wish to provide feedback, is available in an article for the Robert Wood Johnson Foundation’s State Health & Value Strategies project. You can find it here….
…the country. Researchers with the Urban Institute conducted a literature review and evaluated state efforts to introduce competition into provider markets and regulate prices. The report is broken up into three categories of state policy: Promoting transparency Regulating consolidation and promoting competition Overseeing and regulating prices What It Finds All-Payer Claims Databases (APCD), which aggregate claims data to inform policymakers…
…dispute occurs, even if it is ultimately resolved, it puts the consumer in a difficult position of not knowing whether they can schedule or seek care at a facility due to uncertainty that the facility may no longer be covered in-network. Though provider networks are constantly changing, these disputes can make it harder for consumers to select the health plan…
In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. These bills often arise when consumers unexpectedly receive out-of-network care, either in an emergency or while undergoing treatment at an in-network facility. When an insurer and provider don’t have an existing contract, the insurer might pay less than the provider asks for, and the…
…during the 2019 state legislative session. Five other states – Colorado, Maryland, Nevada, New Mexico, and Oregon – tasked agency officials or independent commissions to study and/or develop a Medicaid buy-in or public option program. These states share common goals, such as improving the affordability of insurance, reducing the uninsured, and offering consumers more plan choices. The states also share…
…establishment of waiver-supported reinsurance programs, financial incentives for individuals to maintain coverage, and increased oversight of skimpy, short-term insurance products. In a new brief for the Commonwealth Fund, we update our analysis with attention to state efforts to strengthen individual market coverage in 2019 and policy changes contemplated for the year to come. You can access our full analysis here….
…part of your annual physical, the insurance company cannot impose cost-sharing for either the physical or the cholesterol abnormalities screening. Note, however, that the law covers preventive care and if there is a medical reason for a service, then you may have some cost-sharing requirements. Take the previous example with the man 35 and older, if he goes into his…
…has the legal authority to investigate issues related to air ambulance billing practices and they have a complaint portal available for patients. Though DOT received only 24 complaints related to air ambulance billing in 2018 and 34 in 2019, committee members generally agreed that this is most likely because patients are not aware of the complaint portal. At the same…
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.
