…phenomenon, but this study demonstrates that it can be a contributing factor. As policymakers debate how to improve our health care system in the United States, they can now point to clear evidence that comprehensive health insurance saves lives. Becker T and Babey S. Persistent Gap: Gender Disparities in Health Insurance and Access to Care in California. UCLA Center for…
…limits and deductibles) and treatment limitations (both quantitative and non-quantitative) that apply to MH/SUD can be no more restrictive than those that apply to other medical services. The premise of MHPAEA is straightforward, but ensuring that insurers are complying with parity requirements can be complex. While certain financial requirements and quantitative limits are relatively simple to compare, non-quantitative limits like…
…an out-of-network physician at an in-network facility. If the health plan does not cover this out-of-network care or pays only a portion of the charge, providers will often bill the patient for the balance. These “balance bills” can sometimes be in the thousands of dollars. Many proposed policies to protect people in these situations have bipartisan support, but disagreements between…
…industry. We’ll be looking to see if House and Senate leaders can come to agreement on the best way to settle payment disputes between doctors and insurers. It will have to happen early in the year if it’s going to happen at all. We’ll also be watching recommendations due from a U.S. Department of Transportation Advisory Committee on out-of-network air…
By Jack Hoadley, Beth Fuchs, and Kevin Lucia In September, we wrote about the state of play for federal legislation on surprise medical bills. At the time, two bills had emerged from congressional committees: S. 1895, approved by the Senate Committee on Health, Education, Labor, and Pensions (HELP), and H.R. 2328, approved by the House Energy and Commerce (E&C) Committee….
…plan. The return of lifetime and annual dollar limits on insurance coverage. The end of the cap on consumers’ annual out-of-pocket costs for health care services. The end of cost protections for seniors with Medicare prescription drug coverage. The end of minimum standards for insurance companies, including essential health benefits. For the last three years, President Trump and Republican congressional…
…trust accounts so they weren’t commingled with an administrator or sponsor’s other funds, or correcting plan documents and notices to ensure rights and benefits required under federal law were available and properly communicated to plan participants. DOL district and regional offices typically opened these investigations not because of complaints, but as part of broader sweeps looking at certain types of…
…It noted that in some areas, its competitors are simply “better positioned” and it, therefore, will not enter markets where it cannot offer the most competitive product. This aligns with previous findings suggesting that insurers’ marketplace participation is sometimes dependent on providers’ willingness to contract at a favorable price. It’s Business as Usual While Public Policy Changes Remain Up in…
…company must receive and process your payment at least one day before coverage begins. Make sure you understand your insurance company’s payment requirements and deadlines and follow them so your coverage begins on time. Your enrollment in the health plan is not complete until the insurance company receives your first premium payment. Note that since June 19, 2017, insurers can…
…consumers, and prevent balance billing. On September 13, 2019, DOT announced the formation of the committee and its 13 members. The committee is scheduled to convene early next year but progress has been slow and, as mentioned, the committee’s power is limited to offering recommendations. This year, Congress has yet another opportunity to more directly and definitively fix the issue…
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.
