Health plan consolidation has been in the news lately. The Department of Justice is reviewing proposed mergers between major insurers Aetna/Humana and Anthem/CIGNA, as are a number of state insurance regulators. CHIR’s Emily Curran attended a recent forum airing different perspectives on the mergers, and shares this overview.
Federal health insurance officials and the NAIC have recently put forward proposals to protect patients when a doctor or hospital leaves their health plan’s network. Both are grounded in longstanding state standards, although the scope and strength of these laws vary widely. In their latest post for the Commonwealth Fund, Sabrina Corlette, Ashley Williams and Kevin Lucia share findings from a 50-state survey of continuity of care laws and assess how they compare to the federal proposal.
Although it’s a complicated law, there’s one thing about the ACA that’s not at all complicated: the requirement that insurers stop discriminating against sick people. Yet some insurance companies still appear confused by this rule. Sabrina Corlette looks at recent insurer attempts to discourage sicker, older people from enrolling in their plans – and the efforts of at least one state to combat them.
The deadline for having health insurance starting on January 1, 2016 is quickly approaching. Consumers who want marketplace coverage must enroll by December 15, 2015 for a January 1, 2016 effective date. CHIR summarizes what to do and highlights Frequently Asked Questions related to open enrollment.
At the NAIC’s most recent meeting, two issues stood out: the long-coming Network Adequacy Model Act was finally adopted, and regulators took another look at how insurers count costs for the Medical Loss Ratio. JoAnn Volk provides a summary of the action.
Out of frustration with insurance companies, physicians are increasingly turning to direct patient contracting, or “concierge” practices. For some patients these can be a great value, but the spread of these practices could also cause unintended harms. Georgetown medical student Josh Barrett blogs about the pros and cons – and the implications for aspiring doctors – in his latest post for CHIRblog.
As reports of patient encounters with unexpected provider bills continue to make headlines, state and federal policymakers are working to find solutions to the problem of surprise out-of-network billing. A recent Georgetown report on the issue caught the eye of two states – Pennsylvania and Florida – that are attempting to set new standards to protect consumers from balance bills. CHIR’s Ashley Williams shares a summary of what these states heard from our report’s lead authors.
The U.S. Department of Health and Human Services has finally released a long-awaited study comparing coverage in CHIP plans to qualified health plans offered through the Affordable Care Act marketplaces. Our colleague from Georgetown University’s Center for Children and Families, Elisabeth Wright Burak, takes a look and shares the (not altogether surprising) findings.
One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue.
A new proposed rule from the Obama Administration contains wide-ranging new requirements for insurance companies and marketplaces under the Affordable Care Act, including changes that expand the role of marketplace navigators. CHIR’s Sabrina Corlette shares some highlights.
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.
