…alternative drug that must be tried first – would be ineffective, cause harm, or affect patient compliance with the prescription treatment. And finally, CMS strongly encourages plans to allow the consumer to have access to the medication in dispute as the exceptions process is underway, and, if coverage is granted, to continue to allow the consumer access to the drug…
…brief for the Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette find that consumers nationwide will enjoy improved protections in each area targeted by the reforms. The analysis also shows that some states already have embraced the opportunity to customize their markets by implementing consumer protections that go beyond minimum federal requirements. These findings suggest that states likely will…
…released guidance describing the types of state restrictions that, because they prevent assisters from complying with their federal responsibilities, violate federal law. In a new post for The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss these new federal rules and analyze how they may affect state efforts to regulate assisters. You can read the full post here….
On behalf of the O’Neill Institute for National and Global Health Law at Georgetown University, I’m pleased to invite interested faculty, practitioners, students and fellow wonks to participate in our O’Neill Institute Summer Program on US Health Reform – The Affordable Care Act. The Summer Program will be a one-week intensive from July 21-25, exploring US health care and coverage…
The Commonwealth Fund, in collaboration with the Society of American Business Editors and Writers (SABEW), presented its one-hour webinar on the Affordable care Act’s Small Business Health Options Program, known as SHOP. Moderated by Sara Collins of The Commonwealth Fund, CHIR’s Sarah Dash and Kevin Lucia joined John Arensmeyer of the Small Business Majority, Mila Kofman of the DC Health…
By Sabrina Corlette, JoAnn Volk, Robert Berenson and Judy Feder Twelve percent of the complaints to California’s Department of Managed Health Care this year relate to access to care problems. In New Hampshire, consumers were upset to learn that their local hospital had been excluded from the network of the sole insurance company participating on the state’s health insurance marketplace….
…not comply with ACA protections that went into effect in 2014, through 2017. Most, but not all, states have embraced the extension, including a number of states that have changed their original position and are now allowing renewals of noncompliant policies. In the latest blog post for The Commonwealth Fund, Kevin Lucia, Sabrina Corlette, and Ashley Williams document states’ decisions…
The Center for Consumer Information and Insurance Oversight (CCIIO) released last week a new tool to help consumers determine whether they qualify for a special enrollment period (SEP) to sign up for a plan in the federally facilitated marketplace. This screener tool, along with recent rulemaking that allows people to enroll in a marketplace plan 60 days before the expected…
…like insufficient resources for comprehensive reviews and limited clinical expertise among form reviewers. The general agreement among the regulators we have worked with, that it will be difficult to detect discriminatory designs created by savvy insurance company policy developers during the form review stage, will result in the reliance on “back end” regulation – complaints, complaint trends, and information uncovered…
By Cathy Hope, Georgetown University Center for Children and Families A new PerryUndem survey commissioned by Enroll America and funded by the Robert Wood Johnson Foundation and the California Endowment contributes new information to the discussion about the Affordable Care Act. It’s a fairly extensive survey and I encourage you to read it in full if you have time. What…
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.
