As we enter 2022, consumers are now protected from many of the worst surprise medical bills. The No Surprises Act, enacted with bipartisan support, took effect on January 1. CHIR’s JoAnn Volk describes the new protections, and what patients should keep in mind if they receive care from out-of-network providers and hospitals.
In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas.
Open Enrollment has ended in the majority of states, and almost 8.5 million people signed up for coverage through HealthCare.gov. As consumers begin to use their 2019 plans, a host of questions about covered services, cost sharing, provider networks and more are sure to crop up. Luckily, CHIR has answers to frequently asked post-enrollment questions in our recently updated Navigator Resource Guide.
Summer is over, but health policy researchers have hardly taken a vacation. In August’s research round up, CHIR’s Olivia Hoppe looks into studies examining specialty drug coverage across commercial plans, the effects of the Affordable Care Act on people of different income levels, individual market premium predictions, employer-sponsored high-deductible health plans, and surprise medical bills in employer-sponsored insurance.
More often than not, air ambulance services are called in to serve people in severe physical distress who do not have the capacity at the time to provide consent. Yet many are later hit with huge surprise out-of-network charges for the flight. State departments of insurance and state legislators across the nation have taken notice of this issue and sought to protect consumers, but a federal law that has nothing to do with health care prevents them from regulating air ambulance providers. CHIR’s Maanasa Kona explains two potential federal remedies.
Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that could mean huge costs for plan participants. The new policy does not cover prescription drugs prescribed by out-of-network providers. How does this policy square with the ACA? And what does it mean for consumers? Elissa Dines discusses.
The start of 2014 marks the transition to new health plans that must meet ACA standards for adequacy and affordability. But, as with any transition, there can be disruptions, particularly for people who are in the middle of treatment or need drugs that may not be on a new plan’s formulary. HHS has recently released fact sheets and an interim final rule to help consumers and health plans make a smooth transition. JoAnn Volk has this overview – and answers some common consumer questions.
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.
