Holding Insurance Companies Accountable: The Importance of a Good Appeals Process
Inclusion of a fair and expeditious appeals process that holds health insurance plans accountable is a very important component of the Affordable Care Act.
Inclusion of a fair and expeditious appeals process that holds health insurance plans accountable is a very important component of the Affordable Care Act.
As the primary season heats up, we have heard some outrageous things from the Republican candidates. One of their favorite targets for shockingly false and misleading statements is the health care law.
Health insurance is simply out of reach for many Americans. While many jobs offer it, many don’t. Without an offer of coverage from their employer, workers have to navigate the individual market on their own. And it’s tough—especially for those with pre-existing conditions. If they even get an offer of coverage (which they often don’t), it is likely too expensive.
The health care law gives us new tools to protect consumers who are looking for health insurance in the private market. One of those tools is "rate review". Starting September 1, 2011, in every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. These increases are then reviewed by independent experts to determine whether they are reasonable - providing unprecedented transparency and easy-to-understand information about why insurers are seeking increases.
Today, we received two updates on health insurance premiums. The Kaiser Family Foundation’s annual survey on health insurance looked back at the premiums insurers charged businesses and families in 2011, while the Office of Personnel Management looked ahead to 2012 and provided some important insight into the premiums large employers are negotiating with insurers for the coming year.
The Institute of Medicine (IOM) recently released its recommendations on which services should be added to the list of preventive services new insurance plans must offer at no cost to the patient under the Affordable Care Act.
Since the passage of the health reform law, prevention has become a much talked about issue. We all know that a lot of pain, suffering, and money could be saved with good prevention strategies, but the big question is: Will prevention for women be taken seriously?
Groucho Marx once said, “Those are my principles. If you don’t like them, I have others.” Who knew Groucho was a Republican presidential candidate?
A new poll commissioned by NC Policy Watch from Public Policy Polling has some startling news for state legislators who are going to be voting on House Bill 115 today. H115 creates a new health exchange/marketplace in NC under the new national health reform law. Unfortunately, this bill was written by the health insurance industry and puts health insurers on the board of this exchange so they can “regulate” themselves
Today, judges of the United States Court of Appeals for the Fourth Circuit in Virginia will hear arguments in two cases challenging the constitutionality of the Affordable Care Act. In the first case – Liberty University v. Geithner – a district judge previously found that the law was constitutional. In the second case – Commonwealth of Virginia v. Kathleen Sebelius – a different district judge issued a very narrow ruling on the constitutionality of the health reform law’s “individual responsibility” provision but upheld the rest of the law. Both cases are today being argued on appeal.
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