On October 29, 2020, the Departments of Health and Human Services (HHS), Treasury, and Labor issued the “transparency in coverage” final rule. This rule imposes new requirements on group health plans to disclose cost-sharing estimates at the request of an enrollee and publicly release negotiated rates for in-network providers, historical out of network allowed amounts [...]
With many patients still worrying about contracting COVID-19 by visiting a doctor or pharmacy, large healthcare organizations are sponsoring ad campaigns encouraging people to return to their medical providers. Print ads, TV commercials and social media ads tell people that returning to their doctor for regular checkups, emergencies or diagnostic tests is not only important, [...]
In 2017, according to the Centers for Medicare and Medicaid Services, healthcare spending for every man, woman and child in the U.S. totaled nearly $11,000 – more than any other wealthy country. The interesting thing is that very few of us really know what goes into this number or who pays the bills. Here are [...]
In a recent decision by the U.S. District Court for the District of Columbia, the AHA lost its bid to avoid having to disclose rates hospitals negotiate with insurers. While an appeal is expected, this is a win for the administration, which is committed to providing patients with understandable information about the cost of medical [...]
Inflation-adjusted limits for contributions to health savings accounts and high deductible health plans for the coming year were just announced. According to the announcement, eligible individuals with self-only HDHP coverage will be able to contribute $3,600 to their HSA in 2021, an increase of $50 from 2020. Those with family coverage will be able to [...]
With nearly 40 million workers laid off or furloughed as a result of the Coronavirus, many organizations have urged Congress to expand COBRA coverage. Most of their concerns are focused on encouraging Congress to subsidize COBRA premiums for these workers so that existing health conditions will not get worse because care is delayed. To date, [...]
In late January 2020, The Department of Health and Human Services (HHS) issued a public health emergency declaration. Several payment policies and regulatory adjustments are attached to the public health emergency, including the Medicare inpatient 20% add-on payment, Medicaid matching rates, requirements that insurers and health plans cover COVID-19 testing without cost-sharing, and waivers of telehealth restrictions. [...]
To help consumers compare the different features of health benefits and coverage, the Affordable Care Act requires all group health plans and health insurance companies to provide individuals a “summary of benefits and coverage” that “accurately describes the benefits and coverage under the plan.” The SBC is a snapshot of a health plan’s costs, benefits, [...]
There is little doubt that the COVID-19 pandemic has taken a toll on the mental well-being of many Americans. In addition to dealing with fear of the virus and social isolation, economic pressures have continued to grow. Many who have continued to work have been forced to balance working remotely with caring for children who [...]
After the repeal of the Affordable Care Act’s Individual Mandate, which was effective January 1, 2019, several states began the process of implementing statewide individual mandates. Currently there are six states that have passed some form of the individual mandate. To date, California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont have [...]
