Hospital, Doctor Groups Say New Rules Needed To Protect Consumers From Surprise Bills
The American Hospital Association and the American Medical Association, responding to a proposed federal rule, said the government is not yet providing enough protection for patients against charges they receive when they get care from providers who are not in their insurers' network. Also, in the news, UnitedHealthcare is trying to keep confidential some information it gave the government about rivals' proposed mergers.
Providers Say CMS Needs To Push Plans Harder To Prevent 'Surprise Bills'
Providers say the CMS isn't doing enough to protect consumers from receiving surprise bills and ensuring low-income exchange enrollees have access to care. Surprise medical bills come when consumers get care at an in-network facility by an out-of-network specialist. Many times this happens because their insurer hasn't properly informed its customers. In a proposed rule that outlines coverages policies for plans in 2018, the CMS suggested that plans should count enrollee cost sharing for care provided by an out-of-network provider at an in-network facility toward the enrollee's annual deductible . The agency proposed the policy for plans both and off the exchange. CMS received 664 comments on the proposed rule by its Oct. 6 deadline. (Dickson, 10/10)
The CT Mirror:
UnitedHeathcare A Player In Insurance Merger Lawsuits
UnitedHealthcare, the nation’s largest health insurer and former potential suitor to merge with Cigna, provided the Justice Department with a large amount of sensitive, proprietary and confidential information to help the government investigate and block the mergers by its rivals. In filings in the DOJ’s antitrust lawsuits against the mergers of Anthem-Cigna and Aetna-Humana, UnitedHealthcare said “the sweeping scope of the DOJ’s concurrent investigations required United (Healthcare) to produce extensive, highly confidential documents and data." It is now trying, so far unsuccessfully, to prevent its rivals from gaining access to that information in court. (Radelat, 10/10)