HHS Scales Back Rules For Patient Health Care Appeals
The Obama administration announced Wednesday that it was scaling back its earlier-released rules regarding consumers' right to appeal health plan care denials.
The Wall Street Journal: HHS Delays Rules On Consumer Appeals By Six Months
The Obama administration on Wednesday delayed a piece of the health overhaul designed to help consumers appeal insurance-claim denials. The 2010 health law requires insurance companies to offer an explanation when they refuse to pay a claim and grant consumers an internal and external review of such a denial. States are expected to handle the review, and if they don't, the federal government will step in to do it (Adamy, 6/22).
The Washington Post: Obama Administration Narrows Rules For Patient Health-Care Appeals
The Obama administration tinkered on Wednesday with recent rules that provide patients more clout in disputes with health insurers, altering the standards in ways that disappointed leading advocates for health-care consumers. The rules are intended to guarantee patients nationwide the same rights to appeal if their insurers do not cover care that they consider necessary. The federal standards, part of the 2010 law to overhaul the health-care system, replace a patchwork of separate state policies. The rules allow patients to protest to their health plans and, if that does not work, to take their complaints to an outside arbiter (Goldstein, 6/22).
Kaiser Health News: HHS Scales Back Rules On Health Insurance Appeals
The Obama administration announced Wednesday that it is scaling back some of its earlier rules under the 2010 health law that governed consumers' right to appeal denials by health plans, disappointing patient advocates and earning praise from industry groups (Jaffe, 6/23).
Modern Healthcare: Feds Ease Deadline For State Consumer-Protection Standards
Federal regulators are pushing back a deadline for states to establish consumer protection standards for health plan denials, appeals and independent reviews. States will now have until Jan. 1, 2012, to approve legislation that complies with these standards, instead of the original deadline of July 1 of this year, according to an amended interim final rule released by the CMS (PDF). CMS officials said the deadline changed because states and health plans needed more time to establish these standards (Vesely, 6/22).
The Associated Press: Govt Sets Consumer Rights In Health Care Disputes
The Obama administration says most Americans will soon have the right to appeal to a third party referee when their health insurer denies a claim for a medical service. The rules released Wednesday carry out provisions of President Barack Obama's health care law. Insurers generally give customers a couple of chances to appeal internally, but access to outside review varies. Consumer groups say it's a move in the right direction, just not far enough. For example, advocates wanted 24-hour turnaround in cases involving urgent care, and the rules allow up to 72 hours (6/22).