Critics Say Proposed Rule Would Make Millions Ineligible For Health Insurance Subsidies
The policy would have the greatest impact on women and children.
Physicians Wade Into Efforts To Curb Unnecessary Treatments
Nine groups list 45 practices they say are overused and may harm patients.
Employers Tie Financial Rewards, Penalties To Health Tests, Lifestyle Choices
Whether such programs spur long-term change is unclear, and some fear discrimination against those with chronic conditions.
Even Without The Individual Mandate, Health Law Would Still Affect Millions
KHN’s Julie Appleby reports that the health law is so comprehensive that even if the Supreme Court struck the insurance requirement, many provisions would survive.
Illustrating Illinois Insurance Coverage Before & After Health Law
Health care advocates in Illinois are marking the two-year anniversary of the 2010 health law with an interactive map that shows how two provisions – expansion of Medicaid eligibility and the creation of new insurance marketplaces called exchanges – could expand coverage to the state’s residents, some 13 percent of whom are currently uninsured. The map […]
Rules For New Insurance Marketplaces Give Insurers Clout
The long-awaited rules may disappoint consumer groups which had sought to reduce the clout of insurers on the governing boards.
N.Y. Governor Raps Insurers, Health Providers For ‘Unacceptable Opaqueness’ In Billing
Too often patients who thought they had all the right approvals from their insurers get hit with surprise bills for out-of-network medical costs, New York Gov. Andrew Cuomo says in a report that calls on insurers, doctors and hospitals to help craft reforms. Complaints about out-of-network costs were among the most common found in a state […]
Maine’s Top Court Backs State Authority To Limit Health Plan’s Profits
In a case closely watched by the insurance industry, Maine’s top court Tuesday upheld state regulators’ authority to hold down rate increases sought by Anthem Health Plans of Maine. In its ruling, the Supreme Judicial Court said that Maine’s insurance superintendent had “properly balanced the competing interests” in arriving at an approved rate increase of […]
Medicare Spends Less Than Private Insurers On Knee Replacements
Study finds that’s mostly because the government pays far lower rates for hospital care
Five Questions About The Health Law’s Mandate To Cover Birth Control
While controversy over one aspect of the Obama administration’s contraception rule
Consumers Hit By Higher Out-of-Network Medical Costs
Insurers switch to new way to calculate reimbursement that shifts more of the expenses onto patients.
Panel Sidesteps Controversy On Draft For Comparative Effectiveness Research
The Patient-Centered Outcomes Research Institute (PCORI) — created by the health law to help determine the most effective medical treatments — released its draft priorities and research agenda on Monday, but it did not single out any specific diseases, treatments or procedures to study. Instead, the nongovernmental institute that will oversee billions in research funding […]
A Health Exchange Progress Report, Sort Of …
They’re making progress! Well, at least 28 of them and the District of Columbia are. That was the main talking point from the White House this morning during a press briefing revolving around a report stating that 28 states are “on their way” to establishing new marketplaces, called exchanges, where consumers can begin to shop for health insurance […]
New Group To Set Priorities for Medical Effectiveness Research
Congress is betting more than $3 billion over the next decade that “comparative effectiveness” research can transform medical care by helping determine the best approach to a particular illness.
Feds Face Challenges In Launching U.S. Health Exchange
Technical, political and financial obstacles loom as clock ticks toward 2014 deadline for operations.
HHS Gives States Flexibility On Health Law’s ‘Essential Benefits’
States will be given wide latitude to decide what “essential benefits” insurers must offer in policies offered on new health exchanges come 2014, the Obama administration said Friday in a move that pushes off final federal rules on those benefits until sometime next year.
Blue Shield Of Calif., UCLA Tussle Over Rates
Blue Shield of California, which earlier this year pledged to cap its profits at 2 percent, took public Tuesday a contract dispute with UCLA Medical Center, which saw a nearly 17 percent operating margin this year. Unless the two can agree on contract terms by the end of the year, some Blue Shield customers who […]
Final Medical Loss Ratio Rule Rebuffs Insurance Agents
The Obama administration issued a rule today that is sure to disappoint insurance agents: Fees paid to brokers and agents won’t count as medical care, under limits imposed on insurers in the 2010 federal health law. That’s key because under the health law, insurers must spend at least 80 percent of their premium revenue on medical […]
Report: U.S. Outspends Other Countries On Health Care
We’re No. 1. In health spending. Again. The United States far outpaces other countries in how much it spends on health care, although Americans have a lower rate of doctor visits and hospitalizations than most of the other 34 member countries of the Organization for Economic Co-operation and Development. In its Health at a Glance […]
HHS Flags First ‘Unreasonable’ Premium Increase
Updated at 4:35 p.m. with comments from Everence. Everence Insurance of Pennsylvania on Monday became the first insurer flagged by federal regulators for having an unreasonable rate increase. The insurer, a for-profit arm of the Mennonite Church USA, raised rates starting in September by 11.6 percent for its ShareNet policies covering 4,800 people working for […]
