Most (53%) adults with health care debt say they have received a medical or dental bill they thought contained an error at some point in the past 5 years, and most say a state consumer assistance program would be helpful to them.
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This Policy Watch takes a look at employers ability to access abortion information when their health plan covers abortion services. With some states criminalizing entities who assist in abortions, employers and providers face legal jeopardy and existing privacy laws such as HIPAA (the Health Insurance Portability and Accountability Act) may be limited in their privacy protections.
Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why
Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act…
This analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS) finds that 18% of in-network claims were denied by healthcare.gov marketplace insurers in 2020, with denial rates varying widely from less than 1% to more than 80%. Consumers appealed just over one-tenth of 1% of those denied claims.
This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.
This Policy Watch gives an overview of employers offering to cover travel expenses for workers who need to go out of state for an abortion in the context of increasing restrictions on abortion around the country. We discuss who is offering these benefits, the implications for workers, and some of the legal and political concerns for employers.
A new federal law provides new consumer protections against “surprise” medical bills beginning this year. Test your knowledge about its provisions with this 12-question quiz.
Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.
Less than a week after a new federal mandate to cover such products took effect, about half of the nation’s largest private insurers allow enrollees to directly obtain rapid at-home COVID-19 tests from specific sources without having to pay anything upfront, a new KFF analysis finds. The new coverage requirement…
This policy watch provides an early look at how top private insurers are implementing a new requirement to cover the cost of at-home COVID-19 tests. Initially about half offer a direct coverage option and half require an enrollee to pay upfront and then seek reimbursement.