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‘no’ may not mean ‘no’ for health insurers
under new health reform provisions
By Steve Anderson
healthinsurance.org editor
July 23, 2010
When you start talking about the recently passed health reform legislation, there’s a good chance you’re headed for an argument. But it’s hard to see how anyone – other than health insurance companies – could argue against the consumer protection provisions announced by the Obama Administration yesterday.
Anyone who’s fought it out with an insurance carrier over denial of a claim – and anyone who’s ever prayed they wouldn’t have to fight that fight – will breathe a sigh of relief over the regulations, which give patients a process to appeal health plan decisions in every state. “No” from an insurer may not ultimately mean “no.”
More importantly, the regulations ensure that a patient’s care has to be covered for the duration of an appeal.
But that’s not all. The latest provisions of the health reform legislation also provide funding for a Consumer Assistance Program that actually aids consumers in appealing health plan decisions. That – and the CAP will also steer consumers away from trouble in the first place by helping them choose from a range of coverage options that meet their individual needs before they buy.
You might say these new rules are just what the patient ordered.
Tags: consumer protections, health care, health insurance, health reform, Patient Protection and Affordable Care Act, President Barack Obama
Editor's Note: Opinions expressed on these pages are those of the individual author(s) and do not necessarily reflect the views of the management or ownership of healthinsurance.org™.
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