Next stop for Medicare for all: June 12. That’s when the House Ways & Means Committee will hold a Medicare for all hearing, marking the first time such a proposal is heard by a committee that actually has jurisdiction over health care. While a hearing is a long, long way from federal policy changes, the move is seen as a win for the House Congressional Progressive Caucus.
Need More Medicare for All Insight?
If you want to know more about how experts believe Medicare for all (or similar bills) could change how Americans receive health care if enacted, take a listen to The Dose, a Commonwealth Fund podcast.
STOP Surprise Medical Bills Act Receives Bipartisan Support
The STOP Surprise Medical Bills Act looks to be a point of agreement for many. The act now has 21 Senate cosponsors and has also received positive feedback from advocacy groups representing patients, health care providers and insurers. Take a look at the list of cosponsors: U.S. Senators Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Todd Young (R-IN), Maggie Hassan (D-NH), Lisa Murkowski (R-AK), Tom Carper (D-DE), Dan Sullivan (R-AK), Sherrod Brown (D-OH), Kevin Cramer (R-ND), Ben Cardin (D-MD), John Kennedy (R-LA), Bob Casey (D-PA), Joni Ernst (R-IA), Sheldon Whitehouse (D-RI), Mike Braun (R-IN), Bob Menendez (D-NJ), Lindsey Graham (R-SC), Jacky Rosen (D-NV), Cindy Hyde-Smith (R-MS), Tina Smith (D-MN) and Rob Portman (R-OH).
Among the patient, provider and insurer groups supporting the act:
- Alliance for Aging Research
- American College of Emergency Physicians
- America’s Health Insurance Plans
- American Society of Anesthesiologists
- American Kidney Fund
- Children’s Brain Tumor Foundation
- Cutaneous Lymphoma Foundation
- GO2 Foundation for Lung Cancer
- Mended Hearts
- Mended Little Hearts
- National Alliance on Mental Illness
- National Coalition on Health Care
- National Patient Advocate Foundation
- National Osteoporosis Foundation
- Partners for Better Care
- Physicians for Fair Coverage
- Prevent Cancer Foundation
What Does STOP Surprise Medical Bill Act Cover Though?
From cosponsor Senator Bill Cassidy’s website:
The STOP Surprise Medical Bills Act addresses three scenarios in which surprise medical billing (also known as “balance billing”) would be prohibited:
- Emergency services: The bill would ensure that a patient is only required to pay the in-network cost-sharing amount required by their health plan for emergency services, regardless of them being treated at an out-of-network facility or by an out-of-network provider.
- Non-Emergency services following an emergency service at an out-of-network facility: This bill would protect patients who require additional health care services after receiving emergency care at an out-of-network facility, but cannot be moved without medical transport from the out-of-network facility.
- Non-Emergency services performed by an out-of-network provider at an in-network facility: The bill would ensure that patients owe no more than their in-network cost sharing in the case of a non-emergency service that is provided by an out-of-network provider at an in-network facility. Further, patients could not receive a surprise medical bill for services that are ordered by an in-network provider at a provider’s office, but are provided by an out-of-network provider, such as out-of-network laboratory or imaging services.
Providers would automatically be paid the difference between the patient’s in-network cost-sharing amount and the median in-network rate for these services, but providers and plans would have the opportunity to appeal this payment amount through an independent dispute resolution process, should they see fit. This “baseball-style” process would entail the plan and provider submitting offers to an independent dispute resolution entity that has been certified by the Secretaries of HHS and the Department of Labor. This entity would make a final decision based upon commercially-reasonable rates for that geographic area.
The patient is completely removed from this process between the provider and the plan, and regardless of any outcome from a dispute resolution process, the patient still only owes the in-network rate. States that have established an alternate mechanism for protecting patients and determining payment amounts for providers would be able to continue with those systems.
Inland Empire, Orange County and San Diego Associations of Health Underwriters are teaming up to host the Sixth Annual Senior Summit at Temecula’s Pechanga Resort August 28-29. The two-event is billed as the largest AHU Medicare event in the country and will include keynote speakers, breakout sessions, continuing education, networking opportunities and much more. Early bird pricing is in effect until Aug 1: $79 for members, $99 for nonmembers.
Lawmaker Interested in LTC Benefit for Medigap Plans
Something to watch: House Ways and Means Committee Chairman Richard Neal, D-Mass., has reportedly contacted the National Association of Insurance Commissioners asking for ideas on how lawmakers could create a long-term-care benefit for Medigap plans. The lawmaker also asked for recommendations on keeping plans affordable while ensuring strong coverage. Medigap enrollment and design vary substantially among states, and some states have enabled use of plans for long-term-care coverage.
Guardian Announces Accident Insurance That Delivers Industry-First Injury-Free™ Benefit and Rainy Day Fund
Accident insurance helps offset the expense of injuries requiring treatment that insureds might normally have to cover out-of-pocket to meet their plans’ deductible. Now Guardian has unveiled an industry-first: accident insurance that now includes money back if employees go injury-free for five years and payment for treatments that might normally exceed policy limits. Guardian’s accident insurance now features:
- Injury-Free Benefit™ pays the employee a cash benefit if their family is claim-free for five years. Guardian will pay the benefit even if there are wellness and/or concussion baseline study claims filed during this period.
- Rainy Day Fund pays up to $500 annually to cover costs that are insurable by an individual policy but are not covered by the policy due to limitations, like frequency of follow-up visits or physical therapy sessions, over a defined period of time. For any amount unused over the course of the year, up to half of the original fund will be carried over to the next year, up to a limit of $1,000.
The company says the new features, a response to consumer demand, offer those covered a return on investment.
IICF Women in Insurance Global Conference
June 12-14, 2019, New York City
NAHU Annual Convention –We’ll see you here!
June 29-July 2, Sheraton San Diego Hotel & Marina
Keynote speaker is Retired Master Sergeant Cedric King. Sessions focus on practical solutions for your business, including retaining today’s new workforce, buying or selling your agency, data transparency and alternative healthcare management. And there’s an expanded Medicare Extreme! with proven practices and important trends on changes in Medicare, technology solutions, growing your business with group Medicare sales plus more. Plus plenty of opportunity to visit with a variety of vendors and network with colleagues More info here.
Association of Health Underwriters Senior Summit– We’ll see you here!
The Sixth Annual Senior Summit sponsored by the Inland Empire, Orange County and San Diego Associations of Health Underwriters is the largest AHU Medicare event in the country. Keynotes, breakout sessions, CE and much more. Early bird pricing in effect until Aug 1: $79 for members, $99 for nonmembers.
NAAIA National Conference
Sept 11-13, Atlanta- SAVE THE DATE!Leaders from across the insurance and financial services profession will come together at this high energy industry event to further the education, advancement and uplifting of African American insurance professionals. More info soon at www.naaia.org.
Alliance of Comprehensive Planners 2019 Annual Conference
Nov. 12-15, Hyatt Regency Mission Bay, San Diego
The Alliance of Comprehensive Planners (ACP) is a community of tax-focused financial planners who provide planning strategies for clients on a fee-only retainer basis. Conference early bird registration rates (which expire Oct. 11, 2019) are in effect now. Participation is open to all interested financial professionals. Companies interested in sponsoring the ACP Annual Conference should contact Jill Colsch at email@example.com. The agenda is available here: https://2019.acplanners.org/home. More info here.