Is HHS Compromising with Insurers?
Pardon the football analogy, but it's fall:
It's fourth and ten and the Department of Health and Human Services (HHS) is just out of field goal range. They've been driving hard to an end zone with the words "Affordable Care Act" painted in big letters, but with a comfortable lead and plenty of time on the clock, the smart thing to do is, of course, to punt.
That's exactly what HHS did with the ACA's current 800-pound gorilla: ensuring children with preexisting conditions can get healthcare coverage.
In an October 13 letter from Secretary Sebelius to the National Association of Insurance Commissioners (NAIC), HHS attempted to stem the recent trend among healthcare payers to drop "child only" health plans by clarifying policies that aren't explicitly forbidden by the Act.
Among those clarifications, HHS says insurers are within their rights to (if permitted by state laws):
- Maintain separate "child-only" policies separate from closed policies;
- Penalize members that drop coverage and subsequently reapply;
- Set the number and length of open enrollment periods; and
- Adjust rates based on members' health status.
- CEO Exchange: Preparing for Population Health
- Advocate, NorthShore Deal Would Create 16-Hospital System
- Better HCAHPS Scores Protect Revenue
- Narrow Networks Cut Costs, Not Quality, Economists Say
- 3 Strategies for Retaining Millennial Employees
- Power of price: In South FL and the nation, healthcare costs often are shrouded in secrecy
- Two NY hospitals to offer free hip and knee replacement surgeries for qualifying patients in December
- Hospital mergers may lead to higher prices
- Healthcare data of 1 million NJ patients compromised since 2009
- CEO Exchange: Pressure is On to Partner, Drive Quality