- New rules by the Department of Health and Human Services would give $3.8 billion in low-interest loans to consumer-controlled health plans. HHS hopes that these consumer run plans (or “co-ops”) would concentrate on improving care and would bring needed competition to established insurers. Christopher Weaver, HHS Sets Rules For Consumer-Controlled Health Plans, Kaiser Health News, July 18, 2011.
- Starting in March 2012, all insurers and employers will have to provide information about their health plans in standardized “coverage facts labels” making it easier for consumers to understand and compare health plans. Susan Jaffe, Consumers Add Their 2 Cents to Health Law’s Plan Labels, Kaiser Health News, June 30, 2011.
- The Department of Health and Human Services weakened its proposed rules regarding a patient’s right to externally appeal health insurance decisions. Consumers will still have a right in all states to externally appeal a denial based on “medical judgment,” but not for other reasons such as a mistaken diagnosis coding or a denied request to see a specialist outside the insurer’s network. Also, patients will only have two months to appeal (versus four), insurers will have the option to hire their own consultants to handle the appeals (rather than an outside board), and these rules will not be effective until January 1, 2012. Amy Goldstein, Obama Administration Narrows Rules For Patient Health-care Appeals, The Washington Post, June 22, 2011.
- The Affordable Care Act provided funds to states to assist consumers with health insurance problems. Each state’s Consumer Assistance Program can be found at http://www.healthcare.gov/law/provisions/cap. In Michigan, the Michigan Health Insurance Consumer Assistance Program is run by the Office of Financial and Insurance Regulation and can be reached at (877) 999-6442.
Christopher W. Smith is an elder law attorney and elder mediator specializing in aging and special needs issues. He can be found at http://www.smithelderlaw.com and on Twitter @ElderPlanning. Christopher is licensed to practice law in Michigan and Indiana.