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This week's health policy news was marked by new administration rules regarding the appeals process for denied health insurance claims and continuing state-level efforts to implement high risk pools.
The Obama administration issues regulations that will set some minimum requirements for the process, including allowing patients to appeal the insurer's decision to an independent outside panel.
The health overhaul prohibits new insurance plans from charging higher copayments or coinsurance amounts for out-of-network emergency services or from imposing other coverage limitations that wouldn't apply to in-network care.
This week, news outlets covered the Obama administration as it began implementing parts of the new health law and also unveiled a national HIV/AIDS strategy. And, Capitol Hill is still reacting to the president's recess appointment of Dr. Donald Berwick to head the agency overseeing Medicare and Medicaid.
Panel's recommendations on preventive care will determine which services are covered fully by insurance. That could make it a political lightning rod for lobbyists and disease advocates and conflict with its tradition of scholarly dedication to the science of randomized medical trials.
AHIP walks reporters through the process of how actual premiums are calculated for the individual and small group market.
Under the new health law, many insurers will have to publicly report how much they plan to raise premiums and why, but consumer advocates say draft rules on how much information is required to justify "unreasonable" increases fall short.
Democrats had hoped to extend health insurance subsidies for newly laid off workers, extend extra Medicaid payments to the states, and pass a long term Medicare 'doc fix' before the July 4 recess. But all they could accomplish was a short-term Medicare fix.
The new health law mandated that the government set up a website to help consumers understand all of their insurance options. The site, www.healthcare.gov, launched July 1.
The new health care law promises to make it easier for part-time workers to find and buy affordable coverage, starting in 2014. Until then, they don't have a lot of options.
The Department of Health and Human Services is facing July 1 deadlines for creation of high-risk pools to help individuals who have been without health insurance for six months or longer and a new web portal to provide consumers with information about health insurance plans.
A new federal website will give consumers a list of all private and government health care plans for individuals and small businesses in their areas. Insurers and advocacy groups are clashing over the data to be provided.
As Congress temporarily delayed the 21 percent Medicare pay cut to doctors, it failed to resolve the issue of COBRA benefits and Medicaid funding for hard-pressed states.
Good news and bad news for doctors who treat Medicare patients.
As he trumpeted what he called a new "Patient's Bill of Rights" Tuesday, President Barack Obama tried to calm fears that the new health law would increase insurance costs.
The White House today released a "Fact Sheet: The Affordable Care Act's New Patient's Bill of Rights," the Obama administration's summary of new regulations issued by the Department of Health and Human Services.
High deductible health plans and the associated health saving accounts that allow people to put aside money tax-free to cover medical expenses get mixed reviews from many consumers. But supporters of the plans worry that the health overhaul may hamper their use.
The President will also discuss the health law's new benefits, cost savings.
When the big California health insurer Wellpoint sought rate increases up to 39 percent this year, some wondered if they were unusual. But in a new national survey consumers who buy their own policies report the most recent rate requests averaged 20 percent.
The federal government is giving states until June 25 to say how they intend to run high-risk pools to insure people who have been denied coverage due to a pre-existing medical condition and have been uninsured for at least six months.
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