Original source: https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2019/05/10/the-relationship-between-network-adequacy-and-surprise-billing/
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Brookings Institution (05/10/19) Young, Christen Linke; Adler, Loren Adler; Ginsburg, Paul B.; et al..
As policymakers address the issue of surprise out-of-network statements, some are examining network adequacy regulation as a potential solution. Network adequacy criteria demand network plans to demonstrate they’ve contracted during their service region with sufficient providers. Back in 1996the National Association of Insurance Commissioners adopted its Network Adequacy Model Act, which has formed the basis for many regulation. Network adequacy policies are agnostic about which provider is in-network, and their goal is to make sure that customers can get the services their insurance plan claims to pay. Other potential strategies to curb balance billing comprise”billing regulation,” which places a minimum rate for out-of-network services which insurers are required to pay to providers, along with”contracting law,” which prohibits facility-based emergency and ancillary suppliers from billing separately to insurers or patients and instead receive payment directly from the facility…. Read More
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Original source: https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2019/05/10/the-relationship-between-network-adequacy-and-surprise-billing/
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Brookings Institution (05/10/19) Young, Christen Linke; Adler, Loren Adler; Ginsburg, Paul B.; et al..
As policymakers address the issue of surprise out-of-network statements, some are examining network adequacy regulation as a potential solution. Network adequacy criteria demand network plans to demonstrate they’ve contracted during their service region with sufficient providers. Back in 1996the National Association of Insurance Commissioners adopted its Network Adequacy Model Act, which has formed the basis for many regulation. Network adequacy policies are agnostic about which provider is in-network, and their goal is to make sure that customers can get the services their insurance plan claims to pay. Other potential strategies to curb balance billing comprise”billing regulation,” which places a minimum rate for out-of-network services which insurers are required to pay to providers, along with”contracting law,” which prohibits facility-based emergency and ancillary suppliers from billing separately to insurers or patients and instead receive payment directly from the facility…. Read More
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Original source: https://www.wabe.org/georgia-gets-anthem-to-pay-disputed-bill-still-plans-hearing-on-complaints/
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WABE.org (05/14/19) Miller, Andy
Georgia officials have declared that Anthem Blue Cross and Blue Shield has agreed to pay the $87,000 in exceptional medical bills of a Newnan cancer patient, who had surgery to remove a tumor in an kidney. Late last year when she signed up for this coverage, piedmont Newnan Hospital was listed as part of the network of this insurance plan, along with the Anthem site revealed Piedmont Newnan within her network as recently as a month past. But, Anthem initially refused to cover her expenses, saying that Piedmont Newnan was not a network centre and that her operation was not a crisis. Georgia Insurance Commissioner Jim Beck stated,”It’s always satisfying when we could help a consumer break through bureaucracy and find the life-saving therapy they want and deserve. I’m especially proud of Matthew Padova, one of our latest Consumer Services Researchers, whose decision to see the consumer treated rather was a significant element of the successful outcome.” Associated Story: Marietta Daily Journal… Read More
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Original source: https://www.wabe.org/georgia-gets-anthem-to-pay-disputed-bill-still-plans-hearing-on-complaints/
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WABE.org (05/14/19) Miller, Andy
Georgia officials have declared that Anthem Blue Cross and Blue Shield has agreed to pay the $87,000 in exceptional medical bills of a Newnan cancer patient, who had surgery to remove a tumor in an kidney. Late last year when she signed up for this coverage, piedmont Newnan Hospital was listed as part of the network of this insurance plan, along with the Anthem site revealed Piedmont Newnan within her network as recently as a month past. But, Anthem initially refused to cover her expenses, saying that Piedmont Newnan was not a network centre and that her operation was not a crisis. Georgia Insurance Commissioner Jim Beck stated,”It’s always satisfying when we could help a consumer break through bureaucracy and find the life-saving therapy they want and deserve. I’m especially proud of Matthew Padova, one of our latest Consumer Services Researchers, whose decision to see the consumer treated rather was a significant element of the successful outcome.” Associated Story: Marietta Daily Journal… Read More
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Original source: http://news.ambest.com/newscontent.aspx?refnum=217037
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BestWire (05/10/19) Darragh, Timothy
Talking before Pennsylvania’s House Insurance Committee, Insurance Commissioner Jessica Altman advised lawmakers it is possible to operate a state-based health insurance exchange, cut premiums by 5 percent to 10%, and spend only what the federal government spends to run it today. Altman said,”Since 2014, one thing has fundamentally shifted: the access to already-developed and proven technology” She also added that Pennsylvania can learn from the experiences of New Jersey, New Mexico, Oregon, and Nevada, which can be transitioning to their exchanges. Altman stated Pennsylvania insurers are sending roughly $88 million a year to the national government to run the trade, along with a conservative estimate suggests its currency could run . The section used a study modeling the effect of a reinsurance plan by management consulting company Oliver Wyman on the market…. Read More
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Original source: http://news.ambest.com/newscontent.aspx?refnum=217037
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BestWire (05/10/19) Darragh, Timothy
Talking before Pennsylvania’s House Insurance Committee, Insurance Commissioner Jessica Altman advised lawmakers it is possible to operate a state-based health insurance exchange, cut premiums by 5 percent to 10%, and spend only what the federal government spends to run it today. Altman said,”Since 2014, one thing has fundamentally shifted: the access to already-developed and proven technology” She also added that Pennsylvania can learn from the experiences of New Jersey, New Mexico, Oregon, and Nevada, which can be transitioning to their exchanges. Altman stated Pennsylvania insurers are sending roughly $88 million a year to the national government to run the trade, along with a conservative estimate suggests its currency could run . The section used a study modeling the effect of a reinsurance plan by management consulting company Oliver Wyman on the market…. Read More
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Original source: http://feeds.lexblog.com/~r/propertyinsurancecoveragelaw/YZft/~3/sHhAf6oIXW4/
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“Oh, Boy!” Was my initial thought after reading a situation which holds those arbitration agreements requiring policyholders to arbitrate in far-away places could not be halted by law. This should prevent, and say legislators should write those insurance carriers who sell policies that are such to be banned by laws. Let us be honest and agree…… Continue Reading
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… Read More
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Original source: http://feeds.lexblog.com/~r/propertyinsurancecoveragelaw/YZft/~3/sHhAf6oIXW4/
I run around the world wide web everyday to make you to realize to the betterment of having a Property Damage Adjustment Consultant there to assist you. Read this web post we located.
“Oh, Boy!” Was my initial thought after reading a situation which holds those arbitration agreements requiring policyholders to arbitrate in far-away places could not be halted by law. This should prevent, and say legislators should write those insurance carriers who sell policies that are such to be banned by laws. Let us be honest and agree…… Continue Reading
. … Read More
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Original source: http://www.mpbonline.org/blogs/news/2019/05/14/mississippi-hospitals-pushing-for-a-plan-to-reform-medicaid/
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Mississippi Public Broadcasting (05/14/19) Ellis, Jasmine
The Mississippi Hospital Association is pushing for a strategy, Mississippi Cares, that could reform Medicaid from the nation, allowing the working poor to acquire more powerful accessibility to health care and participants to cover about $20 a month or less premiums. But, Mississippi Insurance Commissioner Mike Chaney says that he has not been able to talk with anyone noting the association hasn’t been obvious about where the money would come in to pay the costs. “It is ill-timed for them to come out with a proposal with a fresh legislature being chosen and a without a new governor in office,” said Chaney. “The legislature is the one that must give permission to this Mississippi Cares group to form a company that could offer insurance for $20 a month.”… Read More
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Original source: http://www.mpbonline.org/blogs/news/2019/05/14/mississippi-hospitals-pushing-for-a-plan-to-reform-medicaid/
Our intent is to browse the net effortlessly to make you to realize to the importance of getting a Property Damage Adjustment Consultant on your team. Take a minute to read this article we ran across.
Mississippi Public Broadcasting (05/14/19) Ellis, Jasmine
The Mississippi Hospital Association is pushing for a strategy, Mississippi Cares, that could reform Medicaid from the nation, allowing the working poor to acquire more powerful accessibility to health care and participants to cover about $20 a month or less premiums. But, Mississippi Insurance Commissioner Mike Chaney says that he has not been able to talk with anyone noting the association hasn’t been obvious about where the money would come in to pay the costs. “It is ill-timed for them to come out with a proposal with a fresh legislature being chosen and a without a new governor in office,” said Chaney. “The legislature is the one that must give permission to this Mississippi Cares group to form a company that could offer insurance for $20 a month.”… Read More
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Original source: https://stjohnsource.com/2019/05/13/lack-of-insurance-options-turns-many-into-health-care-gamblers/
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St. John Source (05/13/19) Akin, Bernetia
A current University of the Virgin Islands research indicates that 30 percent of the land’s population isn’t covered with a job-related group program and isn’t eligible for both of the stopgap national government plans: Medicare or Medicaid. Virgin Islands Lt. Gov. Tregenza Roach, who also serves as the land’s Commissioner of Banking and Insurance, says his office does not dispute the 30 percent estimate. “That’s the identical figure we have been using at the legislature,” he states. Roach adds,”I don’t believe we could require individuals to keep (person ) insurance” when there aren’t any providers offering it. The manager, Gwendolyn Hall Brady of the division and both Roach, state the government is working with a single company that might provide individual medical insurance to attempt and expand coverage and are currently in discussions with carriers…. Read More
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Original source: https://stjohnsource.com/2019/05/13/lack-of-insurance-options-turns-many-into-health-care-gamblers/
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St. John Source (05/13/19) Akin, Bernetia
A current University of the Virgin Islands research indicates that 30 percent of the land’s population isn’t covered with a job-related group program and isn’t eligible for both of the stopgap national government plans: Medicare or Medicaid. Virgin Islands Lt. Gov. Tregenza Roach, who also serves as the land’s Commissioner of Banking and Insurance, says his office does not dispute the 30 percent estimate. “That’s the identical figure we have been using at the legislature,” he states. Roach adds,”I don’t believe we could require individuals to keep (person ) insurance” when there aren’t any providers offering it. The manager, Gwendolyn Hall Brady of the division and both Roach, state the government is working with a single company that might provide individual medical insurance to attempt and expand coverage and are currently in discussions with carriers…. Read More
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Original source: https://www.wdsu.com/article/check-your-flood-insurance-before-hurricane-season/27456536
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Insure U … Read More
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Original source: https://www.wdsu.com/article/check-your-flood-insurance-before-hurricane-season/27456536
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Insure U … Read More
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Original source: http://feeds.lexblog.com/~r/propertyinsurancecoveragelaw/YZft/~3/9o9l839tuN4/
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I had hardly finished my speech with Nicole Vinson at the Georgia Association of Public Insurance Adjusters (GAPIA) Spring Conference this morning when news broke Jim Beck, Georgia’s Insurance Commissioner had been indicted at a 38-count criminal complaint for a deceptive plot involving insurance inspections and bills. It alleged that Beck, a former insurer…… Continue Reading
… Read More
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Original source: http://feeds.lexblog.com/~r/propertyinsurancecoveragelaw/YZft/~3/9o9l839tuN4/
All of the time we access the web nonstop to guide you to understand to the importance of getting a Public Adjuster on your team. Look at this article we ran across.
.
I had hardly finished my speech with Nicole Vinson at the Georgia Association of Public Insurance Adjusters (GAPIA) Spring Conference this morning when news broke Jim Beck, Georgia’s Insurance Commissioner had been indicted at a 38-count criminal complaint for a deceptive plot involving insurance inspections and bills. It alleged that Beck, a former insurer…… Continue Reading
… Read More
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Original source: http://news.ambest.com/newscontent.aspx?altsrc=23&refnum=217048
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BestWire (05/13/19) Kiriluk-Hill, Renée
The U.S. House approved a $19.1 billion emergency spending bill that also extends the National Flood Insurance Program (NFIP) before the end of this fiscal year on Sept. 30. If accepted, it would be the 11th no-change NFIP expansion because September 2017, says that the National Association of Insurance Commissioners (NAIC). The NAIC supports long term reauthorization — for at least 10 years — to avoid uncertainty in the housing and insurance markets. Allocate disaster recovery money for these things as assistance and infrastructure developments for farmers and the House voted to temporarily expand the NFIP. The Federal Emergency Management Agency says it’ll overhaul the NFIP rate structure to reflect human property danger instead of place within a designated flood plain…. Read More
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Original source: http://news.ambest.com/newscontent.aspx?altsrc=23&refnum=217048
Our intent is to run around the internet each day to reach out to you to understand to the idea of keeping a Public Adjuster on your team. Read this story we ran across.
BestWire (05/13/19) Kiriluk-Hill, Renée
The U.S. House approved a $19.1 billion emergency spending bill that also extends the National Flood Insurance Program (NFIP) before the end of this fiscal year on Sept. 30. If accepted, it would be the 11th no-change NFIP expansion because September 2017, says that the National Association of Insurance Commissioners (NAIC). The NAIC supports long term reauthorization — for at least 10 years — to avoid uncertainty in the housing and insurance markets. Allocate disaster recovery money for these things as assistance and infrastructure developments for farmers and the House voted to temporarily expand the NFIP. The Federal Emergency Management Agency says it’ll overhaul the NFIP rate structure to reflect human property danger instead of place within a designated flood plain…. Read More
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Original source: https://home.treasury.gov/news/press-releases/sm688
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U.S. Department of the Treasury (05/13/19)
At the National Association of Insurance Commissioners’ (NAIC) International Forum,” Treasury Secretary Steven Mnuchin stated,”Treasury coordinates together with the nations, their insurance supervisors, along with the NAIC to a number of significant issues, ranging from our work with global standard-setting bodies to our government of the terrorism risk insurance plan. We are pleased to continue this productive relationship as we focus on the vital policies and issues — both domestic and global — facing the U.S. insurance sector. … With respect to our job in these global standard-setting bodies, the U.S. agents should advocate strongly and together for development of international standards that reflect the U.S. regulatory arrangement.” Among other things, he spoke three key regions of focus for Treasury on the Insurance Capital Standard frame, noting,”In this broader context of group capital, it is also important that the Federal Reserve along with the NAIC continue organizing and making improvements within their respective domestic group funding initiatives. … Progress on both these fronts may even help Team USA’s collective advocacy for our U.S. state-based system and regulatory approach at the [International Association of Insurance Supervisors].” Related Story: Politico Pro (subscription)… Read More
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Original source: https://home.treasury.gov/news/press-releases/sm688
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U.S. Department of the Treasury (05/13/19)
At the National Association of Insurance Commissioners’ (NAIC) International Forum,” Treasury Secretary Steven Mnuchin stated,”Treasury coordinates together with the nations, their insurance supervisors, along with the NAIC to a number of significant issues, ranging from our work with global standard-setting bodies to our government of the terrorism risk insurance plan. We are pleased to continue this productive relationship as we focus on the vital policies and issues — both domestic and global — facing the U.S. insurance sector. … With respect to our job in these global standard-setting bodies, the U.S. agents should advocate strongly and together for development of international standards that reflect the U.S. regulatory arrangement.” Among other things, he spoke three key regions of focus for Treasury on the Insurance Capital Standard frame, noting,”In this broader context of group capital, it is also important that the Federal Reserve along with the NAIC continue organizing and making improvements within their respective domestic group funding initiatives. … Progress on both these fronts may even help Team USA’s collective advocacy for our U.S. state-based system and regulatory approach at the [International Association of Insurance Supervisors].” Related Story: Politico Pro (subscription)… Read More
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