Punching Stupid and Evil in the Face Since 1986!

"We are on strike, we the men of the mind. We are on strike against self-immolation. We are on strike against the creed of unearned rewards and unrewarded duties."-John Galt

Friday, December 13, 2013

HHS wants insurers to cover people who have a plan in their basket-no payment required

There is no doubt they're doing this so they can release supercalifragilisticexpialidocious numbers on enrollment in ObamaCare before the end of the year. Otherwise, the enrollment numbers are abysmal.
More specifically, the Department of Health and Human Services will now pressure health insurers to retroactively accept payment for coverage that was supposed to begin on January 1, even if no payments have been made and no coverage has been formally granted. Furthermore, HHS wants insurers to pay out-of-network providers as though they were in-network “to ensure continuity of care for acute episodes,” and to pay for refill prescriptions under previous plans.”
In other words, if you applied for Obamacare, have not been enrolled, have not paid a dime, and get sick on January 1, the Obama administration now wants insurance companies to pay for your care before you ever pay a dime. Furthermore, they want you to get care for which you will not be approved under your insurance plan.
 After I read through the document, it's clear what they are trying to do. With the extended coverage they are encouraging insurers to provide (i.e: out-of-network benefits, extended drug coverage) they don't want consumers to realize the full amount of coverage they are actually going to lose in this process. By hiding exactly what doctors or medications are out of reach in these new plans for the first 30 days, and having insurers in the Exchanges can wait to get the money, HHS is buying time. Insurers can wait to inform (by covering them for the first 30-days) consumers that their preferred doctors or life saving drugs are not covered-and consumers will have plans that don't meet their needs. It delays, until 30-days after the first of the year, the outrage that people will have when the full impact of this legislation begins to hit the masses. I'm sure it is the hope of the Administration that this will spread out the pain out enough that media coverage will not make it look so bad. And, it puts insurers in the position of waiting to receive payment on insurance plans that are most likely covering only the sickest and most needy patients.

Exit question-Since when is it ok for the government to tell companies you must provide service to consumers even though they've made no effort to pay? How about if I start ordering from Amazon with a promise to pay within the next 30-days....how about the government orders that mandate.

No comments:

Post a Comment