Lawmakers and regulators should increase their oversight of commercial health plans and enact fair and patient-friendly reforms, writes AHA President and CEO Rick Pollack in an advertorial published today in the Wall Street Journal. 

“Major commercial insurers have implemented a number of policies that compromise patient care, access and safety,” he writes. “These include frequent changes to coverage, limited provider networks, delays in authorizing treatment and failure to pay providers in a timely manner. … These policies blindside patients and put their health at risk. They also add billions of dollars in added costs to the health care system and contribute to clinician burnout.”

For example, the advertorial highlights recent AHA efforts to prevent UnitedHealthcare from retroactively denying coverage for some emergency department care and Anthem from delaying payments to hospitals, and support for bipartisan legislation to require Medicare Advantage plans to approve coverage for care in a timely manner and policies to protect patient access to specialty drugs. 

Headline
The Centers for Medicare & Medicaid Services March 6 issued guidance to states on transitioning to six-month Medicaid redeterminations in 2027, a change…
Headline
Republican leaders on the House Committee on Energy and Commerce March 5 announced they were expanding their ongoing investigation into waste, fraud and abuse…
Headline
The Centers for Medicare & Medicaid Services has released a toolkit that outlines strategies for states to strengthen access to behavioral health services…
Headline
The Centers for Medicare & Medicaid Services Feb. 25 released a request for information on potential regulatory changes in a possible future…
Headline
The AHA commented today on the Centers for Medicare & Medicaid Services’ proposed rule on the Global Benchmark for Efficient Drug Pricing Model, or…
Headline
The AHA Feb. 17 submitted a comment letter responding to the Centers for Medicare & Medicaid Services’ proposed rule that would prohibit hospitals…