White House to address exchange plan provider directories, surprise medical bills
The Obama administration intends to fix two of consumers' biggest complaints about the Affordable Care Act, according to the New York Times: Inaccurate provider directories and surprise medical bills for treatment not covered by insurance.
The Centers for Medicare & Medicaid Services told the Times that the agency hopes to link Healthcare.gov to an out-of-pocket cost calculator later this year. Several state-run exchanges may follow suit.
Healthcare.gov shoppers struggle to determine their out-of-pocket costs in large part because the federal marketplace ranks plans based solely on premiums as opposed to total costs, the Times noted. This can leave consumers with surprise bills.
Meanwhile, the administration announced publicly its intention to force Healthcare.gov and Medicare Advantage insurers to update their provider directories on a monthly basis. CMS notified insurers earlier this year that it would tighten its provider directory rules for 2016.
Consumers and physicians alike have complained that provider directories "are almost out of date as soon as they are printed," Kevin J. Counihan, CEO of Healthcare.gov, told the Times. However, insurers say physicians themselves are partly to blame for directory issues, as they often stop accepting a particular plan but fail to inform an insurer.
The Obama administration's announcements come at a time when Democrats on Capitol Hill show increased willingness to compromise on other less-popular provisions of the ACA, the Hill reported.
A growing number of Democrats support bills that would do away with the medical device tax, roll back the Cadillac tax on high-priced insurance plans beginning in 2018 and repeal the ACA's 30-hour work week requirement, the article said. All efforts to tweak the healthcare reform bill are on hold, though, as the District of Columbia awaits a verdict in the King v. Burwell case challenging the federal subsidies for insurance acquired on the federal exchange.
King v. Burwell Supreme Court case: What you need to know [Special Report]
CMS tightens provider directory rules for 2016
Healthcare.gov shoppers struggle to determine out-of-pocket costs
Report: Marketplaces can do more to improve transparency
House passes bill redefining full-time work under employer mandate