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Insurance coverage mandates coming from feds and states
The healthcare reform law requires insurers to implement new preventive benefits, but some states also are moving forward with new coverage requirements of their own. Effective Sept. 23, new health plans and plans that make changes will have to offer their non-Medicare enrollees free preventive care at no additional charge (i.e., no co-pay or deductible), reports the New York Times. Insurers will have to wait for the federal government to write the regulations that will implement the law to find out exactly which plan changes will trigger the new preventive services. However, all Medicare beneficiaries, including those who don't change plans, will be eligible for new preventive serves on Jan. 1, 2010. Exactly which preventive services insurers will have to offer still awaits the input of the Department of Health and Human Services. However, the services will be based on the recommendations of the United States Preventive Services Task Force.
On the state side of the coverage equation, Virginia Gov. Bob McDonnell signed a new telemedicine mandate into law, making Virginia the 11th state to require health insurers to cover telemedicine physician visits the same way they cover regular office visits, reports the Bristol Herald Courier. And in Illinois, the state legislature isn't content to wait for the 2014 implementation of new federal rules that would require most health plans to cover medical costs associated with clinical trials. House Bill 5085 would bring Illinois in line with about 30 other states, expanding insurance coverage related to clinical trials for cancer treatments, as well as making oral chemotherapy drugs more affordable, reports the State Journal-Register. The bill passed unanimously in the state house and is currently pending in the senate.
To learn more about federally mandated prevention benefits:
- read the New York Times article
- review the U.S. Preventive Services Task Force's recommendations
To learn more about state activities:
- read the Bristol Herald Courier article
- read the State Journal-Register article
Related Articles:
State lawmakers approve insurance mandate for telemedicine
Health reform's financial implications: HFMA details the issues
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