Government

House adopts health plan disclosure bill

The measure would prohibit insurers from enforcing exemptions that weren't spelled out in advance.

By Doug Trapp — Posted April 17, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Health insurers would be required to disclose coverage exemptions to employers and employees in easily understood language at the time that the coverage is purchased, according to a recently passed House bill.

The House adopted the Health Insurance Restrictions and Limitations Clarification Act of 2009 by a vote of 422-3 on March 31. A Senate version of the bill has not been introduced, but the legislation has been referred to the Senate Health, Education, Labor and Pensions Committee. The Senate did not act on an identical bill the House adopted unanimously in September 2008.

Rep. Michael Burgess, MD (R, Texas), the bill's sponsor, said insurers do not always clarify the types of activities that trigger health plan coverage exemptions. "Trip and fall at home and break your arm -- no problem. Get bucked off a horse while on vacation with the family and break your arm -- you may be slapped with the bill. This is simply unfair."

The measure would not allow health plans to enforce coverage exemptions unless the plans clearly disclose the exemptions ahead of time in writing. The bill would amend the Employee Retirement and Income Security Act of 1974, the Public Health Service Act and the Internal Revenue Code.

America's Health Insurance Plans has not taken a position on the bill. But AHIP spokesman Robert Zirkelbach said the organization supports "efforts to increase transparency so consumers know exactly what their plan covers."

A March 20 Congressional Budget Office estimate concluded that the measure would have negligible costs because the "issuers and sponsors of group health insurance plans generally make such information available and discuss plan information before and after enrollment."

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn