Health Insurers Have Been Breaking State Laws for Years: ProPublica/Daily Kos
- ProPublica, Nov.16, 2023. Ed. - States have passed 100s of laws to protect people from wrongful insurance denials. Yet from emergency services to fertility preservation, insurers still say no.
-----
In North Carolina, lawmakers outraged that breast cancer patients were being denied reconstructive surgeries passed a measure forcing health insurers to pay for them. In Ariz., legislators intervened to protect patients with diabetes, requiring health plans to cover their supplies. Elected officials in more than 12 states, from Okla. to Calif., wrote laws demanding that insurance companies pay for emergency services.
In the last 4 decades, states have enacted hundreds of laws dictating precisely what insurers must cover so that consumers aren’t driven into debt or forced to go without medicines or procedures. But health plans have violated these mandates at least dozens of times in the last 5 years. In the most egregious cases, patients have been denied coverage for lifesaving care.
A recent ProPublica investigation traced how a Michigan company would not pay for an FDA-approved cancer medication for a patient, Forrest VanPatten, even though a state law requires insurers to cover cancer drugs. The expensive treatment offered him his only chance for survival. The father of 2 died at age 50, still battling the insurer for access to the therapy. Regulators never intervened. These laws don’t apply to every type of health plan, but they are supposed to provide protections for tens of millions of people.
AHIP, a trade group that used to be known as America’s Health Insurance Plans, said new mandates are costly for consumers and states, “tie insurers’ hands and limit plan innovation” by requiring specific benefits. Nevertheless, its members take steps to make sure they are following these mandates, the trade group said. State insurance depts. are responsible for enforcing these laws, but many are ill-equipped to do so. The state agencies oversee all insurance - for cars, homes and people’s health. Yet they employed less people last year than they did a decade ago.
Their 1st priority is making sure plans remain solvent; protecting consumers from unlawful denials often takes a backseat...
More, https://www.propublica.org/article/health-insurance-denials-breaking-state-laws
----------
- 'Health Insurers Have Been Breaking State Laws for Years,' ProPublica for Daily Kos, Nov. 19, 2023,
https://www.dailykos.com/stories/2023/11/19/2206516/-Health-insurers-have-been-breaking-state-laws-for-years
= new reply since forum marked as read
