Medical Coding And Billing Online

Changes To Healthcare Laws

President Obama has recently proposed changes to his signature healthcare reform law in order to fix some of its important issues and to check the insurer exits from the marketplace exchanges. CMS Acting Administrator, Andy Slavitt said in a blog post that the proposals makes exchanges an attractive place to do business and removes “potential obstacles to issuers growing their business and entering more markets.”

A 300-page policy brief was released by the Obama Administration as a direct response towards critiques from politicians, media, health insurers, and the public in general. The proposed amendment aims to increase enrollment, balance the risk pool more efficiently, and make participation in the exchange markets more profitable and easier for the insurers.

It is expected that the proposed rule will bring out the following changes.

  • The present rule, that does not allow insurers to enter the exchange marketplaces for five years in case they exit a marketplace, will be removed.
  • The method of calculation of medical loss ratios will be restructured. It will help in determining whether to allocate the user fees to outreach efforts.
  • Space for creative design of the insurance products by insurers will be created.
  • Proof of eligibility for enrollees in Special Enrollment Period will be strengthened.
  • New channels for users to enroll will be opened.
  • More consumers turning 65 will be encouraged to shift to Medicare.
Medical Billing Outsourcing

Affordable Care Act Changes

Oscar Insurance Corp., UnitedHealth, Aetna, and Scott & White, have said that they will eliminate or reduce their ACA exchange offerings in 2017 significantly. Mario Schlosser, Oscar CEO said that, “The individual market isn’t working as intended and there are weaknesses in the way it’s been set up.”

Besides that, comments on the proposals marking it as inadequate have already been raised. A healthcare expert, Bryan Rotella, from the Rotella Legal Group said in a press release that, “Health and Human Services, along with the Centers for Medicare & Medicaid will be the governmental arms moving to implement the Administration’s proposed changes. From a legal and practical perspective, the changes are all likely too little, too late.”

“The Obamacare ‘product’ has a highly negative stigma with the consumers it needs most: young, healthy Americans currently without insurance or those under their parent’s or an employer’s plan. Throwing more tax dollars or fidgeting with timing of enrollment doesn’t cure the law’s underlying illness that it is dependent on the healthy to compensate for the sick,” Rotella added.