Mississippi Insurance Commissioner
"We try to protect the consumer," Chaney said. "That's our mission."
Chaney is particularly concerned about the financial health of rural, independent hospitals.
"They serve a community that tends to be older, sicker and more dependent on public insurance programs than their urban counterparts," Chaney said. Because of declining reimbursements and increasing costs, these hospitals are particularly vulnerable.
"If you lose health care, you lose economic driver in the community," Chaney said.
It also can affect network adequacy requirements for insurers, potentially disrupting coverage across the state, Chaney said.
The insurance department also has been closely tracking regulatory developments on association health plans and short term plans. These plans are not subject to many Affordable Care Act requirements. Chaney had been particularly concerned about how the plans would be regulated.
New federal rules and orders have opened these to oversight by states. The association plans will have to include safeguards similar to large employer health plans, Chaney said.
"You will not see them in
With short term plans, it is important that consumers understand exactly what they are getting, Chaney said. These plans typically have limited if any coverage for pre-existing conditions, are not guaranteed issue and offer limited benefits and very narrow networks. However in a market where individual policies can be very difficult to purchase, they can serve a purpose, Chaney said.
Surprise medical bills
There is an increasing frustration with surprise medical bills, Chaney said. There is a state law prohibiting balance billing, where a medical provider accepts insurance assignment but bills patients above and beyond their obligations. However, federal law doesn't prohibit balance billing for self-funded health insurance plans, and there is bipartisan federal legislation in the pipeline to address the issue.
Although air ambulance providers have argued they are not subject to
There have also been problems with patients receiving bills from out-of-network providers when they've sought care at a hospital that is in their insurance network. Emergency departments and radiology have been the biggest trouble spots.
"We're going to take a pretty hard line," Chaney said.
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