Consumer Advocates Fear Health Law Will Favor Business
by Mary Agnes Carey and Marilyn Serafini
September 7, 2011
Publicly, consumer and patient advocates continue to cheer wildly for last year's health care law. Behind the scenes, however, some worry that they're losing a few key battles to the insurance and business communities.
They point to a long-sought provision in the law that entitles patients to external reviews if insurers won't pay for a medical service, and they charge that recent regulations limit its effectiveness. One of their biggest gripes? It allows insurers to choose their own "external" reviewers.Balber (Carmen Balber, the director of Consumer Watchdog's Washington office) complained that the administration had made the external appeals rule more business-friendly since its initial version was published last year. In the version released this year, a consumer's ability to file an "external appeal" shrank from four months to 60 days, and the scope of what could be appealed narrowed considerably.
It also limited appeals to quarrels that involve "medical judgment" or a rescission of coverage, when an insurer cancels coverage, said Stephen Finan, senior policy director for the American Cancer Society's Cancer Action Network. Those changes mean that patients won't be able to appeal anything that falls into the category of contractual disputes, such as whether a particular service or drug is covered, he said.
Read the full article at:
http://www.mcclatchydc.com/2011/09/07/123384/consumer-advocates-fear-health.html