Category Archives: Regulatory

Work requirements may prompt more states to expand Medicaid

FROM AP via ABC News

In an ironic twist, the Trump administration’s embrace of work requirements for low-income people on Medicaid is prompting lawmakers in some conservative states to resurrect plans to expand health care for the poor.

Trump’s move has been widely criticized as threatening the Affordable Care Act’s Medicaid expansion. But if states follow through, more Americans could get coverage.

“I think it gives us a chance,”  Read More….

February Meeting Reminder

For those of you who have already responded regarding the meeting on February 8th Thank You!

The meeting and website overview will proceed as scheduled, but due to unforseen circumstances there will not be any CE.  We will discuss obtaining CE credits for this webinar at the meeting.

Don’t forget to RSVP if you haven’t already and if you have any questions at all please don’t hesitate to contact Jill Dear.

Take Action Now

Take Action

Last week, Senators Johnny Isakson (R-GA) and Chris Coons (D-DE) introduced S. 2303, joining Representatives Billy Long (R-MO) and Kurt Schrader (D-OR) who introduced H.R. 4575 last month. These bills would remove independent agent and broker compensation from the definition of “administrative expense” from the Medical Loss Ratio (MLR) calculation. The MLR regulation has caused carriers to reduce the commissions of agents and brokers, which has led to a reduction in consumer access to crucial services provided by insurance producers on a daily basis. Treating broker commissions as a pass-through expense will protect jobs and preserve the critical role of agents and brokers and ensure that insurers would be better equipped to compete in the marketplace.

NAHU has long advocated that the MLR should treat broker commissions as pass-through expenses for the following reasons:

  • Commissions are set by insurers but not paid by the insurers. Commissions are paid by the client and passed through carrier to the agent. While carriers currently collect agent compensation along with the regular premium, these funds are passed directly to the broker.
  • Commissions are paid to health insurance agents and brokers for the enrollment and on-going service they provide to consumers throughout the duration of their policy.
  • As a result of agent compensation being included in the cost of MLR, brokers servicing the individual and small business markets are seeing their compensation slashed by as much as 50%.
  • Individuals and employers across the country are relying on their health insurance agent to help them understand and comply with health reform for their business, their employees, and themselves.
  • The MLR has caused serious harm to the insurance market as it has inhibited the number of insurers willing to write health insurance in the individual and small-group markets.

Contact your senators and representative. Send an Operation Shout today asking your member of Congress to cosponsor H.R. 4575 and senators to support S. 2303! You can also call your legislators at the numbers below.

Take Action

Don’t want to send an email? No problem, you can also reach your senators by phone:
Rep. Larry Bucshon (R) can be reached at (202) 225-4636.
Sen. Joe Donnelly (D) can be reached at (202) 224-4814.
Sen. Todd Young (R) can be reached at (202) 224-5623.

Senate GOP tries one last time to repeal Obamacare

From Politico….

“Obamacare repeal is on the brink of coming back from the dead.

Senate Majority Leader Mitch McConnell (R-Ky.) and his leadership team are seriously considering voting on a bill that would scale back the federal government’s role in the health care system and instead provide block grants to states, congressional and Trump administration sources said. ”

Read More

 

 

Help Us Get the Medicare Observation Status Bill over the Line

NAHU works on a wide variety of Medicare issues from legislation to improved agent marketing and commissions, to COBRA as creditable coverage and restoration of the open enrollment period.

Earlier this month, NAHU sent letters of support to the lead sponsors of S. 568 and H.R. 1421, the Improving Access to Medicare Coverage Act of 2017. These bills address Medicare’s “two-midnight” policy and would allow observation stays to be counted toward the three-day mandatory inpatient stay for Medicare coverage of a skilled nursing facility (SNF).

Currently, Medicare beneficiaries who are not officially admitted to a hospital may be classified under “Observation Status,” which is treated as an outpatient procedure for billing purposes. Furthermore, admission status may be changed to observation by the hospital for up to a year following an SNF stay and they can negate the three-day-stay requirement after the fact.

These policies are leading patients who are extremely sick and need skill nursing care to not qualify for paid Medicare SNF care and for others to later have their admission status changed so that their SNF care is now billed directly to the beneficiary instead of Medicare, creating a huge financial burden. You may have clients who have gone this through this experience or know people who did. This is wrong and must be made right.

We need your help to educate other members of Congress on the importance these actions are having on your clients through no fault of their own. The bill already has 34 cosponsors in the House and 15 cosponsors in the Senate. You can help us increase our chances of having this bill become law by contributing to HUPAC today. Click here to take action now.

HUPAC is NAHU’s political action committee and helps us spread the message of the important role agents, brokers and benefit specialists play in the healthcare system and on behalf of the beneficiaries you serve. By contributing, you assist in our legislative efforts to build momentum behind this piece of legislation and improve our odds of this becoming law.

Contribute Now

Thank you for all you do!

John Greene
Vice President of Congressional Affairs

Senators hope to have their own partial health-care draft after next week’s recess – The Washington Post

Senate Republicans plan to return from a week-long holiday recess with a partial draft of a bill to reshape the nation’s health-care laws. But significant and persistent divisions in their ranks have cast the prospect of passing legislation into serious doubt after weeks of discussion.

Source: Senators hope to have their own partial health-care draft after next week’s recess – The Washington Post