Robust consumer protections are crucial in enhancing the value of health insurance by ensuring that health plans are fair, transparent, and provide meaningful coverage. Recent federal legislative and regulatory actions have expanded these protections in health care, and states are implementing their own reforms to protect people from common provider and insurance industry practices. These practices include routine claims denials or charging fees unrelated to a health care service, which can compromise affordability and undermine access to care.
The Center for American Progress will host an event on May 16, 2024, from 1:00 p.m. to 2:00 p.m. ET, focusing on state initiatives aimed at improving affordability through enhanced consumer protections. The topics will include equalizing payment rates across different settings (site-neutral policies), limiting prior authorization, and allowing consumers to apply cash price toward their insurance deductibles.
Dr. Deidre S. Gifford will discuss Connecticut’s regulation of facility fee billing, including the 2023 law (Public Act 23-171) that expands prohibition on facility fees on certain routine services provided at a hospital and grants the Connecticut Office of Health Strategy additional enforcement authority.
Jonathan Wolfson will present an overview of Cicero’s Patient’s Right to Save Act and its influence on Tennessee state law that allows insured individuals to pay cash prices for health care services and have the amount credited toward their plan deductible.
Minnesota state Sen. Kelly L. Morrison will discuss pending legislation (S.F. 3532) that would limit the use of prior authorization for several services—including mental health and substance abuse disorder treatment, cancer treatment, and certain preventive services—as well as limit prior authorization use for generic drugs and biosimilars.
The panelists include State Sen. Kelly Morrison, Assistant Majority Leader (D-MN); Dr. Deidre S. Gifford, MD, MPH, Senior Adviser to the Governor for Health and Human Services; Executive Director, Connecticut State Office of Health Strategy; and Jonathan Wolfson, Chief Legal Officer and Policy Director, Cicero Institute. The event will be moderated by Natasha Murphy, Director of Health Policy at the Center for American Progress.
For more information or to speak to an expert, please contact Sarah Nadeau at [email protected].
