The insurers are hoping that if they voluntarily provide more price transparency in the way they want to, they can convince the Trump administration to abandon its proposal that would force them into it. In other news from the health industry: middle-aged Americans worry about costs, how some patients are setting their own terms when it comes to surprise medical bills, and an update on the Theranos fraud case.
Modern Healthcare: Insurers Counter CMS Transparency Rule With Price Estimator Initiative
Hoping to deflect the Trump administration’s proposed price transparency rule, the Alliance of Community Health Plans is calling for expanding and certifying voluntary price estimator tools offered by health plans. On Tuesday, the trade group for not-for-profit plans presented a framework for certifying online tools that provide personalized, accurate and easily understandable price and quality information to consumers shopping for medical services. While many health plans and some hospitals already offer price estimators, there isn’t a certification process in place. (Meyer, 2/11)
Marketplace: Middle-Aged Americans Worried About Health Care Costs Less Likely To Seek Care
Many Americans in their 50s and early 60s are concerned about meeting health care costs, according to a new study from the University of Michigan. A quarter of adults aged between 50 and 64 are worried about their ability to afford health insurance in the next year, and just under half have low confidence in their ability to afford it once they retire. (Ben-Achour and Conlon, 2/10)
Kaiser Health News: One Defensive Strategy Against Surprise Medical Bills: Set Your Own Terms
When Stacey Richter’s husband recently landed in a New Jersey emergency room, fearing a heart attack, she had an additional reason for alarm: a potential big bill from the hospital if the ER wasn’t in his insurer’s network. So she took an unusual step. Instead of simply signing the hospital’s financial and treatment consent form, Richter first crossed out sections calling for her to pay whatever amount the hospital charged. She wrote in her own payment rate of a “maximum of two times” what the federal government would pay under Medicare, which is in the ballpark, experts said, of what hospitals might consider an acceptable rate. (Appleby, 2/11)
Bloomberg: Holmes Argues To Throw Out Theranos Criminal Fraud Case
Theranos Inc. founder Elizabeth Holmes mounted an attack Monday against charges that she defrauded patients who used her company’s blood tests. The former chief executive of the blood-test startup that imploded after reaching a $9 billion valuation argues that allegations she misled patients should be dismissed as too vague and because the government can’t prove that people who got inaccurate test results were actually harmed. Prosecutors say they’ve got plenty of proof that Holmes and ex-Theranos President Sunny Balwani duped patients into relying on technology they knew was faulty, and put some of those people in peril by providing false lab results. A trial is scheduled for August in San Jose, California. (Rosenblatt, 2/10)
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