Are insurers writing health reform regulations?

Insurance company lobbyists know the media are not paying much attention. And so they are able to influence what the regulations actually look like and how the law will be enforced with little scrutiny, much less awareness.

At a January meeting of several hundred patient and consumer advocates in Washington, a top aide to Health and Human Services Secretary Kathleen Sebelius all but pleaded with those in the audience to bombard the Obama Administration with messages insisting that the law be implemented as Congress intended. Rest assured, he told them, that the insurance industry’s lobbyists were relentless in their demands that the regulations be written to give them the maximum slack.

Insurers don’t like being told what to do by regulators. So they’re pushing back hard. Consumer advocates who have been in meetings at the White House in recent weeks say they believe the administration is bending over backward to accommodate the insurers.

“We have reason to fear that the external appeal regs won’t be very consumer friendly,” said Stephen Finan, senior director of policy for the American Cancer Society Action Network.

Finan and representatives of several other consumer and patient rights organizations, including Consumers Union, the National Partnership for Women and Families and the American Diabetes Association, wrote officials in the Departments of Labor and Health and Human Services in late January pleading with them to “stand firm for consumers” in rejecting several of the insurance industry’s demands.

They expressed concern that the final regulations would allow insurers to stack the decks against patients by allowing health plans to deem a second-level internal appeal of a denial as meeting the requirement for an independent external appeal. They’re also worried that health plans will not be required to provide clear and understandable information to policyholders about their denial decisions, that the plans will not provide adequate translation of written communications into other languages (insurers are claiming this would be too burdensome), and that they will be able to take as long as 72 hours (instead of the recommended 24) to decide an urgent appeal.

Equally as frustrating for the consumer advocates is the administration’s indication that they will give the insurers until January 1, 2012, rather than July 1, 2011, to comply with the regulations.

Link:
http://www.iwatchnews.org/2011/05/05/4485/analysis-are-insurers-writing-health-reform-regulations