Implmenting the Affordable Care Act -- FAQs
affordable care act FAQs.jpg The Centers for Medicare and Medicaid Services updated the Frequently Asked Questions. []
HHS Scales Back Rules On Health Insurance Appeals
Kaiser Health News.jpgHow will the HHS rule narrowing the window for appeal of insurance decisions affect you? Read Susan Jaffee's analysis in Kaiser Health News. []
Reactions to Ryan's proposal
. . .fast and furious []
Medicare Part D shortchanges enrollees
. . .who pays? []
Deep Medicaid cuts for mental health
Doctors, patients, nursing homes, the young, the elderly, and diabetics who already own one pair of shoes will take hits from Medicaid cuts. []
Congress to Investigate Pentagon Decision to Deny Coverage for Brain Injured Troops
The Pentagon's decision to deny treatment for traumatic brain injury justifies a Congressional investigation, says Sen. Claire McCaskill. ProPublica and NPR have persisted in tracking responses. They report hearings will be held to dig into this, a decision made in conjunction with Tricare, the military insurance offered to vets. TBI has been called the signature injury of the wars in Iraq and Afghanistan. []
KHN Column: 'Multiple Fictions' Drive Opposition To Health Law
Kaiser Health News.jpg "The health reform debate is not about a fictional war between market-based health insurance and government regulation. It is about whether to provide adequate subsidies to cover the uninsured and whether to begin a process of leveraging change in the delivery and payment systems through which one-sixth of the U.S. economy is devoted to health care," writes Henry J. Aaron, senior fellow at The Brookings Institution. []
Pentagon Told Congress It's Studying Brain-Damage Therapy
The Pentagon acknowledges the seriousness of brain damage requiring cognitive rehab, but doesn't commit to interventions. That's Tricare's decision. And Tricare is unconvinced that it's effective despite evidence to the contrary. ProPublica and NPR follow-up. []
Pentagon Health Plan Won't Cover Brain-Damage Therapy for Troops
Dukehart,TriCare.jpgAfter Tricare, the military insurance for troops and veterans, denied coverage for cognitive rehab for brain injuries, ProPublica and NPR wanted to know why. The decision to deny this service seems especially confusing given evidence pointing to the importance of early interventions for brain injuries. Gaps in services, inconsistent policies, and congressional hearings are driving tenacious advocacy and investigations such as this. []
How The Health Reform Game Has Changed
Enthusiasts of health reform should not overlook the power of interest groups, or of the states, to influence next steps. "Many of the key implementation decisions won't be made at the federal level because insurance is regulated to a large extent by states," write economists Austin Frakt and Aaron Carroll for Kaiser Health News. []
New Laws Expand Mental Health Coverage
Writing for Kaiser Health News, Michelle Andrews explains how the implementation of new laws will "provide better insurance coverage for more people with mental health and substance abuse conditions." . . . []
Affordable Care Act impacts behavioral health starts soon
sebelius,hyde,9.15.jpg"You can't have a healthy America without having a good behavioral health," said Pam Hyde, SAMHSA administrator. As part of the Obama administration's effort to see that the controversial Affordable Care Act is publicized before opponents redefine the law for the mid-term elections, Hyde and HHS Sec. Kathleen Sebelius participated in a conversation hosted on the government's internet site, []
Donald Berwick is important to behavioral healthcare
Peterbrown.jpg WIth 30.6 percent of the nation covered by Medicaid and Medicare programs, Donald Berwick is key to the success of the Affordable Health Act. That alone makes him central to reforms that will affect people with a behavioral health disorder whose life expectancy is a quarter-century less than the rest of the population. Peter Brown writes about how Berwick's achievements model new ways of thinking, that could be applied to improving behavioral health. []
As many as one-third of people with behavioral health issues are uninsured.
This figure was given during a webchat about the impact of the Affordable Health Care Act for people with a mental health or substance use disorder. Pam Hyde, SAMHSA, and Sec. Kathleen Sibileus participated. To hear or see the entire conversation, go to []
KHN Column: Social Security's Disabled Adult Child Program: A Key Program Often Below The Radar
In this Kaiser Health News essay about Medicare and Medicaid benefits for older, disabled adults, Harold Pollack explains how Social Security has become an effective insurance policy that was patched together by Republican and Democratic leadership over the past 75 years. Yet, despite its centrality as a social support for disabled adults, it still falls short of providing security, and individuals are forced to rely on other help, especially family, to plug the holes. []
New Rules Guarantee Patients' Right To Appeal Insurance Claim Denials
Insurance for mental health and substance use disorders should be protected by new laws establishing parity with other medical conditions. When consumers challenged termination of services, there were few opportunities to appeal. New rules from the Obama administration have now established regulations for third-party reviews of denials of claims. []
Despite Law, Mental Health Coverage Lacking In Many Insurance Plans
Despite last year's passage of the most comprehensive parity insurance law providing coverage for mental illnesses and substance use disorders, waivers still exclude people and many in the high-risk category will have to wait until 2014. KaiserHealthNews spoke to NAMI's Andrew Sperling to learn more about the application of this law to 140 million people affected by it. . . []
Push back attempts to delay parity
Kaiserlogo.jpeg The Hill: "Health plans that say mental illnesses can't be treated like physical ailments are relying on an 'outdated argument' without merit that does not reflect 'three decades of scientific research,' 52 House members wrote in a recent letter to regulators. . . []
White House releases Patient's Bill of Rights
President Obama released a set of guarantees in the form of a patient's bill of rights following a meeting with insurance executives apropos new health reform laws. To read the entire document released by the White House, continue. . . []
How Grandfather Clause might change your insurance
KHN Column: Even With The 'Grandfather Clause' Protection, Change Is Coming To Most Health Plans In his latest Kaiser Health News column, done in collaboration with The New Republic, Jonathan Cohn writes: "Now that Karl Rove doesn't have a Republican president to advise anymore, he's been picking up some new hobbies. One of them is health care policy. In a recent column for the Wall Street Journal editorial page, Rove made the latest in a series of attacks on the new reform law. . . []
Parity or not, insurance companies saying no
An article in the Boston Globe confirms that limits on mental health claims are beginning to be felt in Mass. The Group Insurance Commission has led the way, but a psychologist who spent hours arguing with United Behavioral Health. . . []
Insurance companies attempt to delay parity
In what amounts to trying to delay full implementation of the mental health parity law passed in 2008, a coalition of insurance companies went to federal court in April to claim "irreperable harm" and challenge the date when the new regs take effect. The American Psychiatric Association and other advocates oppose these attempts to roll back parity. . . []
Passing health reform energizes advocates
Historic, jubilant, transformative were among the adjectives enunciated in the on-going celebrations of Sunday's historic pass of health reform in America. Recalling his mother who battled insurance companies on her deathbed, Pres. Barack Obama said passing this law represents the "core principles that everybody should have security." . . []
Catholic nuns, liberal politicians boost health reform prospects
Democrats got a boost from Catholic nuns representing 60 orders, and defying Bishops of the Catholic Church to endorse health reform. . . []
Benefits of parity law showing
Equal payments for mental health services, parity for shorthand, kicked in on Jan. 1 and some people are beginning to see the effects even before the entire set of regulations go are released in July.. . []

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