Rep. Pallone: E&C Launches Investigation Into Health and Dental Insurers – Insurance News Net

14August 2020

Targeted News Service (News Release)



WASHINGTON, Aug. 14– Rep. Frank Pallone Jr., D-New Jersey, chairman of the House Energy and Commerce Committee, issued the following press release on Aug. 13: Energy and Commerce Committee Chairman Frank Pallone, Jr.(D-NJ), Health Subcommittee Chairwoman Anna G. Eshoo(D-CA)and Oversight and Investigations Subcommittee Chair Diana DeGette( D-CO )sent out oversight letters to 9 health and oral insurer today seeking information on their policies and practices amidst the COVID-19 pandemic. Chairman Pallone first announced the Committee investigation last week. The Committee’s investigation follows worrying reports that some health plans might not be adhering to consumer protections in both the Families Very First Coronavirus Action Act (the Families First Act )and the Coronavirus Help, Relief, and Economic Security Act(the CARES Act), which consumers are for that reason experiencing increased barriers to free COVID-19 screening. The investigation likewise follows reports that the medical insurance market is reporting massive revenues throughout the pandemic, as clients defer non-essential healthcare.”These advancements raise important questions about the degree to which the insurance market might be profiting off the pandemic while simultaneously doing something about it to minimize access to free COVID-19 screening, “the Committee leaders composed in their

letters to medical insurance companies.”We compose to request information about your company’s coverage policies and practices for COVID-19 tests and related items and services. Additionally, we are inquiring on whether these increased revenues are being utilized to supply consumers relief, such as through premium reductions, rebates, zero cost-sharing for COVID-19 treatments, or other financial support. “Congress planned for the broad application of the arrangements in the Families First Act and the CARES Act to ensure prevalent access to screening and to get rid of any financial barriers to people seeking COVID-19 tests. {Nevertheless, troubling reports show that some health insurance providers are skirting the law by

refusing to supply coverage of

COVID-19 tests without cost-sharing, while they report massive earnings margins.|Unpleasant reports show that some health insurance providers are skirting the law by

refusing to declining coverage offer
{

COVID-19 tests without cost-sharing, while they report massive profit margins.} Advertisement” Now, at the same time that some insurer have supposedly failed to supply COVID-19 screening coverage free of cost-sharing, the medical insurance market seems having a banner year, “the Committee leaders composed to health insurance providers.”In some cases, insurance providers have doubled their quarterly revenues as compared to in 2015. It appears these increased revenues are mainly the result of insurance providers investing less on

consumers’medical benefits throughout the COVID-19 pandemic.”Numerous elective surgical treatments have been canceled or held off due to the pandemic, saving insurance providers possibly billions of dollars in forgone medical claims. Numerous insurance providers are likewise supposedly investing considerably less on their clients’ routine or preventive health care benefits, consisting of oral benefits, as compared to the previous year. The Committee leaders pointed to protections in the Affordable Care Act (ACA) that top medical insurance companies’ earnings margins and need them in certain circumstances to release rebates to consumers on premiums paid.

“In a time of nationwide crisis and when many families are struggling economically, the insurance market must do its part to assist people who are delaying medical procedures, avoiding physicians’ workplaces, or otherwise not using the medical insurance for which they are paying,” the Committee leaders continued in their letter to health insurance providers. “This consists of releasing consumer rebates as needed under the ACA, however likewise offering instant relief to consumers, such as through premium credits and rebates, coverage of COVID-19 treatments without cost-sharing, and extensive adherence to all COVID-19 screening coverage requirements mandated by law.”

In a separate series of letters, the Committee leaders raised questions about whether the oral insurance market might likewise be profiting off the pandemic and inquired into whether the oral insurance providers are providing consumers or suppliers financial support throughout these challenging times.

As part of their query, the Committee leaders asked for responses and documents to a series of questions from the health and oral insurer by August 27, consisting of:

– The net income and/or earnings for years 2018, 2019, and Quarter 1 and Quarter 2 of 2020.

– The overall quantity of member premiums collected and declares paid out for years 2018, 2019, and Quarter 1 and Quarter 2 of 2020.

– Information on whether the insurance providers are offering financial support to enrollees or employers throughout the COVID-19 pandemic, consisting of through premium credits, grace durations, or rebates for enrollees.

– Information on whether the insurance providers are offering financial support to suppliers throughout the COVID-19 pandemic, consisting of through increased service provider repayment, or low or zero cost loans.

– A complete description of the medical insurance companies’ COVID-19 screening coverage policies and practices.

– Copies and records of all complaints from consumers billed for serological or diagnostic tests for COVID-19 and related items and services.

The letters sent out to each of the medical insurance companies are available below:

– Anthem ( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/Anthem.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-Cigna( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/Cigna.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-CVS Health( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/CVSHealth.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-Humana( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/Humana.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-UnitedHealth Group(

https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/UHG.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)The letters sent out to each of the oral insurer are available below:-Delta Dental Plans Association(

https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/DeltaDental.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-Guardian Life Insurance Company of America( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/Guardian.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-Metlife, Inc.( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/Metlife.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)-United Concordia Dental( https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/UnitedConcordia.2020.8.13.Letter%20re%20Insurers%20COVID19%20Profits%20and%20Testing.OI_.HE_.pdf)Source: insurancenewsnet.com

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