Cleveland Clinic to Charge for Patient Messages

The Cleveland Clinic announced that on November 17, 2022 it would begin billing patients’ insurance for messages that require five minutes or more of a healthcare provider’s time to answer.  The announcement provides: [S]tarting November 17, 2022, MyChart responses that require your provider’s clinical time and expertise to answer may be billed to your insurance. … Continued

Ding Dong the “Glitch” is Dead

New regulations will increase the annual deficit and national debt ultimately shouldered by taxpayers – today and tomorrow. The Biden Administration recently finalized regulations to extend taxpayer subsidized medical coverage to millions of Americans who may not have previously qualified for the subsidy. They accomplished this by updating the 2013 definition of “affordability” with respect … Continued

The Latest Legal Challenge to the Affordable Care Act: Texas Federal Court Decision Threatens Preventive Care Coverage

Key Points: A court decision by a judge in Texas may increase out-of-pocket costs for preventive health care services. This case reintroduces a  dispute that the ACA resolved with a mandate of coverage. While health mandates to provide certain services without cost raised the cost of coverage, re-introducing cost sharing for these preventive services could … Continued

How to Make Reference-Based Pricing Work For Your Plan

aequum Provides Administrators with Partnership and Guidance aequum is a first-of-its kind tech-driven company in the complex field of medical billing. Our tech-driven team of specialists partner with claims administrators, providing them with data-driven insights, technical solutions and legal advocacy support. Working collaboratively, we are advancing the adoption of reference-based pricing (RBP) and price transparency … Continued

“Advanced” EOB Puts Economic Purchasing Power and Decision-Making Into Health Plan Member Hands

Christine Cooper, CEO of aequum LLC, provided eHealth Radio Network’s listening audience with guidance on strategies to take advantage of Advanced EOB price transparencies and advice that health care consumers can capitalize on to manage costs and fully optimize plan value. This insight has the potential to transform an employee’s health coverage usage, putting the … Continued

Bet on the “Over” not the “Under” – Commonwealth Offers an Incomplete Picture of Under-and-Over Insurance

A new survey by the Commonwealth Fund found that the number of Americans without health coverage has fallen to historic lows[i]. The same survey concluded that “a large number of people remain uninsured or inadequately covered.” Of the 6,301 survey respondents who were under age 65: 9% are not enrolled in health coverage[ii] 11% had a gap … Continued

aequum Collaborates with SIIA to Present Webinar on Reference Based Pricing

Christine Cooper and Jack Towarnicky presented on behalf of aequum Reference Based Pricing – Optimized, A Strategic Response to the No Surprises Act, Transparency Requirements. This complimentary webinar, in collaboration with the Self-Insurance Institute of America (SIIA), confirmed why reference-based pricing (RBP), “done right”, is the most appropriate plan design response to recent legislation – … Continued

Litigation Update: AHA, AMA Dismiss Surprise Billing Rule Lawsuit, Plan Further Legal Action

Summary: The American Hospital Association (AHA) and American Medical Association (AMA) filed a motion to dismiss their lawsuit challenging the federal government’s final rule on surprise billing released last year, but cautioned more litigation is pending. The health care lobbying groups say the August 2022 final rule on arbitration still poses concerns for providers.   … Continued

Certainly Not What We Pay For

“Americans born in 2021 can expect to live for just 76.1 years — the lowest life expectancy[1] has been since 1996, according to a new government analysis published Wednesday [August 31]. This is the biggest two-year decline — 2.7 years in total — in almost 100 years.”[2] In the August 2022 Vital Statistics Rapid Release, … Continued