Government Updates
Idaho Patient Act
While the Insurance companies, some hospitals, and many providers worked to fix the “surprise billing” issues this year and were ultimately unable to move a bill forward, it was due in part to Melaleuca in Idaho Falls running House bill 515 which dealt with the fairness issues surrounding collections and the end of the process for the consumer. The owner of the Melaleuca company, Frank Vandersloot, created a $1,000,000 fund to work to eliminate the medical debt collection practices through legislation.
While House Bill 515 will help customers who find themselves trapped and being harassed by aggressive collectors, it doesn’t deal with the root issues of “surprise billing”. IAHU will need to collect as many stories specific to surprise billing as possible and also ensure the issue remains relevant to Idaho legislators who may be operating under the belief that they fixed the problem. Expect legislation in 2021 to fully address the “surprise billing” issue.
Idaho Dept. of Insurance
The Department of Insurance has released four bulletins granting unprecedented regulatory flexibility in certain areas for health insurance companies and producers to help Idahoans retain and use their coverage. The DOI is considering and continuing to work on other efforts in this complex and fluid situation.
The four bulletins are as follows and with links to the full documents:
- Waiver of certain requirements to address COVID-19: This bulletin applies to health insurance carriers offering individual or employer sponsored group major medical health and dental insurance policies, allowing flexibility regarding premium deferral, premium holidays, continuation of coverage, grace periods, and waiver of eligibility requirements. The goal is to provide carriers and employers with the tools to retain coverage even while temporarily closed or operating in reduced hours.
- Temporary waiver of certain pharmacy benefit policy requirements: This bulletin allows flexibility of prescription provisions for all fully insured plans, including the allowance of early refills, 90-day supply, and avoidance of in-person signature logs and subsequent audits of pharmacies.
- Temporary waiver of certain policy and enforcement requirements: This bulletin applies to health insurance carriers offering telehealth benefits through individual or employer sponsored group major medical health insurance policies. Flexibility is granted to expand telehealth access to all in-network providers and expand how telehealth services can be received.
- Provisional producer licenses: This bulletin allows new producers and applicants for producer licenses the procedure for obtaining a provisional producer license during the COVID-19 emergency. A provisional resident producer license is valid for up to six months and does not renew automatically at the end of the license period.
These bulletins will remain in effect so long as the Governor’s emergency proclamation remains in effect. Other flexibility and provisions are currently being considered and will be made available when appropriate.
