Aetna Fined Over Autism And Substance Abuse Coverage

State regulators in Pennsylvania fined health insurer Aetna  this week, for violating rules on coverage of drug and alcohol abuse treatment and coverage of autism spectrum disorder. A federal law called the Mental Health Parity and Addiction Equity Act generally forbids health carriers from discriminating against coverage for mental health conditions or substance abuse disorders.  …

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Happy New Year – Washington Health Insurers Are Now Required to Expand Contraceptive Coverage

In 2019, Washington health insurers are required to expand contraceptive coverage. Any health plan in Washington issued or renewed on or after Jan. 1 must now provide coverage for the following: All FDA-approved contraceptives, including drugs and devices; and Voluntary sterilization procedures. The new law also requires coverage for consultations, examinations and procedures necessary to obtain …

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Texas Judge Strikes Down Affordable Care Act

A federal judge in Texas has ruled the Affordable Care Act (a/k/a "Obamacare") can no longer be enforced.  The judge determined the Act cannot function without its individual mandate requiring virtually all Americans to carry minimum health coverage.  Congress repealed the ACA's individual mandate at the end of 2017. If the ruling becomes the law …

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Know Your Rights Under Washington’s Patient Bill of Rights

Health insurance policyholders are guaranteed specific rights under Washington State's Patient Bill of Rights.  The law's purpose is to guarantee health insurance policyholders have access to quality health care.  If you find yourself in a dispute with your health insurance carrier, knowing these rights may help. Policyholders Have The Right To Know About Their Coverage.  …

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Health Insurer Ordered to Pay $25.5 Million For Wrongful Cancer Treatment Denial

In a timely followup to last week's discussion of how to fight health insurance denials, this week an Oklahoma jury ordered health insurer Aetna to pay $25.5 million for denying coverage for insured's Orrana Cunningham's cancer treatment bills.   Aetna had denied coverage for Orrana's treatment in 2014 on the basis it was "experimental;" after …

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