Health Law reforms in the US set to make insurance appeals easier
New legislation passed in the US will make it easier for people who have been denied claims on their health insurance to appeal the decision. Prior to this, people with health insurance schemes provided by their employer were not allowed to appeal a decision made by a health insurance firm.
Furthermore, consumers with private individual health insurance who were already entitled to appeal a decision made by their insurance provider found this to be a lengthy and difficult process. It was not a straightforward issue at all and they couldn’t sue for damages for consequential pain, illness or injury of delayed or denied treatment.
While currently all health insurance firms are obliged to have an internal review process, researchers have found that more often than not the firm’s original decision is maintained. Add to that the complicated multi-layered processes consumers must go through in order to make an appeal and it can be easy to see why some argue that internal appeals can be unfair and biased.
Come autumn and that is set to change. Now every consumer with a health insurance plan will be able to make appeal through an independent review system operated at state level. However, suing for damages won’t be any less difficult; a point which has fallen heavily on those hoping for more drastic reforms.
Many states already operate a review system, although these new health law reforms will make this process available to US citizens in every state. Needless to say there will be much discussion in the coming months leading up to the enactment of these health law reforms, and in assessment of their effects in the coming months and years after they come into effect.