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Claims chaos: barriers to health insurance: Prior authorization, denials & appeals

Claims chaos: barriers to health insurance: Prior authorization, denials & appeals

NAIC Consumer Reps. Carl Schmid and Deb Darcy discuss barriers consumers face in accessing healthcare through the high number of prior authorizations and the appeals and denials process, and request the NAIC develop a workstream that improves data collection, and consumer awareness of the appeals process, update model laws, and better enforcement of federal and state laws and regulations.

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Copay Accumulators, State Bans & IRS Issues

Copay Accumulators, State Bans & IRS Issues

HIV+Hep’s Carl Schmid’s presentation before the NAIC Regulatory Framework Task Force on the value of copay assistance for Rx, state laws that ensure copay assistance counts, and ways to mitigate any potential conflicts with those state laws with IRS/Health Savings Account issues.

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