#1 New health cost controls get go-ahead from feds by Cincinnatus 15.05.2014 23:31

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Another little twist in the ObamaDontCare fiasco.

WASHINGTON (AP) — The Obama administration has given the go-ahead for insurers and employers to use a new cost-control strategy that puts a hard dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.

Some experts worry that such a move would surprise patients who pick more expensive hospitals. The cost difference would leave them with big medical bills that they'd have to pay themselves.

That could undercut key financial protections in President Barack Obama's health care law that apply not just to the new health insurance exchanges, but to most job-based coverage as well.

Others say it's a valuable tool to reduce costs and help check premiums.

Some federal regulators appear to be concerned. A recent administration policy ruling went to unusual lengths, acknowledging that the cost-control strategy "may be a subterfuge" for "otherwise prohibited limitations on coverage."

Nonetheless, the departments of Labor and Health and Human Services said the practice — known as reference pricing — could continue. Plans must use a "reasonable method" to ensure "adequate access to quality providers." Regulators asked for public comment, saying they may publish additional guidance in the future...

One way the new approach is different is that it sets a dollar limit on what the health plan will pay for a given procedure. Most insurance now pays a percentage of costs, and those costs themselves can vary from hospital to hospital. Now if you pick a more expensive hospital, the insurance still pays the same percentage.


http://www.charter.net/news/read/article...ad_from_feds-ap

Say, isn't the name of this thing the Patient Protection and Affordable Care Act? This smells like a back door way of introducing medical care rationing.

#2 RE: New health cost controls get go-ahead from feds by Frank Cannon 15.05.2014 23:43

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Can we use reference pricing for Zero and all his vacations? Maybe send him to Detroit instead of Hawaii.

#3 RE: New health cost controls get go-ahead from feds by ThirstyMan 16.05.2014 07:26

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Quote: Cincinnatus wrote in post #1
Another little twist in the ObamaDontCare fiasco.

WASHINGTON (AP) — The Obama administration has given the go-ahead for insurers and employers to use a new cost-control strategy that puts a hard dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.

Some experts worry that such a move would surprise patients who pick more expensive hospitals. The cost difference would leave them with big medical bills that they'd have to pay themselves.

That could undercut key financial protections in President Barack Obama's health care law that apply not just to the new health insurance exchanges, but to most job-based coverage as well.

Others say it's a valuable tool to reduce costs and help check premiums.

Some federal regulators appear to be concerned. A recent administration policy ruling went to unusual lengths, acknowledging that the cost-control strategy "may be a subterfuge" for "otherwise prohibited limitations on coverage."

Nonetheless, the departments of Labor and Health and Human Services said the practice — known as reference pricing — could continue. Plans must use a "reasonable method" to ensure "adequate access to quality providers." Regulators asked for public comment, saying they may publish additional guidance in the future...

One way the new approach is different is that it sets a dollar limit on what the health plan will pay for a given procedure. Most insurance now pays a percentage of costs, and those costs themselves can vary from hospital to hospital. Now if you pick a more expensive hospital, the insurance still pays the same percentage.


http://www.charter.net/news/read/article...ad_from_feds-ap

Say, isn't the name of this thing the Patient Protection and Affordable Care Act? This smells like a back door way of introducing medical care rationing.


We should be calling this the Bait And Switch healthcare plan.

Bait-and-switch is a form of fraud used in retail sales but also employed in other contexts. First, customers are "baited" by merchants' advertising products or services at a low price, but when customers visit the store, they discover that the advertised goods are not available, or the customers are pressured by sales people to consider similar, but higher priced items ("switching").

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