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Federal Rule Allows Higher Out-Of-Pocket Spending For One Year
Starting next year, the Affordable Care Act sets maximum limits on how much consumers can be required to pay out-of-pocket annually for their medical care. But some people with high drug costs may find the limits don't protect them yet.
That's because the federal government is giving some health plans extra time to comply with the rules.
Under the law, the maximum amount a consumer with single coverage will pay out-of-pocket in 2014 will generally be $6,350 while a family could pay up to $12,700. Those totals include copayments and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law.
Here's the catch. Although all non-grandfathered plans will have to cap the amount that consumers pay out-of-pocket for major medical expenses, if health plans use more than one company to administer their benefits—as many do for major medical and pharmacy benefits, for example—consumers may face separate caps next year, or no cap on their pharmacy spending at all.
Read the full story here: http://bit.ly/14uf63i
Source: Kaiser Health News
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
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Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
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Contributor: More Informed Management of Preeclampsia Is Necessary
November 29th 2023At present, it is difficult for clinicians to identify patients at greatest risk for developing preeclampsia with severe features and tailor treatment plans for them; this difficulty increases costs significantly.
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Study Validates Smartphone Analysis for Predicting Obstructive Sleep Apnea
November 29th 2023Findings show breathing sounds recorded by smartphones during sleep at home can reliably identify obstructive sleep apnea, presenting an innovative and accessible alternative to traditional in-laboratory polysomnography.
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