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Q. Do we include a copy of the Advance Beneficiary Notice (ABN) with the claim form?
A. No, do not submit a copy of the ABN unless requested to do so by the carrier.
Source: Centers for Medicare & Medicaid Services
Patients with cancer undergo many expensive treatments and tests and often find themselves bankrupt even if they have insurance, according to a new report.
The report, released by the Kaiser Family Foundation and the American Cancer Society followed 20 typical cancer patients. Of those patients, nine had insurance through an employer, one paid for employer coverage through COBRA, seven had individual insurance, two received coverage through a state high-risk insurance pool, and one became uninsured.
The study found that many of the patients became too sick to work, but were able to remain covered by their employer’s insurance up to 18 months by paying the full premium, although they found the added expense hard to bear. Other patients experienced delays in treatment caused by funding problems, debt, and stress about costs.
A recent report by the Center for Studying Health System Change, a nonpartisan policy research organization, states that one in seven Americans under age 65 went without a prescription drug in 2007 because they could not afford it. The study shows the effect increased drug prices were having even before the economic recession went into full swing: in 2003, only one in 10 Americans said they couldn’t afford their prescriptions.
According to the study, people who were most likely to be unable to afford their prescriptions were uninsured and suffering from a chronic condition. Without their medications, their conditions were likely to worsen, causing them to seek expensive medical treatment.
However, in the recent survey, insured Americans were not immune to prescription pricing troubles. One in 10 Americans insured by their employer reported going without a prescription because of cost, also up from the last study in 2003.
Source: The New York Times
Massachusetts Gov. Deval Patrick has asked the state’s most prominent hospital and health insurance leaders to take quick action to hold down rapidly rising healthcare costs, suggesting that if they did not take steps on their own, they might face new government regulation, according to the Boston Globe.
Patrick said he is considering holding hearings on health insurance premiums and the primary driver of premium increases—the rates hospitals charge insurers for members’ medical care. He has also said the state Division of Insurance has the power to reject rates it deems excessive.
Read the full story in the Boston Globe.
Health insurance companies for Medicare received $1.3 billion more than projected in 2006, congressional auditors told the Associated Press.
The Government Accountability Office said in a report that if projections had been more accurate, much of that $1.3 billion could have gone to better benefits and lower premiums.
Read the Associated Press report.
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