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“High performance network” health care insurance plans to leave patients with unexpected medical debt

A Tennessee family faced a potentially catastrophic situation when Joe Smith — a husband and father of four — was diagnosed with a brain aneurysm. Smith, of Chattanooga, had health insurance through his job with Blue Cross Blue Shield of Illinois, but the insurance company refused to pay for the surgery necessary to prevent a life-threatening rupture. “We knew that he kind of had this ticking time bomb in his head,” Stacie Smith, Joe’s wife, said. The insurer claimed that the neurosurgeon that Smith’s family had chosen was out of the network, and the plan had no coverage for out-of-network…
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UC San Diego Health Spotlights SMART Health Insurance Cards

highlights – First demonstration of the new QR code standard for health insurance cards. – New model will allow providers to scan QR code, verify its authenticity and ingest the data into their systems automatically. – Collaborating partners include UC San Diego Health, UC Irvine Health, UCLA Health, UCSF Health, UC Davis Health, UCR Health, Evernorth Health Services, Healthcare Financial Management Association, The Commons Project, VCI Coalition and CARIN Alliance. SMART Health Insurance Card Initiative During a digital health symposium this week, Christopher Longhurst, MD, with UC San Diego Health, pulled up a QR code from his phone’s digital wallet,…
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Ontario passes a health-reform bill that expands private delivery of care

Ontario has passed a health-reform bill that will allow more private clinics to offer certain publicly funded surgeries and procedures in an effort to cut long wait lists for care. Cataract surgeries and diagnostic imaging and testing will be expanded while the government will create an entirely new system to perform hip and knee replacement surgeries. The moves are part of the government’s plan to decrease wait times and reduce a massive backlog of surgeries, which stands at more than 200,000 procedures. “We’re going to shorten the list, we’re going to give people the care they need in a rapid…
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FSRA Takes Action to Protect Consumers of Life and Health Insurance

Annual report highlights examinations of high-risk agents TORONTO, May 2, 2023 /CNW/ – Through market conduct supervision and enforcement activities, The Financial Services Regulatory Authority of ont (FSRA) is working to ensure life and health insurance agents are compliant with legislation, regulations, and that they are working to achieve fair outcomes for customers. In 2021-22, the FSRA reviewed 115 higher-risk life agents and the results are included in the first Life and Health Insurance Agent Supervision Report which is being released today. Annual reporting of life agent supervision contributes to public confidence through promoting transparency, disclosure of information, and deterring…
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Here’s what’s in the bill that spurred the latest Republican walkout from the Oregon Senate

Republicans walked out of the Oregon Senate this week in large part to avoid a vote on a reproductive health care bill that passed the House on Monday. The bill passed despite delay tactics in the House and 6 hours of floor debate. OPB covered that debate and the contents of the bill on Tuesday, publishing a story shortly before the walkout commenced. Below is the short version of that story — just four main things to know about the bill that caused Republican state senators to walk out of the statehouse again. State senate in session at the Oregon…
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Unlicensed health insurer fined, ordered to stop operations in Minnesota

(FOX 9) – A health insurance company based in Texas, but operating in Minnesota, has been fined and ordered to stop selling unlicensed insurance policies in Minnesota. Salvasen Health, its owner Barry Glenn, and multiple affiliates have been fined $553,000 by the Minnesota Department of Commerce (DOC) and ordered to stop their operations in Minnesota, the DOC said in an announcement Wednesday. According to the department, Salvasen and affiliates were not licensed in Minnesota to sell health insurance plans but sold unapproved health plans to Minnesota consumers regardless. The DOC provides regulatory oversight of insurance for Minnesota and initially acted…
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First 113,000 letters about Medicaid health coverage renewals going out in Illinois this week – Chicago Tribune

More than 100,000 Illinois residents will receive the first round of letters this week about how to hold on to their Medicaid health coverage amid federal changes that could lead to many getting kicked out of the program. The state is sending out an initial 113,600 letters that will tell people what actions they need to take, if any, to stay on Medicaid. Medicaid is a state and federally funded health insurance program for people with low incomes and disabilities, covering about 3.9 million people in Illinois. People who receive the letters will have until June 1 to submit proof…