Transparency

health

MDSAVE ECOMMERCE TOOL HELPS INSURERS MEET NEW FEDERAL “TRANSPARENCY IN COVERAGE” REGULATIONS

The October 29, 2020 Federal Rule requires that insurers offer patients a tool to research their financial responsibility and both in-network and out-of-network negotiated rates. The MDsave tool, available now, enables 24/7, consumer-friendly price research and allows patients to purchase their care upfront without fear of surprise bills.

BRENTWOOD, Tenn., Oct. 30, 2020 (GLOBE NEWSWIRE) — MDsave, the leading health technology company in transparent, shoppable medical care, announces its ecommerce solution to help insurers meet new transparency requirements issued in an October 29th Final Rule. The Rule, issued jointly by the Departments of Health and Human Services, Labor, and the Treasury, mandates the creation of “an internet-based, self-service tool” that provides “personalized out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services,” according to the Transparency in Coverage Final Rule Fact Sheet.

The MDsave transparency tool provides a user-friendly, ecommerce interface that allows patients to instantly purchase a procedure of their choice directly from the website, in addition to enabling personalized cost searches for the required 500 shoppable services and hosting machine-readable files containing all negotiated charges. 

Because each procedure on the MDsave platform includes the most commonly related services and their fees, patients can pay for the entire episode of care upfront without fear of surprise bills.

“Our ecommerce transparency platform is already being implemented for hospitals meeting the January 1, 2021 transparency deadline, so the technology is ready for insurers who want to provide a great patient experience but don’t want to build a tool from the ground up,” explains Greg Born, MDsave President and COO. “We have the platform, the searchability and the transaction capability. All insurers need to provide is the data.”

Insurers must launch their online self-service transparency tools for plan years starting January 1, 2023 for the federally specified 500 shoppable services and plan years starting January 1, 2024 for any remaining services or items.

To learn more, visit MDsave.com/price-transparency. 

About MDsave

Co-located in Brentwood, Tenn. and San Francisco, Calif., MDsave is the world’s first online healthcare marketplace, bringing together patients seeking affordable, reliable care with providers offering high-quality services at fair prices. Using cutting-edge technology, MDsave simplifies the healthcare billing process for patients and providers alike through negotiated rates, bundled pricing and upfront payment. The MDsave marketplace also helps employers and payers offer more value to employees and policyholders with out-of-pocket deductible costs. For more information, visit http://www.mdsave.com.

CONTACT: Kate Steurer MDsave 615-814-6260 [email protected]

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health

EU urges quick WHO reform, asks for more transparency in pandemics

By Francesco Guarascio and Caroline Copley

BRUSSELS/BERLIN (Reuters) – The World Health Organization (WHO) should be quickly overhauled, get more powers to handle pandemics and expose its member states’ shortfalls in health emergencies, European Union officials said on Friday.

The comments were made at a video conference of EU health ministers that endorsed an EU document on the reform of the U.N. agency which outlines a series of sweeping changes needed to boost WHO’s powers and resources, as exclusively reported by Reuters in September.

The moves followed criticisms that China and other countries did not share information on the COVID-19 pandemic in a timely fashion at its onset.

“The current pandemic challenges us very acutely (…) but it is very important that the (WHO) reform debate is held in parallel,” Germany’s Health Minister Jens Spahn told a news conference.

He did not say when the reform process should begin, but stressed that as a result of the overhaul the WHO should become faster in its reaction to health crises, while its member states should share more information in emergencies.

WHO officials did not immediately respond to an email request for comment.

“It is extremely important we move ahead with this reform,” EU Health Commissioner Stella Kyriakides told the same news conference.

After months of international pressure, an independent panel was set up in September to review the global handling of the pandemic. The process to reform the WHO would begin after that, officials had said.

The EU draft document, which will represent the EU’s position at a WHO assembly in mid-November, urges the U.N. agency to make public more quickly how and whether its member states respect their obligations on sharing information on health crises.

The United States has accused the WHO of being too close to China in the first phase of the pandemic, when critics say Beijing was slow in sharing crucial information on the new coronavirus which first appeared in the city of Wuhan.

The WHO has repeatedly dismissed these accusations.

“Transparency on who complies with the rules is fundamental,” Kyriakides told ministers at the video conference, according to her speaking notes.

The draft document also says WHO countries should allow independent epidemiological assessments on-site in high risk zones during health crises.

(Reporting by Francesco Guarascio @fraguarascio; Editing by David Holmes and David Evans)

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health

HHS Finalizes Rule on Insurer Price Transparency

WASHINGTON — Private health insurers will have to start posting their prices publicly within the next several years according to a final rule issued Thursday by the Department of Health and Human Services (HHS).

“This shadowy system” of healthcare pricing “has to change; the patient has to be in control,” HHS Secretary Alex Azar said on a phone call with reporters. “That means giving them the right to know what they’re going to owe for a healthcare service before they ever get it.” Right now, however, “patients don’t have the information they need to shop around and get a good deal … and have an informed conversation with their doctor about what makes sense for them.”

The final rule — which was issued by HHS together with the Labor and Treasury departments — would require almost all private health insurance plans to give the 200 million Americans they cover real-time access to information about negotiated prices and cost-sharing, beginning with a list of the 500 most “shoppable” services in 2023, Azar said. This list would be expanded to include all healthcare services in 2024. “This is information that patients typically receive after they get those services, through an EOB [Explanation of Benefits] form,” but now they could get it ahead of time.

Through a shopping tool available through their plan or insurance company, consumers will be able to see the negotiated rate between their doctor and their plan or insurer, as well as the most accurate out-of-pocket cost estimate possible based on their health plan for procedures, drugs, durable medical equipment, and any other item or service they may need, HHS said in a press release. “Consumers will also have access to accurate price and plan information that allows them to shop and compare costs between individual doctors before receiving care, so they can choose a healthcare provider that offers the most value and best suits their medical needs.”

In 2022, a year before the real-time access provision takes effect, insurers will be required to publish their negotiated rates in data files that will be searchable by patients, employers, researchers, and app developers who could then develop tools to help patients choose their providers. “The vast majority of patients don’t have easy access to this information today,” said Azar.

“In one study when prices for imaging were made transparent, the prices dropped almost 20%,” he said. “You should have the right to know what a healthcare service is going to cost, and the right to know what it’s going to cost you out-of-pocket. That’s what today’s rule will do.”

For each insurer, three data files will be available: one with prices for in-network providers and services, one with prices for out-of-network providers and services, and another for in-network prices for all prescription drugs.

HHS giving insurers a lot of time to comply with the new rule “reflects that there’s a lot of work involved, but that work is only necessary because entrenched special interests in the healthcare system have for

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health

The FDA and CDC Promised Transparency in the Vaccine Approval Process. Here’s How Congress Can Hold Them to It

A view of the U.S. Capitol Building as demonstrators march to the Department of Health and Human Services (HHS) headquarters during a protest organized by groups calling for safe vaccines on Oct. 21
A view of the U.S. Capitol Building as demonstrators march to the Department of Health and Human Services (HHS) headquarters during a protest organized by groups calling for safe vaccines on Oct. 21

A view of the U.S. Capitol Building as demonstrators march to the Department of Health and Human Services (HHS) headquarters during a protest organized by groups calling for safe vaccines on Oct. 21 Credit – Graeme Sloan—Sipa USA

The COVID-19 pandemic continues to have a devastating impact on the health and economic well-being of families and communities across the country, and this virus will remain a significant threat until a safe and effective vaccine can be made available to all.

While we all hope to get potential vaccines reviewed, produced and distributed as quickly as possible, we can’t sacrifice safety and efficacy for speed. It is also critically important that the public has confidence in the federal government’s vaccine review process, which includes assurances that the Food and Drug Administration (FDA) has followed the necessary protocols to ensure vaccine safety and effectiveness. Together, we’ve introduced the Safe Authorization for Vaccines during Emergencies (SAVE) Act to ensure that the FDA and the Centers for Disease Control and Prevention (CDC) follow well-established measures so that COVID-19 vaccines meet rigorous standards that the public can rely on.

The FDA and CDC have existing vaccine review processes that are considered the gold standard by public-health experts around the world. During the normal vaccine approval process, the CDC and FDA each have advisory committees that meet and issue findings and recommendations on the safety and effectiveness of vaccines before they enter the market, including whether specific vaccines are safe for certain populations such as children or seniors.

For the COVID-19 vaccine, however, an expedited review process called an emergency use authorization is being used. There’s never been an emergency use authorization for a new vaccine before, and it is important to ensure that any expedited review process does not come at the expense of safety and efficacy.

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By taking key oversight measures, we can ensure the safety and effectiveness of a potential vaccine and promote transparency, even during an expedited process. By extension, we can also help bolster public confidence in the vaccine review process, as well as any vaccine product that enters the market. However, we have a lot of work ahead of us. Public trust in the vaccine approval process is critical to achieving widespread use, and right now, the public is skeptical.

A CBS poll released in September found that two-thirds of Americans would think the process had been rushed if a vaccine enters the market this year, and only one in five plan to get vaccinated as soon as possible. Another poll from the Kaiser Family Foundation showed that 62% of Americans worry that political pressure will lead to premature approval of a vaccine. If a majority of Americans are unwilling to take

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