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Health Insurance Panel Eyes Transportation Costs

Sep 26, 2017
Originally published on September 26, 2017 7:25 am

A state insurance advisory panel on Tuesday will finalize its legislative recommendations for the upcoming session and will consider, among other things, a proposal to ban emergency medical transportation providers from hitting insured customers with out-of-pocket medical bills.

Only proposals with unanimous support from Florida Health Insurance Advisory Board members will be forwarded to the Legislature for consideration.

The so called “balance billing ban” on emergency transportation appears to have unanimous support from the board and was recommended for consideration by two board members with disparate backgrounds: Louisa McQueeney, communications director of Florida Voices for Health and a policyholder representative on the board; and Ken Stevenson, vice president of employee benefits for Earl Bacon Agency, a Tallahassee insurance firm.

Insurance lobbyists in 2016 successfully lobbied the Legislature to pass a bill that prohibits out-of-network providers from balance billing customers of preferred provider organizations (PPOs) or exclusive-provider organization (EPOs) for covered emergency services or covered non-emergency services. The bill establishes a payment process for insurers to provide reimbursement for such out-of-network services.

The bill did not, though, apply to emergency transportation, the “single least competitive market in health care,” according to Florida Association of Health Plans General Counsel Wences Troncoso, who testified in support of the recommendation at the Florida Health Insurance Advisory Board's Aug. 30 meeting in Tallahassee.

McQueeney also recommended that Florida small employers be allowed to offer health plans that don't provide coverage for employees' spouses and children, which would allow spouses and dependents to qualify for subsidized coverage in the federal health exchange.

It's not a new idea. The advisory panel has included it in its legislative recommendations for the past three years, but it has not been endorsed by the Legislature.

The Florida Health Insurance Advisory Board was established in state to serve an advisory role on health insurance issues. It is chaired by the state's insurance commissioner, David Altmaier.

While there appears to be support behind the balance billing ban for emergency medical transportation and allowing small employers to offer employee-only policies other recommended proposals are more controversial.

For instance, a proposal by McQueeney that insurers be precluded from changing drug formularies during a benefit year raised a red flag for insurance company representatives.

And a proposal by Stevenson that Florida pursue a type of waiver allowed under the Affordable Care Act was something McQueeney said she would have to consider. Stevenson said the waiver, known as a 1332 waiver, would allow Florida flexibility to craft its own health plans.

“All we are saying is take a look at it,” Stevenson said of applying for a 1332 waiver.

McQueeney didn't oppose the proposal at the Aug. 30 meeting, which would have precluded any further discussion of the idea, but she warned she would need more information.

Stevenson also said he also would like to repeal a state law that allows dependent children to stay on their parents' policies up to age 30 under certain circumstances. Federal law allows dependent children to stay on their parents' policies until age 26.

Stevenson said the Florida law was passed before the Affordable Care Act and that there no longer is need for the state law. Moreover, he said that “it's an additional burden on employers.”

The Florida Health Insurance Advisory Board will meet at 2 p.m. Wednesday via a conference call. The 2018 legislative session starts in January.