Excerpts
SUMMARY: The new health care law has given one little known agency the power to mandate insurance companies to provide certain preventive services. Find out what the U.S. Preventive Services Task Force (USPSTF) might have to say about your next visit to the doctor. Doctor Emily Senay reports.
----
EMILY SENAY: The group operated with little notice for nearly 30 years…using letter grades to recommend to primary care physicians which preventive services to offer their patients and what insurance companies.
Before the affordable care act was passed in 2010, an “A” or a “B” grade was only a recommendation.
But under the new law, either of those grades now requires private insurance companies and Medicare to pick up 100 percent of the costs.
Doctor Virginia Moyer is the chair of the task force.
VIRGINIA MOYER: The Affordable Care Act includes a provision that says that, ‘any recommendation that receives an A or B grade from the U.S. Preventive Services Task Force is paid for first dollar,’ so no copay for those recommendations.
Since the passage of the Affordable Care Act, the Task Force has recommended more than a dozen preventive services: screenings for HIV, cervical cancer and osteoporosis, as well as counseling for obesity and tobacco use, along with vision screenings for children.
People, who need these preventive services, can now get them within their insurance networks fully covered.
VIRGINIA MOYER: A preventive service is something that is intended to keep something bad from happening. What we do as a task force is we carefully evaluate the science, the science that tells us whether a preventive service is going to benefit people.
----
EMILY SENAY: And the decision of insurance companies like AETNA has been to stick with the task force says. Doctor Lonny Reisman is its chief medical officer.
DR. LONNY REISMAN: We've mostly covered all of the mandates already. So they're baked into our premiums, and we're not expecting a significant increase in costs.
EMILY SENAY: But he says the real financial challenge will be to manage costs and at the same time satisfy customers as more services are mandated in coming years.
DR. LONNY REISMAN: We are compelled to cover it, we are committed to covering it. And any increases in costs will be covered in our premiums, but we will explain the basis for in fact increasing premiums as a result of increasing medical costs.
EMILY SENAY: That could mean no out of pocket expenses for preventive services at the doctor’s office…but higher insurance bills for consumers.
----
DR VIRGINIA MOYER: We want to be independent and we want our recommendations to be based on science, not politics. If you look at our website, it ends in .org. It doesn't end in .gov, so we're an independent panel. We are epidemiologists and primary care clinicians. We are not policymakers (aka politicians).
----
BARBARA HILLARY: Living is not inhaling and exhaling. Living is-- you know you feel it. And if you don't feel it, baby you ain't livin'.
Barbara's comment is philosophy of the day.
No comments:
Post a Comment