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S5E9 - Self-Insurance Legislative & Regulatory Hot Topics
Manage episode 382517777 series 2562989
In this week’s episode, host Dorothy Cociu discusses the self-insurance industry hot topics with Ryan Work, VP of Government Relations and Chris Condeluci, Washington Counsel, for the Self-Insurance Institute of America. We discuss the current threat to ERISA pre-emption following recent Supreme Court rulings on PBM cases that could have adverse effects on self-funded health plans, as well as updates on the Transparency in Coverage, the wide variability and incompleteness of files and inability of plan sponsors and administrators to access their claims data. In addition, we discuss the Surprise Medical Billing and Federal Independent Dispute Resolution process and issues within the portal, the lack of Independent Dispute Resolution Entities to arbitrate the cases, and recent cases that strike at the heart of the NSA rules, the QPA. We also discuss the CAA Gag Clause Prohibition & Attestation and requirements of plan sponsors. Join us for this informative podcast!
#DorothyCociu #self-insurance #RyanWork #ChrisCondeluci #self-fundedhealthplans #Transparency #SurpriseMedicalBilling #Federal IndependentDisputeResolution #NSA #QPA #GagClause
91 afleveringen
Manage episode 382517777 series 2562989
In this week’s episode, host Dorothy Cociu discusses the self-insurance industry hot topics with Ryan Work, VP of Government Relations and Chris Condeluci, Washington Counsel, for the Self-Insurance Institute of America. We discuss the current threat to ERISA pre-emption following recent Supreme Court rulings on PBM cases that could have adverse effects on self-funded health plans, as well as updates on the Transparency in Coverage, the wide variability and incompleteness of files and inability of plan sponsors and administrators to access their claims data. In addition, we discuss the Surprise Medical Billing and Federal Independent Dispute Resolution process and issues within the portal, the lack of Independent Dispute Resolution Entities to arbitrate the cases, and recent cases that strike at the heart of the NSA rules, the QPA. We also discuss the CAA Gag Clause Prohibition & Attestation and requirements of plan sponsors. Join us for this informative podcast!
#DorothyCociu #self-insurance #RyanWork #ChrisCondeluci #self-fundedhealthplans #Transparency #SurpriseMedicalBilling #Federal IndependentDisputeResolution #NSA #QPA #GagClause
91 afleveringen
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