Health insurance companies to make changes to prior authorizations
HHS secretary Robert F. Kennedy and Dr. Mehmet Oz announced that major insurance companies have agreed to cut down and streamline prior authorizations
Five health insurance carriers will soon return $75.6 million to hundreds of thousands of people in Massachusetts, according to Gov. Maura Healey’s office.
Rebates will be issued this year to more than 350,000 people covered by individual and small employer plans, according to state insurance regulators.
When an insurance carrier spends less than 88% of premiums on health care services for individuals and small groups over a three-year period, it must rebate part of the premiums, according to Massachusetts law.
“The enforcement of this law is part of our larger strategy of protecting Massachusetts health care consumers and encouraging insurers to be more efficient, reduce administrative overhead, and focus on cost-effective ways to deliver care,” Division of Insurance Commissioner Michael Caljouw said in a statement.
This requirement, which is stricter than the federal standard, ensures affected policyholders are paid back by check or credit for future premium payments, Healey’s office said.
Which insurance companies are providing rebates in MA?
Here are the five insurance companies returning money to Massachusetts policyholders this year:
- Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.
- Fallon Community Health Plan, Inc.
- Harvard Pilgrim Health Care, Inc.
- Mass General Brigham Health Plan, Inc.
- UnitedHealthcare Insurance Company
When will money be refunded to policyholders?
Money will be refunded to policyholders beginning in September, either directly as a check or credited on future premium payments, according to Healey’s office.
How much money will each policyholder get back?
The exact amounts of the rebates this year depend on the insurance carrier and the premium paid by individual and small group purchasers, Healey’s office said.
The total amount being refunded this year is about $24 million more than last year, the office said.
Clinton Mora is a reporter for Trending Insurance News. He has previously worked for the Forbes. As a contributor to Trending Insurance News, Clinton covers emerging a wide range of property and casualty insurance related stories.