What’s Considered Medically Appropriate for Insurance to Be Expanded

Healthy groceries, home-delivered meals, air conditioners and grab bars in the bathroom may soon be some of the “medically appropriate” benefits covered by insurance. The Centers for Medicare & Medicaid Services expanded the definition of “primarily health-related” benefits insurers can include in their Medicare Advantage policies. Beginning in 2019, insurers can provide retirees care and…

The Benefits of Telemedicine

Recently, the state of Washington passed a law requiring employee health plans to reimburse providers for telemedicine services. That made Washington the 24th state to require “telemedicine parity.” Parity laws remove some of the barriers to more widespread adoption of telemedicine. Knowing they will be reimbursed for services makes healthcare providers more willing to offer…

Compliance Alert: Medicare Part D Notification Requirements

Employers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non-creditable.” Medicare Part D, the Medicare prescription drug program, imposes a higher premium on beneficiaries who delay enrollment in Part D after initial…