Health Insurance Industry Issues and Legislation

IRS's Notice 2022-11 provides the methodology for calculating the QPA in 2022 when a plan either does not have sufficient information to calculate the median of the contracted rates in 2019 or when it's a newly covered item during its first coverage year.

Will the courts eliminate the QPA as the base IDR Entities use to make their decisions? You can avoid the uncertainty and the IDR process completely. Have highly-skilled negotiators, like H.H.C. Group, settle the claim with the provider when you receive the bill or during the open negotiation period.

Hospital prices for everything from surgical procedures to pathology and lab services are already higher than those delivered in non-hospital settings. They continued to increase sharply in the last year. Evaluation and management service prices alone rose by 7%.

The CMS's just-released Office of the Actuary Report projects increases in private health insurance spending will skyrocket in 2022 and then return to historical rates through 2030. CMS projects all key healthcare service and product spending will share in the increases.