Move Comes On Heels of Bennet Letter Spotlighting Case of La Rosa Carrington, Who Was Threatened Denial of Coverage Over One Penny
Washington, DC – Michael Bennet, U.S. Senator for Colorado, welcomed today’s announcement of new rules and funding that will allow Coloradans to appeal decisions made by their health plans or insurance companies. The announcement comes on the heels of a letter Bennet sent to the Administration after reports that a Colorado Springs cancer patient was told by her insurer that her coverage would be dropped after failing to pay her premium in full – by one, single cent.
In his letter to Health and Human Services (HHS) Secretary Kathleen Sebelius, Bennet spotlighted the case of La Rosa Carrington, who in the midst of receiving treatment, was told by her insurer, Discovery Benefits, that her benefits would be terminated because she was one penny short on her premium payment. Bennet called on HHS to keep in mind stories like that of La Rosa Carrington when crafting the appeals process to ensure Coloradans don’t lose their coverage when they need it most.
“People like La Rosa, who have been forced to fight their insurance companies while fighting for their lives, can now count on having someone in their corner who will fight for them,” Bennet said. “The insurance companies have held the cards for far too long. Without a second thought they are willing to come between us and our doctors and literally make life-and-death decisions based on a stray penny. It’s wrong, it’s shameful, and thanks to health insurance reform, it’s going to change.”
Specifically, the Departments of Health and Human Services, Labor, and the Treasury issued new regulations that give consumers in new health plans in every State the right to appeal decisions, including claims denials and rescissions, made by their health plans. For more information on the new regulations, please click here.
Next year, an estimated 31 million people in new employer plans, and 10 million people in new individual plans, will benefit from the new appeals rights announced today. The number of individuals in employer plans who will benefit is expected to rise to 78 million by 2013, for a total potential of 88 million Americans who will be guaranteed the right to appeal decisions made by their health plan.
In addition, today Secretary Sebelius announced a $30 million grant program to establish and strengthen consumer assistance offices in States and Territories. The new Consumer Assistance Grants Program will help States establish consumer assistance offices or strengthen existing ones. The new funds will be used to provide consumers with the information they need to pick from a range of coverage options that best meets their needs. For more information about this grant opportunity, please visit www.grants.gov.