PartnerRe Health

With wishes for a joyous and safe holiday season.

Here is a very interesting article on "Organ Transplant Trends Continue to Challenge Solvency of Companies Self-Insured Health Plans". https://issuu.com/sipconlinepub/docs/selfinsurerdec2020web

A surprise billing fix is part of the government funding deal. Patients will only be responsible for their in-network cost-sharing for both emergencies and certain non-emergencies where patients do not have the ability to choose an in-network provider. Out-of-network providers will be prohibited from billing a patient for the balance unless they provided notice of their network status and an estimate of charges 72 hours in advance, and the patient consents to receiving out-of...-network care. The legislation will cover air ambulances, but not ground ambulances. The legislation will further require that insurers and providers resolve the remaining bill through negotiation or an independent dispute resolution process. The arbiter will be required to consider the median in-network rate, previous contracts, the complexity of services, training of the provider, market share of the parties and other factors. However, the latest version of the legislation forbids arbiters from taking into account Medicare and Medicaid rates. There will also be a 90-day window before the parties can return to arbitration for the same service. Unlike prior deals, there will be no minimum payment threshold to enter arbitration. For more information feel free to reach out to your PartnerRe Client Partner.

Jean-Sebastien Theberge IT Systems Administrator [email protected]

Dr. Achim Regenauer, Chief Medical Officer, PartnerRe participated in this panel discussion on Digital Health. https://www.youtube.com/watch?v=pWB3gUtNMYs&feature=youtu.be