Ngakhale kuti pali lamulo latsopanoli, ogula amaona kuti akungoyembekezera kuti azilipira mwadzidzidzi

The No Surprises Act, yomwe imatchedwa kuteteza odwala ku ngongole zosayembekezereka zachipatala, inayamba kugwira ntchito pa Tsiku la Chaka Chatsopano 2022. Koma lamulo la federal lachepetsa kale malipiro a Medicare pamitengo yapamwamba ya kunja kwa intaneti, komanso mitundu ina ya “malipiro owerengera” ku gawo la zolipira zoperekera Utumiki zomwe sizilipidwa ndi inshuwaransi?

Lipoti lanthawi yayitali la lamulo latsopanoli likusakanikirana.

Ma inshuwaransi azaumoyo amapereka malipoti angapo odabwitsa omwe amaletsedwa ndi lamulo, koma amadandaula za kuchuluka kwa mikangano yodandaula.

Ofufuza amakhulupirira kuti lamuloli lidalembedwa kuti lipereke chitetezo chambiri kwa ogula, koma sanawonebe deta yokwanira kuti aweruze kutsatiridwa.

Ogula zachipatala amazichepetsa, malinga ndi kafukufuku wa Morning Consult mu June. Kafukufukuyu anapeza kuti mmodzi mwa anthu asanu amene anafunsidwa ananena kuti analandira ndalama zachipatala zosayembekezereka m’theka loyamba la chaka. Koma sizikudziwika kuti ndi angati – ngati alipo – mwa zodabwitsazi zikadayenera kuletsedwa chifukwa chachitetezo chochepa cha Musachite zodabwitsa.

Ndizovuta kudziwa ngati lamuloli likugwiritsidwa ntchito chifukwa vuto ndilakuti: Kodi ogula salandira ndalama zodzidzimutsa?

katswiri pamunda

Patricia Kilmar | Director of Healthcare Campaigns ku American PIRG

Lamuloli laletsa ndalama zopitilira 2 miliyoni zomwe zingadabwe kuti zifikire odwala omwe ali ndi inshuwaransi kuyambira Januware 1 mpaka February, malinga ndi mawu ochokera ku AHIP, gulu lazamalonda la inshuwaransi. Koma akatswiri amakayikirabe.

“Ndizovuta kudziwa ngati lamuloli likugwiritsidwa ntchito chifukwa vuto ndi: ogula Ayi Patricia Kilmar, mkulu wa makampeni a zaumoyo ku American Public Interest Research Groups, bungwe ladziko lonse la mabungwe olimbikitsa ogula, akutero Patricia Kilmar.

Chowonjezera kukayikira kwa owonera za mphamvu ya lamuloli ndikudziwitsa ogula za chitetezo chatsopanocho. Mu June, 16% yokha ya akuluakulu adanena kuti adawona, kuwerenga, kapena kumva chinachake chokhudza lamulo la No Surprises Act, malinga ndi kafukufuku wa Morning Consult. Ogula omwe sadziwa malamulo samadziwanso ufulu wawo ngati opereka chithandizo ndi ma inshuwaransi alephera kutsatira.

Kuvuta kwa lamuloli—makamaka m’njira zosiyanitsira zomwe zimaloleza chindapusa chakunja kwa intaneti ndi kulipiritsa koyenera mumikhalidwe ina—kumabweretsa mafunso ena. “Sizinthu zonse zomwe odwala akuganiza kuti ndizodabwitsa zomwe zimayang’aniridwa ndi NSA,” akutero Lauren Adler, wotsogolera wamkulu wa University of Southern California-Brookings-Schiffer Health Policy Initiative. Chisamaliro chachangu, mwachitsanzo, sichitetezedwa ndi lamulo la chisamaliro chadzidzidzi.

Kodi lamulo latsopanoli likugwira ntchito?

Kungakhale koyambirira kwambiri kuti muwone momwe njira zatsopano zotetezera ogula zilili, ndipo mabungwe aboma satulutsa ziwerengero. The Centers for Medicare and Medicaid Services kapena CMS ndi Dipatimenti ya Zaumoyo ndi Zaumoyo za Anthu sanayankhe pempho la deta pa madandaulo ogula za kuphwanya kwa No Surprises Act.

akutero Karen Politz, mnzake wamkulu komanso wotsogolera pa Patient and Consumer Protection Programme ku KFF, bungwe lofalitsa nkhani zaumoyo komanso malamulo. “Ngati cholakwika chachitika, zimagwera kwa wogula kuti adziwe zoyenera kuchita, ndipo si momwe izi ziyenera kukhalira.”

Owonera ena amakhutira ndi momwe lamuloli likugwirira ntchito. “Lamulo lopanda zodabwitsa limagwira ntchito bwino,” akutero Adler. “Sizithetsa vuto lililonse m’dongosolo laumoyo, ndipo pali magwero awiri otsala a ngongole za mphepo.”

Kodi lamulo likuyenera kukutetezani bwanji?

Chitetezo chosadabwitsa ndi chachikulu kwambiri m’chipinda chadzidzidzi, komwe odwala ali pachiwopsezo chachikulu ndipo sangathe kuwongolera ngati madokotala awo onse ali pakampani ya inshuwaransi.

“Malipiro odabwitsa azachipatala adzakhudza chithandizo chadzidzidzi,” akutero Politz. “M’chipinda chodzidzimutsa, palibe kuchotserapo. Aliyense amene akukhudzani kapena kukutumizirani akuyenera kutumiza zonena zawo mwachindunji ku dongosolo lanu laumoyo – asanakutumizireni bilu – kuti adziwe kuchuluka kwa ndalama zomwe mumagawana pa intaneti. Ngati satero, nthawi iliyonse amalangidwa $10,000.

Zipatala zimaletsedwanso kubweza ndalama zothandizira pambuyo pokhazikika, zomwe ndi ntchito zoperekedwa ndi dipatimenti wodwala atalandira chithandizo chadzidzidzi.

Lamulo latsopanoli limatetezanso kubweza kwa kunja kwa intaneti ndi bajeti ya chisamaliro chopanda chithandizo chadzidzidzi, koma ndi zosiyana zosiyanasiyana. Mwachitsanzo, ngati dokotala wanu wapaintaneti akulamula kuyezetsa kuchokera ku labu yakunja, labu ikhoza kukulipiranibe kusiyana pakati pa mitengo yapaintaneti ndi yakunja kwa intaneti.

The No Surprises Act imapereka chitetezo chosiyana kwa ogula ngati simugwiritsa ntchito inshuwaransi. “Ngati mukulipira m’thumba kapena mulibe inshuwaransi, ndiye kuti muli ndi mwayi wokhala ndi chikhulupiriro chabwino,” akutero Kilmar. “Izi zimapatsa ogula mwayi wobwerera m’mbuyo ndikukonzekera zachuma kuti alandire chithandizo chamankhwala.”

Ngati mwapemphedwa kusaina kusiya ufulu wanu pansi pa No Surprises Act, ganizirani musanavomereze zomwe zingakhale zopanda malire zandalama. Ngati mutasaina ndikunong’oneza bondo pambuyo pake, mutha kuyambiranso. Othandizira saloledwa kupempha odwala kuti achotse chitetezo ngati wothandizira pa intaneti palibe, kapena ngati pali zofunikira zachipatala zosayembekezereka kapena ntchito zina zowonjezera.

Zoyenera kuchita mutalandira bilu yosayembekezereka?

Kodi mukuganiza kuti mtengo wa operekera chithandizo ndi wokulirapo bwanji kuposa momwe mungapangire dongosolo lanu pa intaneti? Mungafunikire kuthandizidwa kuti mudziwe chomwe chikuyambitsa mlanduwo. “Izi zitha kukhala zolakwika, kapena opereka chithandizo akuyeserabe kupezerapo mwayi potumiza ndalama,” akutero Kilmar.

Mutha kuyesa kulumikizana ndi CMS ‘No Surprises Help desk pa 800-985-3059; Ntchitoyi ikuuzani momwe mungasulire mkangano kapena madandaulo m’dziko lililonse. Thandizo likupezeka mu Chingerezi ndi zilankhulo zina. “CMS ikuyenera kudziwa yemwe angathetse madandaulo aliwonse,” akutero Politz.

Ndikofunikira kudziwa kuti CMS ili ndi njira ziwiri za ogula omwe savomereza kulipira kwa omwe amapereka:

  • Ngati mugwiritsa ntchito inshuwaransi yazaumoyo ndikuganiza kuti mukulipira ndalama zochulukirapo kuposa mtengo wanu wapaintaneti kwa madokotala kapena ntchito zomwe zimaperekedwa ndi No Surprises Act, mutha Pangani dandaulo.

  • Ngati mulibe inshuwaransi kapena mwasankha kusagwiritsa ntchito inshuwaransi yanu ndipo woperekayo amalipiritsa ndalama zoposa $400 pazomwe akuyerekeza, mutha kutsutsa bilu.

Pansi pa No Surprises Act, dziko lanu lasankha njira imodzi yoyendetsera:

  • Mayiko ena amakhazikitsa lamulo paokha.

  • Mayiko ena amasiya kukakamiza mabungwe a federal.

  • Mayiko enanso amagwirizana ndi mabungwe aboma pazachitetezo.

The No Surprises help desk ikuyenera kukuuzani momwe malamulo amagwirira ntchito mdera lanu.

Adler akupereka lingaliro losiyana poyambira: “Mukalandira bilu yosayembekezereka kuchokera kwa wothandizira, njira yanu yoyamba ndi kampani yanu ya inshuwaransi; iwo amakhala pachiwopsezo cha kutaya laisensi yawo ngati satsatira.

Politz ikupereka njira ina: boma Mapulogalamu othandizira ogula, kapena mabungwe ena aboma kapena aboma omwe amapereka chithandizo kwa ogula ndi nkhani za inshuwaransi. “Ogula akuyenera kufikira aliyense amene akuganiza kuti angawathandize,” akutero.

Leave a Comment

Your email address will not be published. Required fields are marked *