Hoping once again to dodge federal managed-care legislation and consumer ire, the American Association of Health Plans is urging its members to start using independent review programs to resolve contested claims more quickly and fairly.
Such programs would require health plans to contract with a neutral third party to play referee when health plans and their members disagree over coverage decisions.
Although consumers may enjoy a more expedited process, they will likely be paying for such programs through higher premiums.
At the group's annual policy conference in Washington last week, AAHP President Karen Ignagni also outlined the group's policy initiatives, including a preference for developing industry standards over passing "patient protection" legislation.
In fact, the group of health plans is prepared to fight off aggressive federal legislation with a television advertising blitz and grass-roots campaigning. "We stand ready to work with the new Congress to address the real issues that matter most to working families, senior citizens and small business," Ignagni said. "However, if the debate again focuses on how best to enrich trial lawyers . . . we will reject these approaches and work actively to defeat them."
The AAHP spent $5 million last year to kill managed-care legislation it deemed unfavorable to the industry, including proposals that would have allowed members to sue their health plans.