Ex-insurance exec: Amendments to telemedicine bill benefit payers, not patients

While states increasingly are pushing for telemedicine to be covered by insurance, that's not necessarily a good thing for patients in one state, according to a former payer executive.

Wendell Potter (pictured)--who previously served as head of communications for both Cigna and Humana--said that while he thinks the intentions behind such legislation proposed in Missouri might be good, amendments added on to the bill will help insurance companies more than patients, Missourinet has reported.

In a blog post on his personal website, Potter, who now serves as a senior analyst for the Center for Public Integrity, says that the 11th-hour amendments to Senate Bill 262 would "result in a financial windfall for insurance companies … at the expense of residents" by allowing payers to convert HMOs into high-deductible plans.

"HMO customers enjoy relatively low copayments when they get care from in-network doctors and hospitals," Potter writes. "The bill would remove the current requirement that HMO cost sharing be 'reasonable' and allow HMOs to impose high deductibles and coinsurance--up to $3,100 for an individual and $6,250 for a family--in addition to copayments."

According to Missourinet, Gov. Jay Nixon has not indicated his intentions to sign or veto the bill; inaction would cause the bill to automatically become law after July 15.

Potter also says that under the amended bill, only licensed agents or brokers can give advice to Missouri citizens about health plan selection. "This would be a major victory for agents and brokers who are concerned that their incomes might take a hit when people start shopping for insurance on the online health insurance marketplaces or exchanges that states must have up and running by Oct. 1.," he says.

To learn more:
- here's the Missourinet post
- read Potter's blog post
- peruse the amended legislation


The Real Payback of Healthcare Analytics

Tuesday, April 6 | 2pm ET / 11am PT

With the unpredictability of healthcare today, organizations are sharpening their focus on analytics to make more data-informed decisions. Join us for a roundtable session in which thought leaders will discuss how they are maximizing their analytics investments.