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UnitedHealth Backs PPACA Consumer Protection Provisions

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A unit of UnitedHealth Group Inc. says it will stick with some of the patient relationship requirements set by the federal Patient Protection and Affordable Care Act of 2010 (PPACA) no matter what the U.S. Supreme Court concludes about the constitutionality of the law.

UnitedHealthcare, the health insurance arm of UnitedHealth, Minnetonka, Minn. (NYSE:UNH), says one of the PPACA provisions that it will adopt as its own standard includes the requirement that plans that offer dependent coverage make the coverage available to dependents up to age 26.

UnitedHealthcare also will continue to follow the new appeals process standards; a rule that bans moves to rescind coverage except in cases of fraud; a rule that bans lifetime benefits limits; and a rule requiring non-grandfathered plans to provide a package of basic preventive health services, such as blood pressure checks, with no out-of-pocket costs for the patient.

UnitedHealthcare will work with other companies to try to find a practical way to implement a rule banning plans from imposing pre-existing condition exclusions on children up to age 19, the company says.

UnitedHealth President Stephen Hemsley says in a statement that the company is voluntarily agreeing to keep the standards because the standards promote access to quality care and can help control health care costs.

“These provisions make sense for the people we serve, and it is important to ensure they know these provisions will continue,” Hemsley says.

Observers expect the Supreme Court to issue a ruling on the constitutionality of PPACA by the end of the month.

The biggest health insurance company trade group, America’s Health Insurance Plans (AHIP), Washington, is getting ready to head to Salt Lake City for its annual meeting, which is set to start June 20.

Executives at two of UnitedHealth’s competitors, Aetna Inc., Hartford (NYSE:AET), and Humana Inc., Louisville, Ky. (NYSE:HUM), told the Wall Street Journal that their companies are unlikely to rush to eliminate new PPACA-related coverage features such as the young adult coverage access provision.

Dr. Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, Princeton, N.J., put out a statement welcoming news that the three big insurers will be continuing to abide by some of the PPACA patient relationship requirements.

“We applaud UnitedHealth, Humana and Aetna for their determination to not be held hostage by the political and judicial process and for their leadership in ensuring Americans have access to the health care they need,” Lavizzo-Mourey says in the statement. “We encourage others to follow suit.”

Paul Keckley, executive director of the Deloitte Center for Health Solutions, Washington, says he expects many plans will continue to offer no lifetime limits, expanded preventive health benefits and dependent coverage for dependents up to age 26.

“These are attractive to enrollees and relatively inexpensive,” Keckley says in an e-mail. “The tougher discussion, if the individual mandate is set aside, will be how the guaranteed issue and community rating requirements of [PPACA] will be negotiated. Otherwise, plans will have no choice other than to raise premiums substantially.”


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