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Local Leagues in New Mexico

 

Possible Questions to Consider in the Study

Billing transparency and Accuracy:

Should we take positions on issues like "Surprise billing", incorrectly itemized or non-itemized bills, other related issues?

How important is transparency?

What is the status of NM's health care sunshine website?

What are other states' experiences with sunshine websites, limitations on surprise billing, or related measures? (California, Florida, and New York have legislation limiting surprise billing. Which other states, and what is the legislation like? How is it working?)

Contesting bills

Should consumers be entitled to contest bills they feel are inaccurate?

How much information should they be entitled to?

What sorts of procedures should be in place related to billing? (This is vague ... can we make it more specific?)

Choosing Healthcare Plans

Is there a way to police transparency in what's covered by various healthcare plans, both before signing up for a plan and after coverage begins?

Should short-term or limited insurance plans be allowed? If so, should there be restrictions on them?

Copays

There's a proposal to start requiring copays for Medicaid. Are copays acceptable because they help consumers be invested in their own healthcare, or are they a barrier that keep poor people away from doctors?

Retroactive Medicaid eligibility

Is this an issue we should take a position on? What are the issues?

Single-Payer at the State Level

Several states, including CA and NY, are considering single-payer health care legislation, usually based on Medicaid. Is it a good idea?
LWVUS already has a position in favor of single-payer health care; but are there issues we should look at related to implementing it on a single state basis?


Relevant Reading

General Articles

LWVAZ Members Speak Out on Healthcare
from the LWV Arizona

The Company Behind Many Surprise Emergency Room Bills (New York Times)

Protect Medicare Now' campaign is an industry-backed attempt to squash one of the few ways to control health care spending
(Health News Review)

Hospitals and doctors: Is their role in soaring health care costs overlooked? with lots of useful links to other articles and lists.
(Health News Review)

Proposed Federal and State Legislation

(As of October/November 2017)

On Oct 4, Michelle Lujan Grisham introduced a bill to ban "surprise billing" and related practices:
The Fair Billing Act on GovTrack.

On Oct 25, Ben Ray Luján was one of the two introducers of the State Public Option Act, which would allow states to create a Medicaid buy-in program for all state residents regardless of income. Lujan Grisham is also a sponsor, as are senators Udall and Heinrich.
And then on Oct 27, Lujan Grisham introduced another bill, the Health Care Choice and Affordability Act, that would allow states that contain counties with one or fewer insurers to offer Medicaid through the health insurance marketplace.
GovTrack links for those bills:
State Public Option Act, House
State Public Option Act, Senate
The Health Care Choice and Affordability Act

Some press coverage:

Meanwhile, at the state level, New Mexico's Human Services Department (HSD) has proposed changes to the state's Medicaid program. ABQ Journal guest column by Dr. Brian Etheridge / President, New Mexico Pediatric Society, opposes them:
HSD's proposed Medicaid redesign has too many flaws (Albuquerque Journal).

Background on Medical Billing and Coding

Top 25 Medical Billing and Coding Articles
including a glossary, a description of the process, etc.

Older articles related to medical billing:

Bitter Pill: Why Medical Bills Are Killing Us, How outrageous pricing and egregious profits are destroying our health care.
Steven Brill's acclaimed 2013 Time magazine article, though Time seems to have abridged the original online version, perhaps because there's now a book version: America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System.

Why You Should Care about the New Major Changes in Medical Billing: The transition to 142,000 new diagnostic and procedure codes from the current 19,000 could significantly alter our understanding of care and how to improve it
(September 2015, Scientific American).

Those Indecipherable Medical Bills? They're One Reason Health Care Costs So Much. Hospitals have learned to manipulate medical codes -- often resulting in mind-boggling bills
(March 2017, New York Times).