In 2009, managed healthcare facilities are required to comply with a number of issues regarding health plans. According to Rose Leidl, president of Managed Healthcare Unlimited, "Health plans large and small will be facing increasing regulatory scrutiny from Congress, the states and consumer watchdog groups in the coming year. Some of this increased oversight comes as the result of heightened consumer outcry against claims denials, underwriting issues and rescission policies that resulted in investigations that grabbed national attention this past year. But additionally, health plans are facing new coverage mandates and timelines that will require extensive changes in how they do business."
One of the top compliance changes involves language assistance. This requires all health plans be familiar with state requirements for assessing and servicing the language needs of their members. These health plans must provide appropriate translation and interpretation services, as well as oversight of the linguistic services used by medical providers.
"Even organization with strong compliance programs in place should consider reviewing and shoring up their processes and procedures to prevent unexpected problems," said Leidl.
12 January 2009
