Addressing Commercial Health Plan Abuses to Ensure Fair Coverage for Patients and Providers

Health care coverage is eroding for many Americans as some health insurers are restricting access to services through administrative barriers and inappropriately withholding reimbursement from providers. The American Hospital Association released this white paper to examine a number of these tactics and the implications for patients and providers. This white paper is the result of interviews with and data collection from hundreds of hospitals and health systems around the country. Their experience demonstrates that policy interventions are needed to protect patient access to care and streamline requirements to reduce burden and cost in the health care system, and the paper includes a number of recommended policy solutions.

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