Manual Explains Autism Law to Health Insurers

Since 1991, over half the states have enacted laws that restrict or prohibit insurers’ use of genetic information in pricing, issuing, or structuring health insurance. Wisconsin was the first state to do so, in 1991, followed by Ohio in 1993, California and Colorado in 1994, and then several more states a year in each of the next five years. Similar legislation has been pending in Congress for several years. Also, a 1996 federal law known as the Health Insurance Portability and Accountability Act (HIPAA) prohibits group health insurers from applying “preexisting condition” exclusions to genetic conditions that are indicated solely by genetic tests and not by any actual symptoms.

Download Full-text

British health insurers fail to learn lessons from the US

BMJ ◽

10.1136/bmj.312.7044.1482a ◽

1996 ◽

Vol 312 (7044) ◽

pp. 1482-1482

Author(s):

A. Hopkins

Keyword(s):

The Us ◽

British Health ◽

Health Insurers

Download Full-text

Do health insurers have an ethical responsibility to cover treatment of vitiligo?

Pediatric Dermatology ◽

10.1111/pde.14689 ◽

2021 ◽

Vol 38 (S2) ◽

pp. 187-187

Author(s):

Lionel Bercovitch

Keyword(s):

Ethical Responsibility ◽

Health Insurers

Download Full-text

FACTORS INFLUENCING HEALTH INSURERS' DECISIONS TO COVER NEW GENETIC TECHNOLOGIES

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230016115x ◽

2000 ◽

Vol 16 (1) ◽

pp. 178-189 ◽

Cited By ~ 15

Author(s):

Michele M. Schoonmaker ◽

Barbara A. Bernhardt ◽

Neil A. Holtzman

Keyword(s):

Gene Therapy ◽

Critical Role ◽

Medical Costs ◽

Outpatient Setting ◽

Carrier Screening ◽

Consensus Conference ◽

Detection Rates ◽

Factors Influencing ◽

Genetic Technologies ◽

Health Insurers

Objective: To examine the relative importance of factors influencing health insurers' coverage of new genetic technologies.Methods: A national survey in which the decision makers for private health insurers were asked whether they would cover cystic fibrosis (CF) carrier screening, testing for genetic susceptibility to breast cancer (BRCA test), and medical costs of a clinical trial of gene therapy for CF under a variety of conditions.Results: Respondents' coverage of the two tests and of medical costs of clinical trials was low at the time of the study (4%–15.5% of insurers.) Their coverage of CF carrier screening and BRCA testing would be increased significantly if the group tested was restricted to those at high risk, if detection rates were higher and costs lower, and if testing was endorsed by a national professional group or consensus conference. Coverage of the medical costs of a trial of CF gene therapy would be significantly more likely if the trial was restricted to children or adults with severe CF, safety and effectiveness was proven, and therapy could be administered in a regional hospital or an outpatient setting rather than in a research hospital.Conclusions: Health insurers play a critical role in the diffusion of new genetic technologies. The validity of genetic tests and the safety and effectiveness of new therapies are primary factors influencing health insurers' coverage. Lower costs and approval of professional groups are other factors associated with increased coverage.

Download Full-text