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Consumer Coalition Sends Letter to OPM Opposing Health Insurance Denials

On September 19th, the Consumer Choice Center, alongside individuals impacted by the actions of Blue Cross Blue Shield (BCBS), sent a letter to the Office of Personnel Management regarding BCBS denying legitimate medical claims from members of the Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) agencies for equipment needed to do their jobs safely and effectively. 

OPM Consumer Coalition Letter - Health Insurance Denials

Blatant denials in health insurance coverage are on the rise and pose a great threat to consumer choice.  In 2022, an estimated 15 percent of all claims submitted to private payers faced denial, including treatments and services that received pre-authorization. However, the reality might be much worse considering the severe lack of quality data collected by regulators from health insurance companies regarding their coverage denial rates. 

There is a clear need for health insurance reform. As the Consumer Choice Center has stated before, one easy solution is to require health insurance companies to be more transparent in their coverage decisions to ensure consumers are aware of a company’s denial rates and standards they use to determine what is and what is not a medical necessity. 

Additionally, more preventative care and coverage should be encouraged. In the case of CBP and ICE agents, having better hearing protection now as a preventative safety measure will alleviate costs in the long term. The faster we can address and prevent a medical issue, the less people’s health and wallets will suffer. 

This is why we hope that the Office for Personnel Management will take the necessary steps to ensure federal employees receive the equipment that they need to do their jobs safely and effectively.

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