Hospital chiefs call for more oversight of limited/ tiered health plans


Edward J. Benz, Jr., MDEdward J. Benz, Jr., MD 

In an editorial in Saturday's edition of The Boston Globe, Dana-Farber President Edward J. Benz, Jr., MD, and Children's Hospital Boston President James Mandell, MD, warn that new, lower-premium health insurance plans may hinder patients with complex medical conditions from receiving the specialized care services they need.

Such plans cover treatment at "limited" or "tiered" networks of hospitals and clinics. Patients enrolled in these plans often are not covered for care at more costly hospitals, or they must pay higher deductibles or insurance co-payments for treatment at such facilities.

In the op-ed piece, Benz and Mandell urge state insurance regulators, who write and enforce the rules for limited and tiered networks, to ensure that these networks not become a barrier to specialized care, particularly for low-income patients, and not disrupt the continuity of care for patients with cancer and other complex diseases.

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