As of July 1st, 2018, VSP will no longer allow Out-of-Network (OON) providers to access benefits for their patient’s. They have turned off the phone line that providers use to access patient benefits. Additionally, they have removed the OON benefits information from the member web portal, whereby, a member has no way of visibly discerning all of their benefits. Only audibly over the phone. There are no major changes to Patch, our platform will continue to work as before.This is the first instance we have seen of a carrier offering benefit information and subsequently choosing to actively veil it from consumers. Frankly, we’re in shock that an organization which claims to be consumer and provider friendly, would ever do such a thing… ostensibly, looking to take away the ability for their provider of choice to help a consumer through their insurance process. As an organization whose core mission is to create maximum price transparency for consumers and take friction out of the healthcare purchase process, we are deeply concerned that this action has the potential to create a lack of transparency for consumers benefits, preventing them from making fully informed healthcare decisions at the provider of their choice. We are also deeply concerned for marginalized parties who might be prevented from understanding their benefits.
Why we care
This announcement was not written due to any major changes with how Patch works and will continue to work. This post is a call to action. A move by an insurance company that may marginalize people from getting benefits and could prevent providers from treating patients in an expeditious way is a dangerous precedent, and we encourage you to stand for your industry and patients across the country. Some of the laws which could be brought up in this fallout are:
- The information-blocking provision under the 2016 Cures Act
- The Affordable Care Act Section 1557
According to the 21st Century Cures Act, technologies or entities discovered to knowingly "Interfere with, prevent, or materially discourage access, exchange, or use of electronic health information" will be subject to fines up to $1 million per violation.
I want to share Patch’s core values and mission statement, so you understand why this is so important to us:
Our mission is to take all of the friction away from individuals who seek to understand and pay for healthcare services, regardless of the option an individual chooses.
We have said this from day one; we are not like the other companies in this space. We are different because we see how things should be and want to invest in that future. When my co-founder, Jeremy Bluvol, and I created this platform two years ago, we did it with you in mind. Please see my most recent blog post on why this is important. We want you to choose your path and provide the best patient experience possible, regardless of if you use our services or not. We built Patch to help empower your practice help your patients make buying decisions with complete transparency of their health care options.
Today we are asking you to help us build the future we’re striving for. We are asking you to get upset and outraged, tell your friends and colleagues and help us make the long overdue change this industry needs. You are a part of building the future of healthcare, but we need your help to make sure there is a consistent balance.
“The Only Thing Necessary for the Triumph of Evil is that Good Men Do Nothing”
- Edmund Burke
What to do next
If you want to help hold VSP accountable for any wrongdoings they may have committed in this action, please send complaints to ALL of the following agencies. Remember, VSP has actively removed benefits from the member portal and also shut down their provider benefits phone line.
Office of the National Coordinator (ONC) - 21st Century Cures Act: http://www.healthIt.gov/healthItcomplaints
Office of the Inspector General (OIG) - 21st Century Cures Act: 1 (800) 447-8477
California Department of Managed Healthcare - Whistleblower Hotline: 1 (888) 466-2219
Consumers interested in submitting a complaint regarding their right of access or discrimination based on disability can do so with the HHS Office of Civil Rights: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf