HLT-201: Health Insurance Law
Welcome to Lawshelf’s video course on health insurance law. This course looks at the complex regulatory framework under which the primary driver of the healthcare industry, which accounts for almost 1/5 of the American economy, operates. This is a beginner-level course, and no prior knowledge or experience is necessary to take this course.
The course starts by defining health insurance and going over the types of health insurance plans. We’ll also look at standard policy terms and provisions and their effects.
Module 2 focuses on risks and coverage. All insurance policies are tools for spreading risks and coverage rules are functions of that principle. State and federal laws, including and especially the Affordable care Act, govern what policies must cover.
In Module 3, we’ll focus on pre-existing conditions and the Affordable Care Act’s mandate requiring these to be covered in most cases. We’ll also look at grounds for rescission of health insurance policies, such as fraud and misrepresentation. Finally, the module covers portability of health insurance policies, including the role of the federal HIPAA law.
Module 4 turns to claims. We’ll look at notices of claims and the necessary proofs of loss before insurance companies are required to pay claims. We’ll also look at the timing of claims and notice requirements.
Finally, in Module 5, we’ll turn to a potpourri of miscellaneous topics relevant to health insurance. These include characteristics of group coverage, coordination of benefits when a patient is covered by more than one policy, continuing health coverage under COBRA and the evolving field of healthcare fraud.
This course should familiarize you with the landscape of health insurance law and how the industry operates.
Best of luck and we welcome your feedback.