Understanding reasons, risks and benefits of commercial health plan disclosure of confidential services through billing

Many states mandate access to confidential sexual health care services for adolescents. Federal and state insurance laws, however, mandate commercial health plans to forward statements documenting all billed and reimbursed medical services to the subscriber, usually the parent/caregiver, with no exception for minors. This catch-22 results in limited access to confidential covered sexual health care services in commercial health plans. Since Medicaid's claims systems support the delivery of confidential adolescent health care services while most commercial plans do not, the fiscal burden of confidential sexual health care services in adolescents is shifted to the public sector or self-pay private sector.