[MMA News Now, Aug. 22, 2013]
The MMA, along with the Minnesota Hospital Association (MHA) and the Minnesota Medical Group Management Association (MMGMA), sent a letter
to the Centers for Medicare and Medicaid Services (CMS) on Aug. 19 asking the organization to reconsider its grace period regulation for certain MNsure plan enrollees.
A similar letter was also sent to Minnesota’s eight U.S. representatives asking them for support on the matter.
A March CMS ruling provides health insurance exchange enrollees a 90-day grace period for nonpayment of Qualified Health Plan (QHP) premiums. According to the rule, providers’ claims for payment made within the first 30 days of the grace period must be covered by the QHP. However, the QHP may “pend” any claims made in the following 60 days. This leaves providers with little protection and at risk of increased uncompensated care costs – costs the Affordable Care Act was intended to lower.
The letter asks the CMS to modify its ruling so that any uncompensated costs are covered by the federal government and/or the QHP.
“Placing the financial risk on providers who deliver care and treatment with the good faith understanding that the patient continues to be covered is patently unfair,” the letter says. “Moreover, it undermines the basic policy objective of continuing to provide coverage to people who are unable to pay premiums for a month or two.”
The letters to CMS and the U.S. representatives are signed by MMA President Dan Maddox, M.D., MHA President Lawrence Massa, and MMGMA President Sandra Kamin.