HHS will not forbid qualified health plans sold through the health insurance exchanges from accepting premium payments made by private, nonprofit foundations, according to a letter HHS Secretary Kathleen Sebelius sent to the American Hospital Association.
Ms. Sebelius wrote QHPs can accept third-party premium and cost-sharing payments from nonprofit foundations as long as the payments are made on behalf of health plan enrollees "who satisfy defined criteria that are based on financial status and do not consider enrollees' health status." Additionally, CMS expects premium and any cost-sharing payments to cover the entire policy year.
Ms. Sebelius wrote in response to multiple inquiries from the AHA about third-party premium and cost-sharing payments. Earlier this month, the AHA wrote to CMS Administrator Marilyn Tavenner urging her to issue an interim final rule requiring QHPs offered through the Patient Protection and Affordable Care Act exchanges to accept payments from hospitals, hospital-affiliated foundations and other charitable organizations. AHA President and CEO Rich Umbdenstock wrote, "Any effort to limit the ability of hospitals or hospital-affiliated foundations and other charitable organizations to help individuals in need obtain access to health insurance coverage is bad public policy. Not only does it undermine one of the core objectives of the [PPACA] — making affordable insurance coverage available to the uninsured — it would adversely impact those who need it most, the poor and sick."
Last month, the AHA and the Catholic Health Association sent a similar letter to HHS, asking the agency to clarify that it doesn't discourage hospital-affiliated and other charitable foundations from subsidizing health insurance premiums for exchange plans. The AHA and CHA wrote the uncertainty surrounding third-party premium payments from charitable foundations limited their ability to help Americans obtain health insurance coverage under the PPACA.
More Articles on Premium and Cost-Sharing Payments:
Qualified Health Plans Should Accept Third-Party Premium Payments, AHA Says
Hospital Groups Ask HHS for Clarification on Health Insurance Subsidies
Health Insurers: Most Exchange Enrollees Have Paid First Premiums