The rule was set to take effect Friday. However, Judge Mazzant issued a temporary restraining order, according to the report.
HHS initially said dialysis providers have a “strong financial incentive … to use premium payments to steer as many patients as possible to commercial plans” such as individual plans sold in the ACA marketplace, according to the report. The rule said the dialysis companies benefit financially when patients are insured through commercial plans rather than through government programs, which often have lower reimbursements than commercial plans, the report states. Additionally, according to the report, HHS said patients are harmed because they sometimes have problems enrolling in the individual insurance plans, facing potentially higher costs and disruption if an insurer decided to stop accepting their third-party premium support.
Major dialysis providers and a patient group, including DaVita and Fresenius Medical Care North America, a subsidiary of a German company, filed a lawsuit, claiming the federal governemnt had improperly rushed out the rule and it could hurt patients trying to enroll in individual plans, reports WSJ.
In issuing the temporary restraining order, Judge Mazzant said the plaintiffs had demonstrated HHS “likely violated the procedures” of a law governing the issuance of federal regulations, according to the report. He also said the rule might hurt patients by causing them “to shift to public insurance options, and many patients would be better served by private insurance options.”
Under the rule, dialysis providers would have to notify insurers when their patients are getting help from the providers, directly or indirectly, to pay premiums for individual insurance plans, according to the report. Additionally, the report notes, under the rule, providers are expected to get confirmation the insurer will accept those payments.
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