CMS Could Require Health Insurers to Accept Ryan White Funds

CMS is considering making it mandatory that health insurers accept third-party premium payments made under the Ryan White Act to ensure coverage for people with HIV/AIDS, according to a Reuters report.

Blue Cross and Blue Shield of Louisiana, the state's largest health insurer, has been rejecting Ryan White funds and telling customers their enrollment in health plans offered through the Patient Protection and Affordable Care Act health insurance exchanges will be discontinued, according to the report. Blue Cross has said it is rejecting third-party premium payments in an effort to prevent potential fraud.

Many HIV/AIDS patients fall into the PPACA coverage gap, meaning their incomes are too high to qualify for Medicaid (which Louisiana opted not to expand under the healthcare reform law) but too low to qualify for federal subsidies to help pay for premiums, according to the report.

The 1990 Ryan White Act offers people with HIV/AIDS federal financial assistance in paying for medications and health insurance premiums. This past Saturday, CMS issued a statement reiterating its guidance encouraging health insurance issuers to accept Ryan White payments. CMS is considering amending federal rules to require insurers to accept those funds, according to the report.

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