HHS Discourages Hospital Premium Subsidies for Exchange Plans

HHS has discouraged hospitals, other healthcare providers and commercial entities from providing people with premium payment and cost-sharing support for plans purchased under the Patient Protection and Affordable Care Act.

HHS has "significant" concerns about the practice, potentially skewing the insurance risk pool and creating an unequal playing field in the health insurance marketplaces, according to a CMS notice. Therefore, the agency will monitor the practice and has advised health plan issuers to reject such third-party payments.

This statement comes on the heels of guidance HHS issued last week in response to a query from Rep. Jim McDermott , MD (D-Wash.), stating qualified health plans, programs related to the federally facilitated marketplaces and other programs under Title I of the reform law aren't considered federal healthcare programs.

That classification means the federal Anti-Kickback Statue shouldn't apply to qualified health plans and therefore won't present a barrier for hospitals looking to subsidize premiums for health plans purchased through the exchanges, according to the American Hospital Association.

Although the latest notice from CMS doesn't contradict that guidance, AHA Executive Vice President Rick Pollack has said it creates unanswered questions and is "extremely disappointing and entirely inconsistent with the goals of expanding access to care and coverage," according to an AHA News report.

More Articles on PPACA Health Plans:
Study: 17M Eligible for Tax Credits Under PPACA
Report: A Look at PPACA Health Insurance Exchange Premiums
HHS: Qualified Health Plans Aren't Federal Programs 

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