Dear Chapter Executive Directors: We told you last week that we would update you regarding any information we learned about the status of the Centers for Medicare & Medicaid Services’ (CMS) Interim Final Rule regarding patient assistance programs. Yesterday, Health and Human Services (HHS) Secretary Kathleen Sebelius issued a letter to the President & CEO of the American Hospital Association, Richard Umbdenstock, regarding CMS’ Interim Final Rule. In her letter, Secretary Sebelius indicates that there are no restrictions on non-profit assistance programs providing patient assistance to individuals who purchase qualified health plans (QHPs) in the various federal and state Marketplaces. Non-profit assistance programs are required to comply with criteria included in a February 7, 2014 FAQ issued by CMS, which requires these programs to have defined financial criteria for individuals participating in the program and not consider an enrollee’s health status. What constitutes as consideration of an enrollee’s “health status” is unclear. Unfortunately, the letter does not directly rectify the situation that is occurring in Louisiana with three (as of today) health insurers who have prevented non-profit assistance programs like PSI from providing patient assistance for their QHP enrollees, since it still remains optional for insurers to accept these payments. The letter also indicates that CMS will issue no further guidance on this issue. We hope that this letter serves to apply pressure on the Louisiana plans to encourage them to reverse their current position, but it is unclear whether they will do so. We will continue to monitor the situation and will seek additional opportunities to advocate for consumer access to these vital programs. Sincerely, Nicole Quinn-Gato Nicole D. Quinn-Gato, J.D. Senior Policy Analyst National Hemophilia Foundation (801) 884-8120 [email protected]
Posted on: Thu, 22 May 2014 20:03:33 +0000
Trending Topics
Recently Viewed Topics
© 2015