The rising costs of health care are affecting financial bottom lines for families all across the country – especially those confronting expensive, chronic health conditions. To make matters worse, a misguided federal policy is now preventing charities – one of the only lifelines these families have left – from helping to access the care they need.
Patient advocacy groups are pushing bipartisan legislation that would require qualified health plans to accept premium payments from charitable organizations since CMS has so far refused to impose such a requirement. Patient organizations say CMS' silence on the issue leads plans to reject payments on behalf of chronically ill patients and threatens to undermine the goal of the Affordable Care Act.
CMS issued an interim final rule in March 2014 clarifying that QHPs must accept third-party payments from the Ryan White program and from tribal entities, but did not mandate that plans need to accept payments from charitable organizations. Advocates say this led to plans rejecting payments in at least 35 states.