Earlier this year, BlueCross BlueShield of
Louisiana, the state's largest carrier, said it would begin
rejecting checks from the Ryan White HIV/AIDS Program for Obamacare
policies it sells. For decades the Ryan White program had helped
low-income people with HIV and AIDS pay for both AIDS drugs and
insurance premiums, but Louisiana Blue said such "third party
payments" invited fraud.
The chief federal agency administering Obamacare, the Centers for
Medicare and Medicaid Services, said on Friday it was requiring
insurers to accept the funds, after saying last month that it
"encouraged" carriers to accept the Ryan White payments and did not
see any potential for fraud.
"Given the importance of access to care for people with HIV/AIDS,
today CMS amended its rules to require health insurance issuers to
accept Ryan White HIV/AIDS Program funds on behalf of eligible
enrollees in individual Marketplace plans," said a CMS spokeswoman.
"We will work directly with issuers to ensure they are in compliance
with this policy."
Although the controversy over the Ryan White payments attracted the
most attention, the CMS rule also requires insurers to accept
premium payments on behalf of Obamacare customers from Indian
tribes, tribal organizations, urban Indian organizations, and state
and federal government programs.
After CMS had encouraged acceptance of the funds, Louisiana Blue had
said it would not take the Ryan White payments after this month,
threatening hundreds of customers with loss of coverage due to
inability to pay. Lambda Legal, a civil rights group that works on
behalf of gay men and lesbians, filed a lawsuit against the company,
asking a court to require Louisiana Blue to accept the payments.
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On Monday the company said it would do so, but only through
November 15, 2014, when the next open enrollment period for
Obamacare begins. The current enrollment period, for coverage in
2014, ends on March 31.
Friday's CMS announcement means that Louisiana Blue and all other
carriers will have to accept the Ryan White payments for premiums.
If an insurer refuses to comply with the interim final rule, CMS
said, the organization that submitted the payment or the affected
individual should contact CMS. If a company continues to refuse, CMS
might levy a penalty, it said, without specifying its size.
(Reporting by Sharon Begley; editing by
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