The FEHBlog noted last week that HHS Secretary Sebelius had sent a letter to Congress last week indicating that exchange plans are exempt from the federal health programs anti-kickback law. Hospitals saw that law as an obstacle to pay patients’ premiums for exchange coverage, The Wall Street Journal reported that brand name drug manufacturers were jumping for joy because the letter appeared to give the green light for the use of co-pay cards in the exchanges. Yesterday, however, CMS posted the following FAQ which will not make hospital or drug manufacturer CFOs happy:
Q: Are third party payors permitted to make premium payments to health insurance issuers for qualified health plans on behalf of enrolled individuals?
A: The Department of Health and Human Services (HHS) has broad authority to regulate the Federal and State Marketplaces (e.g., section 1321(a) of the Affordable Care Act). It has been suggested that hospitals, other healthcare providers, and other commercial entities may be considering supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces. HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discourages this practice and encourages issuers to reject such third party payments. HHS intends to monitor this practice and to take appropriate action, if necessary.
But let’s end on an upbeat note. The Cleveland Clinic, a hospital, recently announced its top ten medical innovations for 2014 (not a typo). The number one innovation is a “bionic retina, capable of restoring rudimentary sight in patients after years of near blindness,” Amazing.