Posted on 12/06/2013 6:15:21 AM PST by Kaslin
"Uh-oh." That's the sound being uttered in doctors' offices and hospitals across the country as medical providers realize they're getting stuck with another bottomless Obamacare bill. While the White House desperately tries to pivot from the havoc wrought by the "Affordable Care Act," its hidden regulatory bombs keep exploding.
I heard about the latest problem this week from an eye doctor friend who received a letter from a Colorado-based insurer informing her that she's essentially on the hook for Obamacare's payment grace period for debtors. The optometrist is bracing for a flood of similar letters from other insurers. Like countless other independent providers, she's extremely concerned about the potential liability, uncertainty and fraud the rule imposes on her business.
Here's the raw deal: The Affordable Care Act created a 90-day grace period before insurers can drop patients who fall behind on premiums. So, delinquents who obtain tax-subsidized health insurance through an Obamacare health insurance exchange have three months to settle up their bills prior to their policy being canceled. As written, the law puts insurers on the hook for the grace period.
But the bureaucrats at the Centers for Medicare and Medicaid Services decided to issue a rule in March making insurers responsible only for paying claims during the first 30 days of the debtors' grace period. Who's on the hook for the other two months? Well, customers are entrusted to foot the bills for additional services. But if they blow off the payments, it's up to physicians and hospitals to collect.
In real-world practice, this means providers will be eating untold costs. Several large hospital associations raised red flags over the issue this summer. In August, the Missouri Hospital Association noted that the regulatory shift "unduly burdens physicians, hospitals and other health care providers" by making them directly collect payments from patients, which "puts them at an unfair and significant risk for providing uncompensated care to patients."
Emillie J DiChristina of Practicefirst Medical Management Solutions spelled out the financial risks for clients on the company's blog: "This leaves providers in a potentially bad place as they have a high potential for accruing bad debt on services provided between 31 and 90 days of the allowed grace period." Can you spell f-r-a-u-d? People could "go on and off" insurance plans, Tampa Bay health care lawyer Bruce Lamb told me, and game the system by bailing on payments and exploiting Obamacare protections against denial of coverage.
Or as MHA officials put it: "We also are very concerned that some disreputable individuals will learn they can manipulate the system and win a full year's insurance coverage on only nine months of premiums. Knowing they are entitled to three months of grace period coverage, dishonest persons could stop paying premiums on the ninth month, enjoy free coverage during the 90-day grace period, have their coverage terminated, and then re-enter the exchange market where the Affordable Care Act's guaranteed issue mandate would prohibit another plan from denying them coverage."
Think such nefarious behavior won't occur? Then you haven't been paying attention to the data manipulators and con artists in the Obamacare navigator program. As I reported earlier this year, the seedy nonprofit Seedco secured multimillion-dollar navigator contracts in Georgia, Maryland, Tennessee and New York to recruit Obamacare recipients into the government-run exchanges -- despite settling a civil fraud lawsuit for faking at least 1,400 of 6,500 job placements under a $22.2 million federally funded contract with New York City a year ago.
Additionally, investigative journalist James O'Keefe and his Project Veritas team have caught Obamacare navigators on tape advising health insurance exchange customers to under-report their income and lie about their health status in order to cheat the system.
CMS has made no effort to repeal its cost-shifting rule or to do anything to address the concerns of providers who will be left holding the bag. As one hospital rep told me: "It's potentially catastrophic." Private practices are already being hit hard with slashed reimbursements, the electronic medical records mandate, ICD-10 medical diagnostic code changes, and increasing federal intrusions on how they provide care. In yet another entry on the laundry list of Obamacare's unintended consequences, this regulation will hurt patients by dissuading doctors from participating in exchange plans.
In short: less choice, higher prices, increased potential for fraud, more bureaucratic headaches and more disincentives to enter or stay in the medical profession. When the government grants "grace," everyone must watch their wallets. It's always easy to afford compassion when someone else is paying for it.
This would appear to force doctors to say to patients, You got cash? No cash, no appointment; we don’t accept OCare IOU’s.
Which is a good thing.
OHOH
Dr. Atlas is going to shrug and look for other things to do.
Upside, maybe, will be the appearance of a new set of self pay facilities, perhaps with ridiculously easy financing plans, or something like what has already been seen to work, a fixed monthly dues to get anything seen in the office that can be seen in an office.
The jello of medicine WILL squeeze out of these rubber bands of regulation. Maybe it will even be a good thing, which Obarack will then promptly take credit for, but by now he will be known as an egotistical gasbag, a rooster that pretends his crowing is what brings the sun up in the morning.
I remember back in the 80’s paying in full for doctor visits, then filling out the paperwork at work and sending to HR, and THEN getting a reimbursement check from the insurance company. Maybe they should return to that.
My internist is already a cash up front kind of doc.
If your deductible isn’t met when you complete your visit, his receptionist hands you a bill. He takes cash or check. No CC’s.
Now that our deductible will be $12500 starting Jan 1, this means we only get one visit per year with him. Hubby and I will have to alternate yearly visits.
Ha!
Most doctors I visit require payment UPFRONT.
To include to co-pay.
This is really a 2% cost increase to the medical provider’s operating cost. Which probably translates to an increase of 2.5-3% passed along to the consumer. Multiplied by hundreds of customers, this is a significant increase to the provider.
Good grief. This couldn’t possibly result in people waiting until they get sick to sign up, paying foy one month, but collecting four months benefits.
Oh the games... which is how people commonly get around socialism’s ills. That would be only one of the possible games.
Becoming a Doctor in today’s world is laborious, studious and expensive in both length of time for qualification and cost of study, yet this administration seems to treat it as an infinite resource in money and population.
Notice that Obama has previously expressed enthusiasm towards Britain’s National Health Services (NHS) and its universal care. Aside from the not infrequent NHS horror stories, a prominent aspect of NHS staffing is the large numbers of foreign born and trained caregivers. It is not hard to prognosticate that if the government wants healthcare done on the cheap, ways will be found to do it. Remember the triad axiom, you can have a job done well, done quickly or done cheaply but you can get only 2 of these three! Obamacare has started off with cheap and it looks like it will choose quick as well.
Two is the maximum. One or none are also possible results.
Why would anyone want to sign up on a site that is not secure?
Obamacare the gift that keeps on giving...other peoples money!
Some people lose little by having their identities and personal information stolen. That said, you have a point that using the website at all may still be a bigger risk for some than the gain from straightforward benefits fraud.
Agreed and I should add that if you do get the 2-of-3, you get the opposite of the missing triad, (done well+fast) = expensive, (done well+cheap) = slow, (fast+cheap) = shoddy!
Of course, this comes IF you can make a decision and does not apply if the decision is FORCED upon you!
How can you say you made the insurers provide "coverage" when they don't have to pay the providers? For 60 days, you're not cancelled but you might as well be, because they won't pay. But you're still "covered"?
This is confusing, a concept that's true and not true at the same time. It's like someone telling you that 2+2=4 and 2+2=5, and they're right (where have I heard that before)?
The whole idea makes my head spin, like it's in a centrifuge...wait, are the centrifuges still spinning? I thought we stopped them...
< TILT >
All of this and more is designed to force everyone into a single-payer system under the Fed. Gov. I can see the consequences of this from here. One of which could easily be the demand of sterilization to get ‘Healthcare’. If you are capable of breeding then you get no help from the ‘system’.
Another that comes to mind is the lifetime cap on services including drugs. Exceed it and no more service. It’s time to die M.F.
Think it won’t happen? These people want to be the deciders of life and death and the morality of everything in between. They don’t care about you as an individual... you are a percentage in a demographic, nothing more than that.
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