Insurers Should Reject 3rd Party Premium Payments, HHS Says

The U.S. Department of Health & Human Services is discouraging hospitals and other health systems from providing patients with premium payment and cost-sharing support for plans purchased under healthcare reform.

In a question-and-answer document, HHS said it has “significant concerns” with hospitals supporting premium payment and cost-sharing obligations because it “could skew the insurance risk pool and create an unlevel field in the Marketplace.”

That’s why HHS is encouraging insurers to reject these third-party payments. The agency added it will monitor this practice and take appropriate action, if necessary.

Although HHS said last week that the federal anti-kickback statute doesn’t prevent hospitals and other health systems from subsidizing premiums for patients who buy insurance coverage on exchanges, the recent Q&A doesn’t contradict that clarification, AHA News Now reported.

“While the latest guidance creates many unanswered questions, its message is extremely disappointing and entirely inconsistent with the goals of expanding access to care and coverage,” Rick Pollack, the American Hospital Association’s executive vice president, said.

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