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I would love to see the actual law that michelle malkin is speculating about....she did not link to it....as usual and expects the world to believe her on her word....and she may very well be trustworthy to do such, but she still should have linked to this law, as a real journalist would have....i'm telling you, before its over you are going to see doctors and hospitals start refusing obamcare policies. at every turn there seems to be another issue. getting the website functioning will be the worst thing for obamcare because then more and more issues will come to light.
Obamacare's Perilous Protection Plan for Debtors
Who are these bureaucrats in Medicare and Medicaid that introduced this "rule" in March?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.
I would love to see the actual law that michelle malkin is speculating about....she did not link to it....as usual and expects the world to believe her on her word....and she may very well be trustworthy to do such, but she still should have linked to this law, as a real journalist would have....i'm telling you, before its over you are going to see doctors and hospitals start refusing obamcare policies. at every turn there seems to be another issue. getting the website functioning will be the worst thing for obamcare because then more and more issues will come to light.
Obamacare's Perilous Protection Plan for Debtors
here is what is said in her article:
Who are these bureaucrats in Medicare and Medicaid that introduced this "rule" in March?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.
Where is the "rule", is there a copy of it anywhere...is it in print?
And her article says this is for MEDICARE and Medicaid recipients....????
Is the rule ALSO for people who buy Obamacare on the exchange? She talks as if it is the rule for those on the exchange as well, doesn't she? Yet she never mentioned this "rule" covering those who bought on the marketplace?
So, who knows what this is all about....we need more answers, more information, I guess?
here is some more info on it....several articles following California vs the feds on it.... I am reading them now....I would love to see the actual law that michelle malkin is speculating about....she did not link to it....as usual and expects the world to believe her on her word....and she may very well be trustworthy to do such, but she still should have linked to this law, as a real journalist would have....i'm telling you, before its over you are going to see doctors and hospitals start refusing obamcare policies. at every turn there seems to be another issue. getting the website functioning will be the worst thing for obamcare because then more and more issues will come to light.
Obamacare's Perilous Protection Plan for Debtors
here is what is said in her article:
Who are these bureaucrats in Medicare and Medicaid that introduced this "rule" in March?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.
Where is the "rule", is there a copy of it anywhere...is it in print?
And her article says this is for MEDICARE and Medicaid recipients....????
Is the rule ALSO for people who buy Obamacare on the exchange? She talks as if it is the rule for those on the exchange as well, doesn't she? Yet she never mentioned this "rule" covering those who bought on the marketplace?
So, who knows what this is all about....we need more answers, more information, I guess?
It always helps me when I go straight to the source:
Michelle Malkin | Obamacare?s perilous protection plan for debtors «
The article didn't say Medicare and Medicaid recipients, but did reference Centers for Medicare and Medicaid Services (aka CMS).
Here are links from the original article, not the copied Yahoo article.
http://www.modernhealthcare.com/article/20130817/MAGAZINE/308179924
Under the rule interpreting the law, insurers offering plans on the exchanges must provide a three-month grace period to individuals who have enrolled and who have stopped paying their premiums. In the first 30 days, the insurer must continue to pay incurred claims. But for subscribers who ultimately fail to pay premiums within the 90 days and whose coverage is terminated, payers are not required to pay for claims incurred during the last 60 days of the 90-day period.
Commenters Say ACA Grace Period Rule Puts Unfair Burden on Hospitals, Providers | Bloomberg BNA
I can tell you this is already happening with MediCal and Managed MediCal in California. Providers are having to stay on top of when a patient reverts from Managed MediCal to regular MediCal.
The State is not communicating with the provider.
This is especially daunting to hospitals, long term care facilities or any type of inpatient facility.
MediCal pays a flat rate per day no matter what type of inpatient treatment is giving to the patient.
It is rare when a provider breaks even with a MediCal patient.
It gets even more complicated when contractual Managed MediCal ends for a patient who then reverts to regular MediCal.
The provider isn't notified and when they do find out about the insurance switch the provider is responsible for enrolling the patient in MediCal.
Since the provider is already caring for the patient at a loss the delay in enrollment results in further loss of reimbursement for the patient.
Having to jump through hoops like these is one reason providers are staying away from MediCal patients.
Only a few weeks before California’s health benefit exchange begins open enrollment, major strides have been made on the topic of the federal grace period provision, an issue which initially looked as though it would bring significant financial risks to the state’s physicians.
In late August, federal regulators from the Centers for Medicare and Medicaid Services (CMS) informed state officials that a proposal to suspend coverage in months two and three of the federal grace period was generally “consistent” with federal policy. Under this proposal, health plans would not be able to represent to physicians that a patient’s coverage was active during an eligibility verification in months two and three of the grace period. Previously some plans had intended to continue representing the patient as having “active” coverage, despite months of unpaid premiums.
The proposal to suspend coverage was put forward by the state’s Department of Managed Health Care (DMHC) in an attempt to remedy the state-federal conflict and preserve California’s hard-fought patient and provider protections. Under DMHC’s proposal, physicians would provide services during the first month of the grace period, and those claims would be paid normally. However, during months two and three of the grace period, providers would not be under an obligation to render non-emergent services pursuant to their contracts with health plans, and health plans would not be under an obligation to pay claims for those services if rendered – similar to an HMO enrollee seeking out-of-network care. Enrollees would still be able to pay out-of-pocket for services on a fee-for-service basis.
DMHC has since communicated the basics of its suspension of coverage policy to plans participating in Covered California’s new online health insurance marketplace. Additionally, Covered California outlined how it sees the grace period provision functioning during its September meeting, noting that plans will be responsible for informing physicians that an enrollee’s coverage has been suspended, paying claims submitted during the first month regardless of whether or not premiums had been paid, and enrollees would assume financial responsibility for any care received during the second and third months of the grace period under a coverage suspension. Stakeholders are still awaiting details as to the requirements on plans for reinstating a patient’s coverage, such as applicable notices and timeframes.
looks like it was all settled and taken care of and clarified in September, and there is no problem anymore...
Insurance companies will be responsible for first 30 days of medical care, 60-90 days they will SUSPEND their insurance, so all docs and hospitals will not have to see the patient and or provide any services (unless it is a life or death situation) when they see the patient has been suspended....
here's the article explaining it....
Federal, state regulators weigh in on novel grace period proposal - News - California Medical Association
Only a few weeks before California’s health benefit exchange begins open enrollment, major strides have been made on the topic of the federal grace period provision, an issue which initially looked as though it would bring significant financial risks to the state’s physicians.
In late August, federal regulators from the Centers for Medicare and Medicaid Services (CMS) informed state officials that a proposal to suspend coverage in months two and three of the federal grace period was generally “consistent” with federal policy. Under this proposal, health plans would not be able to represent to physicians that a patient’s coverage was active during an eligibility verification in months two and three of the grace period. Previously some plans had intended to continue representing the patient as having “active” coverage, despite months of unpaid premiums.
The proposal to suspend coverage was put forward by the state’s Department of Managed Health Care (DMHC) in an attempt to remedy the state-federal conflict and preserve California’s hard-fought patient and provider protections. Under DMHC’s proposal, physicians would provide services during the first month of the grace period, and those claims would be paid normally. However, during months two and three of the grace period, providers would not be under an obligation to render non-emergent services pursuant to their contracts with health plans, and health plans would not be under an obligation to pay claims for those services if rendered – similar to an HMO enrollee seeking out-of-network care. Enrollees would still be able to pay out-of-pocket for services on a fee-for-service basis.
DMHC has since communicated the basics of its suspension of coverage policy to plans participating in Covered California’s new online health insurance marketplace. Additionally, Covered California outlined how it sees the grace period provision functioning during its September meeting, noting that plans will be responsible for informing physicians that an enrollee’s coverage has been suspended, paying claims submitted during the first month regardless of whether or not premiums had been paid, and enrollees would assume financial responsibility for any care received during the second and third months of the grace period under a coverage suspension. Stakeholders are still awaiting details as to the requirements on plans for reinstating a patient’s coverage, such as applicable notices and timeframes.
looks like Michelle Malkin and others, didn't do enough research or follow through on it?
And HOORAY for California fighting tooth and nail for Fed clarification!
Obamacare will kill middle class
Obamacare is the biggest assault ever on the middle class.
If not radically altered or repealed, it will diminish lifestyles and increase the financial struggles of average individuals and families. Combined with other costly government meddling in the economy, it will destroy the concept of an American middle.
Incomes that over the past decade have barely kept pace with inflation will not absorb the surging cost of health insurance that will come for many, if not most people, on Jan. 1.
We’re painfully familiar with Obamacare’s impact on the individual insurance market. Those who buy their own insurance are seeing policies canceled and replaced with ones costing two to three times as much. President Barack Obama’s fake fix won’t provide much relief.
But Obamacare’s pain is spread much broader. Those with employer-provided insurance are also getting stung. Policies that previously asked for manageable contributions from employees will now carry either much higher monthly premiums or outrageous deductibles and co-pays, or both. Out-of-pocket costs are leaping to an average $5,000 to $6,000 annually for individuals, and $10,000 to $12,000 for families.
That means a young, middle class couple that decides to have a baby will come home with both an infant and a $10,000 bill for delivery and related care. Maybe it’s a good thing Obamacare mandates contraception coverage. Only the poor and the rich will be able to afford to have babies.
I owe Mitt Romney an apology.
During the 2012 Republican presidential primary season, I repeatedly criticized Romney — and personally challenged him during his editorial board meeting with the Washington Examiner — for promising that if elected, on day one of his presidency, he would grant Obamacare waivers to all 50 states.
As I reported, under the text of the law, the ability to offer waivers to states was subject to many restrictions and wouldn’t even be an option until 2017, four years after his hypothetical swearing in.
Though I still believe I was right about what the statute said, as it turns out, I was being old-fashioned by taking the letter of the law so literally.
Having watched President Obama and Secretary of Health and Human Services Kathleen Sebelius over the past several months unilaterally alter or outright ignore major portions of the law, I now believe that a future Republican president would have greater latitude to gut Obamacare than I once thought possible.
....
In pursuing all of these desperate measures, Obama seems to have lost sight of the fact that Republican presidents have lawyers, too.
....
If the administration wanted to go further, a Republican HHS secretary could potentially issue a revised Internal Revenue Service ruling eliminating health insurance subsidies on the federally run exchanges, in accordance with the actual text of Obamacare.
....
True and likely. Given the probable flight of primary care doctors especially from exchange coverage and the subpar finances of Blue/purple states and districts Obama has probably nuked the D base for a very long time."If the administration wanted to go further, a Republican HHS secretary could potentially issue a revised Internal Revenue Service ruling eliminating health insurance subsidies on the federally run exchanges, in accordance with the actual text of Obamacare."
^^
What a novel, priceless concept! A Republican president could nuke Obamacare but actually following the law.
The Obama administration has directly conceded for the first time that 'in many cases,' health insurance plans offered through government exchanges are more expensive than plans consumers bought before the Affordable Care Act became law even when government subsidies are figured in.
In a letter to state insurance commissioners, Center for Consumer Information and Insurance Oversight director Gary Cohen wrote on Thursday that one reason for the new Obamacare measures the president announced Thursday is that millions of consumers receiving cancellation letters from their insurers are learning the Affordable Care Act options are in fact less affordable.
'Although affected individuals and small businesses may access quality health insurance coverage through the new Health Insurance Marketplaces,' Cohen wrote, 'in many cases with federal subsidies, some of them are finding that such coverage would be more expensive than their current coverage, and thus they may [be] dissuaded from immediately transitioning to such coverage.'
His written statement contradicts President Obama's campaign promises that the Affordable Care Act would lower costs for Americans.
In October 2008 he said during a campaign rally in Columbus, Ohio that 'we are going to work with you to lower your premiums by $2,500. We will not wait 20 years from now to do it, or 10 years from now to do it. We will do it by the end of my first term as president.'
Harry Reid: Obamacare 'Costs Me About $4,500 More'
President Barack Obama may have famously promised his signature healthcare plan would cost consumers less money — but Senate Majority Leader Harry Reid, D-Nev., is proof that it's often not true.
"Under Obamacare, my insurance costs me about $4,500 more than it did before," Reid told the Reno Gazette Journal. "Yes, because it is age-related and it wasn't like that before."
Reid, while noting that 150 million families get insurance through their employers, "so should all federal employees."
Reid's comments came while he denied a CNN story claiming he is the only top congressional leader to exempt some of his staff from having to buy coverage through the Obamacare exchanges.
"I followed the Affordable Care Act,” Reid said. “It is the law. The law says that if you have committee staff, leadership staff, they stay where they are. If you have other staff, which is most everyone, they go to the exchanges."
Reid is worth $2.8 to $6.2 million, according to an OpenSecrets.org report, so he would not qualify for subsidies that would lower his Obamacare insurance costs.
But his rate hike is an eye-opener after promises made by people like House Minority Leader Nancy Pelosi, who told Meet the Press last year that "everybody would have lower rates" under Obamacare.
Harry Reid can afford it some of us can't
Harry Reid: Obamacare 'Costs Me About $4,500 More'
President Barack Obama may have famously promised his signature healthcare plan would cost consumers less money but Senate Majority Leader Harry Reid, D-Nev., is proof that it's often not true.
"Under Obamacare, my insurance costs me about $4,500 more than it did before," Reid told the Reno Gazette Journal. "Yes, because it is age-related and it wasn't like that before."
Reid, while noting that 150 million families get insurance through their employers, "so should all federal employees."
Reid's comments came while he denied a CNN story claiming he is the only top congressional leader to exempt some of his staff from having to buy coverage through the Obamacare exchanges.
"I followed the Affordable Care Act, Reid said. It is the law. The law says that if you have committee staff, leadership staff, they stay where they are. If you have other staff, which is most everyone, they go to the exchanges."
Reid is worth $2.8 to $6.2 million, according to an OpenSecrets.org report, so he would not qualify for subsidies that would lower his Obamacare insurance costs.
But his rate hike is an eye-opener after promises made by people like House Minority Leader Nancy Pelosi, who told Meet the Press last year that "everybody would have lower rates" under Obamacare.
Harry Reid: Obamacare 'Costs Me About $4,500 More'
The host, Chris Wallace, said: "President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn't that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn't it a fact, sir, that a number, most, in fact, of the Obamacare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?"
"The president never said you were going to have unlimited choice of any doctor in the country you want to go to," said the Obamacare architect.
"No. He asked a question. If you like your doctor, you can keep your doctor. Did he not say that, sir?"
"He didn't say you could have unlimited choice."
"It's a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?"
"Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain -- for a wider range of choices or wider range of benefits.The issue isn't the selective networks. People keep saying, Oh, the problem is you're going to have a selective network--"
"Well, if you lose your doctor or lose your hospital--"
"Let me just say something," said Emanuel. "People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network."
"Which will mean your premiums will probably go up."
"They get that choice. That's a choice they always made."
"Which means your premium may go up over what you were paying so that, in other words --
"No one guaranteed you that your premium wouldn't increase. Premiums have been going up."
"The president guaranteed me I could keep my doctor," said Wallace.
"And if you want to, you can pay for it," said Emanuel.
Wrong, look at the pro-Obamacare posts on this and other threads. They still believe.They can not run, they can not hide, they can not lie. obamacare's true, ugly side is showing. They don't care.
Chris Wallace interview with Zeke Emanuel <--- the bastard
The host, Chris Wallace, said: "President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn't that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn't it a fact, sir, that a number, most, in fact, of the Obamacare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?"
"The president never said you were going to have unlimited choice of any doctor in the country you want to go to," said the Obamacare architect.
"No. He asked a question. If you like your doctor, you can keep your doctor. Did he not say that, sir?"
"He didn't say you could have unlimited choice."
"It's a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?"
"Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain -- for a wider range of choices or wider range of benefits.The issue isn't the selective networks. People keep saying, Oh, the problem is you're going to have a selective network--"
"Well, if you lose your doctor or lose your hospital--"
"Let me just say something," said Emanuel. "People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network."
"Which will mean your premiums will probably go up."
"They get that choice. That's a choice they always made."
"Which means your premium may go up over what you were paying so that, in other words --
"No one guaranteed you that your premium wouldn't increase. Premiums have been going up."
"The president guaranteed me I could keep my doctor," said Wallace.
"And if you want to, you can pay for it," said Emanuel.
Obamacare Architect: If You Like Your Doctor, You Can Pay More | The Weekly Standard
Video at link.
The bolded? During his campaign obama pledged families would save up to $2,500 on their premiums. Per year, per family. Liar.
Wrong, look at the pro-Obamacare posts on this and other threads. They still believe.They can not run, they can not hide, they can not lie. obamacare's true, ugly side is showing. They don't care.
Chris Wallace interview with Zeke Emanuel <--- the bastard
The host, Chris Wallace, said: "President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn't that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn't it a fact, sir, that a number, most, in fact, of the Obamacare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?"
"The president never said you were going to have unlimited choice of any doctor in the country you want to go to," said the Obamacare architect.
"No. He asked a question. If you like your doctor, you can keep your doctor. Did he not say that, sir?"
"He didn't say you could have unlimited choice."
"It's a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?"
"Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain -- for a wider range of choices or wider range of benefits.The issue isn't the selective networks. People keep saying, Oh, the problem is you're going to have a selective network--"
"Well, if you lose your doctor or lose your hospital--"
"Let me just say something," said Emanuel. "People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network."
"Which will mean your premiums will probably go up."
"They get that choice. That's a choice they always made."
"Which means your premium may go up over what you were paying so that, in other words --
"No one guaranteed you that your premium wouldn't increase. Premiums have been going up."
"The president guaranteed me I could keep my doctor," said Wallace.
"And if you want to, you can pay for it," said Emanuel.
Obamacare Architect: If You Like Your Doctor, You Can Pay More | The Weekly Standard
Video at link.
The bolded? During his campaign obama pledged families would save up to $2,500 on their premiums. Per year, per family. Liar.
