ACA Grace Period for Late Payments Could Pose Problems for Doctors

By Andrew Kitchenman (Courtesy of NJ Spotlight)

A safeguard designed to protect people who buy health insurance through the new federal marketplace has hospitals, doctors and other healthcare providers concerned that they might not be paid for some services under the Affordable Care Act.

People who don’t pay their monthly insurance premiums will have a 90-day grace period before their coverage is dropped. Federal regulations require insurers to pay claims for the first 30 days after payments lapse. After that, they will be able to deny pending claims, leaving hospitals to foot the bill. In New Jersey, health insurance is generally in force for a 31-day grace period.

“This is going to be a nationwide problem,” said Neil Eicher, director of government relations and policy for the New Jersey Hospital Association. He spoke about the issue at the NJ Spotlight conference “Implementing the Affordable Care Act in New Jersey,” held on September 20.

Eicher said hospitals could be a position where they are informed that a patient’s insurance is still valid, only to learn later that they won’t be paid for the services provided.

Access to the marketplace website has been bogged down since it was launched on Tuesday. The marketplace is intended to be a one-stop shop for people who don’t receive insurance from an employer to buy coverage and learn whether they are eligible for federal tax credits to subsidize their insurance purchase. They are supposed to be able to apply for insurance online, in person, by phone or by mail.

Read more at NJSpotlight.com