Obamacare | The Health Law Firm Blog

Grace Period Included in the Affordable Care Act Could Pose Financial Risk to Healthcare Professionals and Providers

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A little known rule published by CMS to implement the Affordable Care Act (ACA) could pose a significant financial risk for doctors, hospitals and other healthcare providers. The rule requires health plans participating in the exchanges to provide individuals purchasing insurance through the exchanges a grace period before terminating the coverage for non payment of the premiums. Doctors and other healthcare providers will continue to provide care during the grace period, but the insurance plan will not be required to pay the claims incurred during most of the grace period. The result could be that physicians and other healthcare providers would provide a significant amount of […]

By The Health Law Firm|2024-03-14T10:00:53-04:00June 1, 2018|Categories: In the News, The Health Law Firm Blog|Tags: 90 day grace period, ACA, ACA grace period risks for physicians, Affordable Care Act, Centers for Medicare and Medicaid, CMS, defense attorney, defense lawyer, enrollees, grace period, grace period risks for providers, health insurance company, health insurance programs, health insurers, health law firm, health plan, healthcare reform law, hospitals, insurance exchange, Obamacare, practice administrators, premium payment delinquency, the health law firm, unpaid health insurance premiums, who pays claims during grace period, withhold payments on claims|Comments Off

Verifying Patients’ Affordable Care Act Exchange Insurance is Putting Doctors’ Office Employees Through the Ringer

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The ultimate goal of the Affordable Care Act (ACA) is to provide millions of previously uninsured Americans with access to health care. Open enrollment does not end until March 31, 2014; however, practices are already seeing an influx of patients who have bought insurance through the exchanges. With that, some offices are reporting a new challenge being presented in doctors’ offices.

In a National Public Radio (NPR) article, some doctors’ office employees report having to call insurance companies to verify that each exchange patient is paid up. These calls are reportedly taking up to an hour or more, which costs the practice both time and resources.

Click here to read the entire NPR article.

Doctors’ Offices Used to Check Insurance Online.

In the past, practices […]

By The Health Law Firm|2024-03-14T10:00:55-04:00June 1, 2018|Categories: In the Know, The Health Law Firm Blog|Tags: 90 day grace period, ACA, ACA grace period risks for physicians, Affordable Care Act, Centers for Medicare and Medicaid, CMS, defense attorney, defense lawyer, enrollees, grace period, grace period risks for providers, health insurance company, health insurance programs, health insurers, health law firm, health plan, healthcare reform law, hospitals, insurance exchange, Obamacare, practice administrators, premium payment delinquency, the health law firm, unpaid health insurance premiums, who pays claims during grace period, withhold payments on claims|Comments Off

Department of Health and Human Services Announces Mental Health Parity Final Rule

By Lance O. Leider, J.D., The Health Law Firm

On November 8, 2013, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the promulgation of the agency’s final rule related to parity of coverage of mental health and substance use treatment. According to Sebelius: “For way too long, the healthcare system has openly discriminated against Americans with behavioral health problems.”

The purpose of the regulations is to close the gaps in coverage that permit insurance carriers to treat mental and substance-abuse related treatment different from traditional medical and surgical benefits.

Among the key provisions of the regulations are the elimination of separate mental health deductibles, co-insurance, etc.; elimination of limits on lifetime benefits; as well as several other measures insuring that mental health benefits are treated on par with traditional medical and surgical benefits.

Compliance with the final rule will be required […]

By The Health Law Firm|2024-03-14T10:01:51-04:00May 15, 2018|Categories: Mental Health Counselor, Mental Health Counselor Law, Psychology|Tags: ACA, administrative complaints, Affordable Care Act, behavioral health, civil complaints, defense attorney, defense lawyer, Department of Health and Human Services, Final Rule, health law firm, hhs, insurance coverage, mental health, mental health and substance use disorder parity rule, mental health audit, mental health deductibles, mental health insurance treatment, mental health services, mental health treatment, mental healthcare, Obamacare, substance abuse, substance abuse treatment, the health law firm|Comments Off