AHIP Statement On Third Party Payments

posted by Kristine Grow

on December 16, 2016

Washington, D.C. –  Today, America’s Health Insurance Plans (AHIP) issued the following statement on the recently released CMS rule on third party payments:

This interim final rule is an important step to ensure that individuals are enrolled in coverage that best meets their needs. Dialysis patients need to be aware of and understand the differences in coverage and not be improperly steered into a commercial plan if they are eligible and better served by Medicare or Medicaid.

We support:

  • the rule’s requirement that dialysis facilities provide consumers with information about their full range of coverage options, including Medicare and Medicaid.
  • the rule’s requirement that dialysis facilities disclose to health plans their role in funding premium payments.
  • the rule’s continuation of CMS’ long-standing policy that plans may reject dialysis facility-funded payments.

While this rule represents progress, we continue to urge CMS to prohibit these payments when there is alternative coverage for patients.

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