American Medical Association President Andrew Gurman, said in a release CMS' final rule that gives enrollees a grace period to pay past-due premiums may impact providers.
Here are six takeaways:
1. Providers may not receive payment based on the finalized rule. Dr. Gurman wrote Congress should "address the resulting inequity of the ACA's grace period, which allows issuers to collect unpaid premiums for months in which healthcare services were provided but not actually covered by insurance."
2. The grace period leaves physicians unable to collect payment from a payer for two months worth of claims if the payer doesn't clear a patient's debt.
3. A Kaiser Family Analysis found the three-month grace period applied to approximately 9.4 million enrollees in 2016.
4. Before CMS finalized the rule, AMA issued a letter to CMS saying the agency, "is proposing to make an insurer who is owned past premiums whole. Then physicians who have treated an enrollee under these circumstances should also be paid."
5. CMS indicated it was open to conversations about the rule as it pertains to giving providers notifications for denied claims when a patient is in either the grace period' second or third month.
6. The rule goes into effect June 19.