Last week, the Department of Health and Human Services (HHS) issued a press release announcing an interim final rule (“IFR”) to ensure “a more seamless transition” into the wonderland that is Obamacare. (The IFR is scheduled to be published on December 17; a pdf version is here.) Per HHS’s press announcement, the rule will, inter alia,
- Requir[e] insurers to accept payment through December 31 for coverage that will begin January 1, and urging issuers to give consumers additional time to pay their first month’s premium and still have coverage beginning Jan. 1, 2014.
- Formaliz[e] the previously announced decision giving individuals until December 23, instead of December 15, to sign up for health insurance coverage in the Marketplaces that would begin January 1.
- Strongly encourage[e] insurers to treat out-of-network providers as in-network to ensure continuity of care for acute episodes or if the provider was listed in their plan’s provider directory as of the date of an enrollee’s enrollment.
- Strongly encourage[e] insurers to refill prescriptions covered under previous plans during January.
These policies apply to all “qualified health plans” (QHP) sold through an exchange. Translated into plaintext: HHS is requiring insurers to provide coverage for which consumers haven’t paid (full) premiums and is “strongly encouraging” them to provide services that aren’t covered under the policy. All to “smoothly transition to coverage that best fits [consumers’] needs.” Can they do that? I’m pretty sure the answer is “no.”