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Patient Cost Share Collection Task Force
Patient Cost Share Payment Policy
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Patient Cost Share Payment Policy
Please add/delete any policy recommendations below that should be incorporated into legislation to hold health plans responsible for the patient cost share.
Health plans have the responsibility for collecting the patient cost share
Health plans cannot cancel coverage if the enrollee does not pay the cost share
Health plans shall consolidate the patient cost share
Health plans shall provide an affordable payment plan
Payment plans cannot exceed 10% of monthly income
Health plans shall pay timely the full allowable amount directly to the clinician
Health plans shall not contractually require clinicians to collect the patient cost share
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4 Replies
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Any thoughts about capping interest rates for medical debt?
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In the preamble to suggested legislation, I think it’s important to provide rationale for why insurers should be responsible for collecting the cost sharing amount. It’s a tough sell as I can’t think of any other type of insurance where the deductible is directly paid to the service provider -home, auto, boat, etc. One argument could be that for emergency care, the cost-sharing amount is frequently greater than the provider’s bill, making medical billing unique versus, for example, collision damage to an auto. Non-payment by the patient of a high-deductible amount would often totally offset the physician’s bill whereas with non-medical cost-sharing amounts, non-payment by the insured only minimally impacts the service provider’s total bill.
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I agree with Jeff’s thoughts on this, but would add in some data on the percentage of collections from patient cost sharing, I’ve heard a range of 20-50%. I’m sure the auto insurance industry has far better collections for ‘patient’ deductible. This would also be an opportunity to highlight EMTALA requirements and erosion of the nation’s healthcare safety net.
I think capping rates on medical debt would be a good step in protecting patients; however, we would need to explore the downstream ramifications. If RCM’s sell bad debt which is now getting paid at lower rates, who absorbs that cost?
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