CMS issued an interim rule on Monday that places new regulations on dialysis centers that make payments of premiums for individual market health plans.
The interim rule requires dialysis centers that provide premium assistance either directly or through third parties to inform patients of the difference in coverage offered by private plans compared with coverage offered by Medicare or Medicaid.
- The move signals the agency's continued efforts toward improving transparency to protect patients' health.
While this rule applies only to dialysis centers, CMS seems to be taking a tougher approach to all providers who guide patients toward private plans when they could qualify for Medicare or Medicaid.
In August, CMS issued a call for comments on this practice. Providers in at least five states offer financial support through non-profit groups to patients who purchase private coverage in the individual insurance market, Kaiser Health News reported.
The practice of steering patients away from public plans is presumably driven by higher reimbursements delivered by private payers. However, CMS said this can compromise patient choice whenpicking a health plan. America’s Health Insurance Plans (AHIP) has also argued the practice undermines the individual insurance market by skewing the risk pool.