With no change at the White House, provisions of the Affordable Care Act (ACA) will begin to move forward quickly. Krieg DeVault attorney Tom Neal expects “a slew of regulations by the end of the year.” That means physicians and medical practices will be impacted and, therefore, need to stay informed.
One part of the ACA moving quickly is the concept of health insurance exchanges. By Nov. 16, states must provide a letter of intent to the federal government, indicating intentions to plan their own state-based exchanges. The actual plans must now be submitted by Dec. 14. If states fail to develop their own exchanges, the federal government will do so, making them ready for 2014.
Exchanges are intended to give citizens a simple way to shop for health insurance, particularly those not covered by employer-sponsored health insurance plans. An exchange will be an online store where people can find the right health insurance product for themselves or their families, comparing cost and coverage.
The ISMA has been participating with the state in discussions about a health insurance exchange for Indiana.
Health plans are preparing
Soon, you may be contacted by health insurers, especially those with whom you contract, regarding options for health insurance exchange networks. Reportedly, some ISMA members have already received agreements asking for their signatures.
Proceed with caution, making sure all your questions are answered before adding your signature. Find out if new rules, processes and payer regulations will be attached to plans rolled out for the exchange networks. Ask about the deadline for opting in and how and when can you opt out. Can you drop out of the exchange network plans without terminating from other product lines or plans with that insurer?
Neal said, “My basic advice to doctors will be the old-fashioned message: Know how to terminate your participation in the exchange networks without jeopardizing your participation in the other products and plans, in case this new deal should go south.”
The ISMA will continue to seek answers from insurers as their agreements become known and will pass along information. As always, before signing a contract or agreement, check with your legal counsel and seek their review of any agreements.