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CMS offers help with verifying health coverage for patients on new insurance exchanges, revises EHR
e-Reports, Feb. 10, 2014
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Under the Affordable Care Act, with its insurance marketplace or exchanges, many citizens are gaining health coverage for the first time. Reports indicate some who have signed up are not receiving their I.D. cards or do not realize they need to carry their cards to medical appointments.

In those cases, the Centers for Medicare & Medicaid Services (CMS) has instructions, a database and fact sheet to help you with the coverage verification process. Because the federal government runs the marketplace in our state, CMS says it’s best to check the database of plans for the correct customer service number.

Find the database on the CMS website.

Here’s how to get patient questions answered
Are your patients asking you questions about the new health insurance exchange or marketplace?

Print out documents at the following websites for your patients, or refer patients to these sites for information (Patients can gain access to computers at most public libraries.)

To assist you in using the database, access a CMS fact sheet here. It explains that you first go to the “State” column (top, left) and click on the three small gray horizontal bars. Next click on “Filter this column” and go down the list to find IN for Indiana.

If you cannot find the appropriate customer service number, call the Marketplace Call Center at (800) 318-2596. Also, remind your patients to bring their insurance cards at every visit. They can contact their plans to obtain cards if necessary.

Uninsured patients have until March 31 to sign up for non-employer-based coverage. They should visit the national health care site to shop for a plan and apply for financial assistance. CMS noted that the vast majority of uninsured will qualify for some financial assistance to reduce their costs.

The AMA and the Medical Group Management Association have developed a checklist for medical practices with tips for addressing issues about coverage through the new exchange health plans. Find it on the AMA website.

Donation/safe harbor rules for ‘nearly free’ EHRs extended through 2021
CMS and the Office of the Inspector General (OIG) published rules extending exemptions that allow physicians to accept donations of nearly free electronic health records (EHRs) without violating Stark self-referral and anti-kickback rules. Published in the Dec. 27 Federal Register, the new rules allow you to accept EHR systems from certain health care entities through 2021.

The rules underwent several other changes; find them detailed on the CMS website and at OIG here.

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