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Doctors worried that Obamacare rule will leave them with unpaid bills

A computer screen shows some of the price plans for health insurance under the Affordable Care Act
A computer screen shows some of the price plans for health insurance under the Affordable Care Act
(Photo by Joe Raedle/Getty Images)

Kaiser Health News (KHN) reported on Wednesday that an Obamacare rule may stick doctors with unpaid bills because of a 90-day grace period for government-subsidized health plans and have urged doctors to check patients' insurance status before every visit.

Roni Caryn Rabin of Kaiser Health News noted a press release from the American Medical Association (AMA) in which the AMA has issued resources to guide physicians on navigating a little known rule in the Affordable Care Act (ACA) that could pose a significant financial risk for medical practices.

In the AMA release, AMA President Ardis Dee Hoven, M.D., said. “The grace period rule imposes a risk for uncompensated care on physicians so the AMA has created resources to help medical practices navigate the key aspects of the rule to minimize its potential negative impact.”

“Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers. The AMA is helping physicians take proactive steps to minimize these risks.”

Rabin explained the problem the Obamacare rule will pose for doctors.

"If an enrollee in a subsidized plan falls behind on their premium payments, the Affordable Care Act requires insurers to cover their medical bills for 30 days.”

“But for the next 60 days, insurers may “pend,” or hold off paying the claims -- and ultimately, deny them if the patient doesn't catch up on his premiums. That means doctors don’t get paid for their services. If the insurer ends up canceling the policy after 90 days, doctors can bill patients directly but may face difficulty collecting.”

“For some medical specialties, treating patients who have fallen behind on their payments could end up being quite costly. Oncology practices that administer chemotherapy drugs have to purchase the medications, which can cost thousands or even tens of thousands of dollars. If a patient’s claims are not paid, the cost to the practice is high,” said Rabin.

“Obstetricians who provide pre-natal care throughout the pregnancy could also take a hit financially if women fall behind on payments when they’re about to deliver their babies.”

Although the concerns are growing, AMA president Hoven said, “Most physicians are not going to turn away these patients, particularly if someone comes in with a life-threatening condition.”

If patients are not able to pay, the question will be, “Who will pay for these bills?”

In related news, The Hill reported that health industry officials are concerned that ObamaCare-related premiums will double in some parts of the country.

The Hill said, “The industry complaints come less than a week after Health and Human Services (HHS) Secretary Kathleen Sebelius sought to downplay concerns about rising premiums in the healthcare sector. She told lawmakers rates would increase in 2015 but grow more slowly than in the past.”

“Areas of the country with older, sicker or smaller populations are likely to be hit hardest, while others might not see substantial increases at all.”

Earlier in March 2014, the Paulding County Republican Examiner reported that the Robert Powell Center for Medical Ethics at the National Right to Life released a report that warned that the Affordable Care Act (Obamacare) will not allow consumers to spend money what they choose on their own health care, including access to life-saving treatments.

Such denial of life-saving treatments could end the lives of seniors, those with disabilities, and those with pre-existing health conditions.

Meanwhile, Katie Pavlich of TownHall reported that House Republicans will present an alternative to Obamacare soon.

Pavlich said, “Not only can Republicans running for election in the fall run against Obamacare, a law that will only continue to make the lives of Americans worse and more expensive, they can run on a new alternative.”

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