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BCBS Rejecting AIDS Subsidies For Obama-Care

From an outraged Reuters:

Exclusive: AIDS patients in Obamacare limbo as insurers reject checks

By Sharon Begley and Julie Steenhuysen | February 8, 2014

NEW YORK (Reuters) – Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama’s healthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and the interpretation of federal rules about preventing Obamacare fraud.

Some healthcare advocates see discrimination in the move, but Blue Cross and Blue Shield of Louisiana says it is not trying to keep people with HIV/AIDS from enrolling in one of its policies under the Affordable Care Act, also known as Obamacare.

The state’s largest carrier is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.

The carrier says it no longer will accept third-party payments, such as those under the 1990 Ryan White Act, which many people with HIV/AIDS use to pay their premiums.

“In no event will coverage be provided to any subscribers, as of March 1, 2014, unless the premiums are paid by the subscriber (or a relative) unless otherwise required by law,” Blue Cross Blue Shield of Louisiana spokesman John Maginnis told Reuters.

The dispute goes back to a series of statements from Centers for Medicare and Medicaid Services (CMS), the lead Obamacare agency.

In September, CMS informed insurers that Ryan White funds “may be used to cover the cost of private health insurance premiums, deductibles, and co-payments” for Obamacare plans.

In November, however, it warned “hospitals, other healthcare providers, and other commercial entities” that it has “significant concerns” about their supporting premium payments and helping Obamacare consumers pay deductibles and other costs, citing the risk of fraud.

The insurers told healthcare advocates that the November guidance requires them to reject payments from the Ryan White program in order to combat fraud, said Robert Greenwald, managing director of the Legal Services Center of Harvard Law School, a position Louisiana Blue still maintains.

“As an anti-fraud measure, Blue Cross and Blue Shield of Louisiana has implemented a policy, across our individual health insurance market, of not accepting premium payments from any third parties who are not related” to the subscriber, Maginnis said.

So, in a nutshell, people want to use money given to them by the government for AIDS treatment for their Obama-Care premiums and deductibles. But BCBS won’t let them, because it is against CMS’s guidelines.

On Friday, CMS spokeswoman Tasha Bradley told Reuters that, to the contrary, Ryan White grantees “may use funds to pay for premiums on behalf of eligible enrollees in Marketplace plans, when it is cost-effective for the Ryan White program,” meaning that having people with HIV/AIDS enroll in insurance under Obamacare could save the government money…

Of course, this won’t be a problem for long. CMS will ‘clarify’ its guidelines, and Blue Cross Blue Shield will be forced to accept this money. But it’s a great way for people who are getting their health insurance completely subsidized by taxpayers because of a disease (brought on by their own activities) to portray themselves as victims of discrimination.

Before Obamacare, the 1990 Ryan White Act offered people with HIV/AIDS federal financial help in paying for AIDS drugs and health insurance premiums, especially in state-run, high-risk pools. Obamacare, which bans insurers from discriminating against people with preexisting conditions, was designed to replace these high-risk pools.

Starting on October 1, AIDS advocates and others in Louisiana “were enrolling anyone and everyone we could” through the Obamacare exchange, said Lucy Cordts of the New Orleans NO/AIDS Task Force.

Gee, nobody saw that coming.

Last month, her clients and those of other AIDS groups began to hear from Louisiana Blue that their enrollments were in limbo because the company would not accept the Ryan White checks for premium payments.

The only other carrier that is refusing to accept such payments is Blue Cross Blue Shield of North Dakota, according to a CMS official.

North Dakota Blue “restricts premium payment from third parties including employers, providers, and state agencies,” said spokeswoman Andrea Dinneen, but “is currently reviewing its eligibility policies with respect to recipients of Ryan White Program funding.” …

They better, and quick. Some diseases are sacred.

This article was posted by Steve Gilbert on Monday, February 10th, 2014. Comments are currently closed.

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