More than 85 Percent of the 829 Responders to CMS Request for Information on Third-Party Assistance Advocate for Charitable Premium Assistance Programs Which Help the Chronically Ill

WASHINGTON, D.C. (October 25, 2016) – The Marketplace Access Project (MAP), a group of leading national patient advocacy organizations dedicated to protecting non-profit insurance premium assistance for individuals suffering from chronic and life-threatening illnesses, today announced that more than 85 percent of the 829 responders to a U.S. Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) regarding the impact of third-party premium assistance expressed their support for non-profit programs that provide premium assistance to patients in-need. 

On August 23, 2016, CMS issued an RFI seeking public comment on concerns that some health care providers and provider-affiliated, third-party organizations are directing patients eligible for, or currently receiving, Medicare and/or Medicaid benefits onto individual market plans under the Affordable Care Act (ACA) in order to obtain greater reimbursement. The majority of respondents disputed these claims and highlighted the importance of charitable programs that help patients with chronic and life-threatening conditions afford their monthly insurance premium payments.  

“This overwhelming show of support for premium assistance programs underscores the critical lifeline that these organizations provide to Americans most in-need,” said Dana Kuhn, Ph.D., president and founder of Patient Services, Inc. (PSI), the founding member of MAP. “Charitable premium assistance programs help Americans living with devastating diseases bridge to the health insurance they need to access life-saving and life-sustaining care. Patient assistance programs across the country adhere to the principle that health insurance enrollment decisions should be made, without influence, by each individual based on their specific circumstances, health and financial needs.” 

The RFI comes on the heels of a CMS rulemaking on third-party insurance payments for the new Exchange plans offered under the ACA. In direct contradiction to the standard currently followed by Medicare, CMS failed to include non-profit charities on the list of acceptable premium arrangements for patients covered by qualified health plans. As a result, insurers across 38 states are citing this rule to deny coverage to patients by rejecting the premium assistance they were previously receiving from third-party charities. 

In response to CMS’ third-party rulemaking, more than 130 bipartisan members of Congress have cosponsored the Access to Marketplace Insurance Act (H.R. 3742), commonsense legislation that would allow non-profit charities to continue to provide critical assistance to patients under CMS’ existing third-party policy, effectively heeding the original intent of the ACA to ensure uninhibited access to health coverage for all Americans. 

“CMS’ misguided rule is allowing health insurers across the country to deny coverage to patients who need it most,” added Kuhn. “We hope that Congress will take notice of the ongoing public support for premium assistance programs and allow charities to continue to be charitable by passing H.R. 3742.”

For more information on the Marketplace Access Project, visit www.marketplaceaccess.org. 

About MAP

The Marketplace Access Project (MAP) is a patient advocacy movement dedicated to protecting non-profit insurance premium assistance for individuals suffering from chronic and life-threatening illnesses. MAP supports the Access to Marketplace Insurance Act (H.R. 3742), bipartisan legislation that would secure non-profit premium assistance for patients enrolled in qualified health plans and help ensure health care coverage that works for everyone. For more information, visit www.marketplaceaccess.org, or follow MAP on Twitter (@AccessProjectUS) and Facebook (www.facebook.com/marketplaceaccess).

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