Feds try to smooth bumpy health care transition

Associated Press Published:

WASHINGTON -- Anticipating more health care disruptions, the Obama administration Thursday announced a batch of measures intended to help consumers avoid lapses in their care and coverage as the president's overhaul takes effect in January.

Health and Human Services Secretary Kathleen Sebelius also announced a one-month extension of a special insurance program created by the law for people who cannot get coverage because of health problems. Scheduled to expire at the end of the year, the Pre-Existing Condition Insurance Plan will remain in place through January.

Some of the measures are binding, such as requiring insurers to provide coverage on Jan. 1 for any customer who pays by New Year's Eve. Others are recommendations, like urging insurers to let customers keep filling prescriptions covered by a previous plan.

Among the provisions:

n Strongly encouraging insurers to refill prescriptions covered under previous plans through January.

n Advising consumers who got bogged down with the HealthCare.gov website that they still may be able to enroll after Dec. 23 and get coverage on an expedited basis, if the issue was caused by technical problems.

n Encouraging insurers to allow people who sign up after Dec. 23 to still get coverage at the first of the year, even retroactively.

Officials said this would also be in the interest of the insurance company because it would get that month's payment.

n Requiring insurers to provide coverage for enrollees who pay as late as Dec. 31. Addressing questions about the exact timing of the Dec. 31 deadline, administration spokeswoman Joanne Peters said payment is due at the time of day the insurer sets, customarily local time. Insurance companies can set a later payment deadline. The administration also encouraged them to accept partial payment.

Mike Hash, health reform director for the Health and Human Services Department, told reporters that "it's quite common" for insurers now to make accommodations for patients switching coverage.

But insurers weren't happy.

"With only weeks to go before coverage begins, continued changes to the rules and guidance could exacerbate the challenges," Karen Ignagni, president of the industry trade group America's Health Insurance Plans, said in a statement.

The federal pre-existing conditions plan extended Thursday was designed as a temporary lifeline to get uninsured patients with serious conditions through to 2014. Starting next year, insurers no longer may turn away people with health problems. Nearly 86,000 people are still in the plan, including many patients with serious conditions such as heart disease and cancer.

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