The Washington Health Benefits Exchange (Exchange) announced this week it would be giving people two more months – until April 17 – to enroll for 2015 coverage in qualified health plans. This special enrollment period applies to people that have experienced technical problems or just recently discovered the financial impacts of the individual mandate. Recently, the Exchange experienced a surge in enrollment as people became aware of the increasing income tax penalties for not having health insurance set by the Affordable Care Act.
At this time, overall enrollment for 2015 is similar to last year’s with about 160,000 individuals and family members enrolled in coverage. The Exchange’s enrollment is falling short of its 2015 goal of 213,000 enrollees. If this gap in enrollment remains moving forward, the Exchange will face a significant budget shortfall, which is already being hotly debated in Olympia. Click here for more information on the special enrollment period. (Chelene Whiteaker, firstname.lastname@example.org)
Standardizing Charity Care Application and Information
House Bill 1504, introduced in the legislature this session, proposes to create a standardized charity care application form and detail standards regarding how and when patients are notified about the availability of charity care. WSHA supports the concept of this bill and has worked closely with the sponsor, Rep. Laurie Jinkins. At this point, we are not sure that the bill will move forward during session. However, WSHA is committed to working with our members to develop a standardized application form and standardized notice about financial assistance being available and how to apply. WSHA will bring our members together to work on these materials and provide resources and translated materials to hospitals. (Zosia Stanley, 206-216-2511)
Proposed Changes to Medical Liens Statute
If someone is the victim of an accident or other wrongful act, their health insurance company will usually not pay for medical services once it is determined that another party will ultimately be liable. Because of this non-payment, current law allows hospitals and providers, such as doctors, to file a lien against the future personal injury settlement.
As introduced, HB 1503 makes several changes to existing law:
- Hospitals and other providers must be licensed debt collectors in order to collect on a lien.
- Those entitled to a lien under the statute must include a notice in billings and collection practices that liens may be placed on patients’ future settlements.
- Hospitals must remove liens within 20 days of receiving payment. Violation of the 20-day period would be deemed an unfair or deceptive act or practice under the Consumer Protection Act (CPA).
WSHA supports additional transparency and notice provided to patients about medical liens. WSHA has been working closely with the bill’s sponsor, Rep. Laurie Jinkins, to address concerns regarding other portions of the bill. WSHA is concerned that requiring hospitals and providers to be licensed debt collectors is onerous and inappropriate, and the sponsor has agreed to revise this language. WSHA has suggested substituting language from RCW 60.04.071 (the release of lien rights’ section of the Mechanics’ and Materialmen’s lien statute) to replace the bill’s current language requiring lien release within 20-days with violation constituting an unfair/deceptive act/practice under the CPA. (Zosia Stanley,206-216-2511)
Hospital Presumptive Eligibility Implemented; Online Training Available Soon
The Washington State Health Care Authority (HCA) has implemented “Hospital Presumptive Eligibility” (HPE) and hosted several in-person trainings for participating hospitals in late January. The HCA will also provide HPE training via a recorded webinar and online training later this month for those who were unable to attend the in-person training. “Hospital Presumptive Eligibility” for Apple Health Enrollment allows a hospital to enroll someone in Medicaid for up to 60 days with minimal information from the client. For example, if a client does not know their tax filing status, hospitals can enroll via HPE. Or if there is a glitch preventing enrollment using the Washington Healthplanfinder website, a hospital can enroll someone immediately via Hospital Presumptive Eligibility. According to the HCA, so far a handful of patients have been covered via HPE. For additional background, see WSHA’s December11, 2014 Bulletin. (Zosia Stanley, 206-216-2511)