Health Exchange’s 90 Day Grace Period Could Pose a Big Problem for Doctors and Hospitals
Insurance carriers currently allow a 30 day grace period before terminating coverage for individuals and businesses. Under the Affordable Care Act, coverage purchased through the exchange must offer a 90 day grace period prior to terminating coverage. However, the insurance carrier can withhold payments to physicians and hospitals for the last 60 days of claims until premiums are collected. If premium is not collected within 90 days, the insurer is not required to pay the provider and can retroactively terminate coverage. This may result in the provider having to try to recoup monies owed by the patient directly. While this will provide a windfall for collection agencies, the impact on physicians, hospitals, and other medical providers could prove to be devastating.