CMS might require insurers to accept third-party payments for HIV/AIDS patients

Blue Cross Blue Shield of Louisiana says it will not amend its practice

The U.S. Centers for Medicare & Medicaid Services is considering requiring insurers to accept third-party payments--like those allowed under the Ryan White Act--to help guarantee that insurers don't deny coverage to consumers with HIV/AIDS.

The issue arose after Blue Cross Blue Shield of Louisiana denied checks from a federal program that helps consumers with HIV/AIDS pay for medications and insurance premiums. The insurer notified consumers that their enrollment through plans sold on health insurance exchanges will be canceled, reported Reuters.

CMS issued a statement over the weekend explaining that federal rules don't prevent Ryan White funds from paying for health insurance and said it encourages insurers to accept such payments. However, the agency added that, "given the importance of access to care for people with HIV/AIDS," it is "considering amending those rules to require issuers to accept these payments."

Although Blue Cross admitted to receiving "the latest communication" from CMS, it refused to amend its practice. "Our policy is that effective March 1, 2014, we will only accept individual members' premium payments from the policyholder or an immediate family member/blood relative or legal guardian of the policyholder," Blue Cross Spokesman John Maginnis said in a statement. "We will no longer accept third-party payments."

Meanwhile, Lambda Legal, a non-profit civil rights group, has filed an administrative complaint against the insurer claiming that its action violates critical nondiscrimination provisions of the Affordable Care Act, a Reuters reported yesterday. Blue Cross denies targeting consumers with HIV/AIDS, saying instead it's rejecting third-party premium payments so it can avoid potential fraud.

To learn more:
- read the Reuters first article and second article
- see the Blue Cross statement

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