CMS has agreed with comments filed by MSNJ and clarified in its recently finalized Market Stabilization Rule that if an individual pays outstanding premiums in order to avoid a gap in coverage the insurer must pay the outstanding medical claims that were filed during the unpaid period. Physicians are at risk of non-payment during months two and three when an individual stops paying premiums. Now, if the arrearage is cured to avoid a gap in coverage, the claims must also be paid.
Released: April 13, 2017, 8:48 am
| Updated: May 16, 2017, 6:52 am