Where Obamacare and ICD-10 Collide
Posted on November 17th, 2014
The Affordable Care Act, or more commonly known as ACA or “Obamacare”, continues to put pressure on providers and employers with respect to insurance coverage’s, quality of care standards, cost controls, and overall coverage. A significant component of ACA is the enforcing governmental entity, which is the IRS. Yes – the same IRS that is in charge of tax collection, has a reputation for making rules completely unintelligible, enforcing large fines against the “little guys” while big offenders and bazillion-aires pay little or nothing, targeting and auditing those they politically disagree with, and running their own court system with practically no due process for the accused.
The IRS continues to put out memos regarding the ACA’s 501(r) rules that affect non-profit hospitals and the collection of what is owed to them. There are a number of items to be considered, but for the sake of this Post lets take a look at the discussion regarding “extraordinary collection efforts” as defined by the 501(r) rules and enforced by the IRS. A non-profit hospital, among other things, MUST create a financial assistance policy and make that policy known in their community. Within the first 120 days of the date of service a patient has, the provider is prohibited from taking any “extraordinary collection efforts”, which include credit reporting, filing a lawsuit, and a few other actions. The rules go on to extend to another 120 days if the hospital has not correctly created and communicated their financial assistance policy, OR the patient asks for a financial assistance form. If the patient asks for one, then all “extraordinary collection efforts” must cease and/or be reversed, indefinitely. Or until the hospital has reviewed their application for assistance. So – no credit reporting, lawsuit, garnishments for up to 240 days after date of service.
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