HHS issues final rule governing reimbursement PCIP rate

CQ (5/18, Adams, Subscription Publication) reported that under a final rule HHS released Friday, “the reimbursement rate for medical services provided under the high-risk pools,” known as the Pre-Existing Condition Insurance Plan, “will be lowered to Medicare rates.”

Further, the rule “bans medical providers in the program…from asking patients to pay the difference between what the program will cover and what the provider wants to charge.”

According to the rule, that is “to protect enrollees in the federally administered PCIP from having to shoulder potentially significant costs that could be shifted to them as a result of this new payment policy.”

Paul King and Charlotte Hildebrandt
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