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Life Health > Health Insurance

What if you owe the PPACA 3R’s programs money?

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The government is giving health insurance company managers lessons on how to read and pay their Patient Protection and Affordable Care Act (PPACA) risk management program bills.

Officials at the Centers for Medicare & Medicaid Services (CMS) gave the managers tips on paying into the PPACA reinsurance, PPACA risk corridors and PPACA risk-adjustment programs, which are also known as the PPACA three R’s programs, Monday, during a webinar.

The webinar was aimed at insurers selling plans through the system.

CMS, an arm of the U.S. Department of Health and Human Services (HHS), set up to provide PPACA exchange enrollment services in states unwilling or unable to run their enrollment systems.

CMS has been running insurer payment process webinars for months. 

See also: PPACA World managers prepare to collect bills

Interest in the process may be growing, because insurers are now starting to get invoices from the government, and they are asking questions about what they should do if they see possible errors or run into other sorts of problems.

See also: What if CMS risk-adjustment bill collectors fail?

In a webinar slidedeck, CMS officials note that the people who use the government’s payment system must read and agree to the system’s rules of behavior.

The top rule is that a user who gets a password agrees “to be responsible for the consequences that result from the disclosure or use of the password.”

Users may not make their passwords known to others or their passwords in written form in an unsecured fashion.

Users can store payment account information in the system.

After they store the account information, they go through an agency payee selection process. To pay money to the PPACA three R’s programs, they must choose the agency option “CMS Health Insurance and Premium Stabilization Programs Payment Form.”

The system is supposed to direct insurers that want to pay their PPACA reinsurance bills to another system.

CMS officials also talked about the three R’s programs’ dunning letters

The first dunning letter HHS sends will not include any extra interest or fees, according to a dunning letter job aid.

If an issuer takes more than 30 days to pay the bill, the next dunning letter will include charges for administrative fees and interest charges, officials said.

A risk corridors program dunning letter, for example, might include the entity’s ID number, an invoice number, the invoice date, the invoice amount, an administrative fee and an interest charge.

See also:

What if a plan skips a PPACA reinsurance payment?

3 ways the PPACA data filing mess makes insurers want to SCREAM


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