120.878 Transparency – Non-Payment for Services to Patients with ACA Exchange Plans with Unpaid Premiums
MSSNY will advocate for legislation to require that health plans inform healthcare providers whether the plan premium has been paid and whether the account is late on payment as part of benefit verification, whether by phone, fax, or electronic transaction, including but not limited to X12 270/271.
MSSNY will advocate that the AMA seeks legislation or regulation to require that health plans inform healthcare providers whether the plan premium has been paid and whether the account is late on payment as part of benefit verification, whether by phone, fax, electronic transaction including but not limited to X12 270/271.
MSSNY will advocate that the AMA seeks that X12 includes plan premium payment status as part of X12 270/271 standard transaction code updates.
That the AMA will report on the status of this resolution at the 2025 Annual Meeting. (HOD 2024 – 265)
