Healthcare Payment System Still to be Built

Here is an article by Brian M Kalish that appeared in a newsletter I get. The article is dated January 18, 2014.

The back-end payment system of Healthcare.gov is still being built, a senior Centers for Medicare and Medicaid Services official said Thursday (January 16) in testimony on Capitol Hill.
 
“The automated process for payments is still being built, but we have a process in place that is working,” said Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, in response to questioning by House Energy and Commerce Subcommittee on Oversight and Investigations Chairman Tim Murphy (R-Pa.). Cohen did not elaborate on the process in place.

Asked if there was a predicted finish date for the system, Cohen responded that he does not “have an answer on a predicted date.”

On Nov. 19, 2013, Henry Chao, the top IT official at CMS, said in testimony on Capitol Hill that more than 30% of the "back-end" infrastructure still remains to be built in the federally-run marketplace.

At the time, CMS Spokeswoman Julie Bataille said those tools included things needed in order to process payments to issuers, and they were not required until 2014. CMS added they were on track to complete these applications by mid-January.
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What does this mean to purchasers of individual & family health insurance - those who purchased inside the exchange?  For one, insurance companies may not receive your premiums (paid to the exchange) and the Federal tax credit money in time to guarantee coverage for January until sometime much later than normal.

Second, doctors and other providers unsure of being paid by the insurance company you chose in the exchange, will be skittish about "putting it on your tab" and crossing their fingers that payment will be made.

Third, your broker/agent that helped you enroll and kept you informed about the process won't get compensated until the back-end system is working.

This is all brand new territory for everyone - you the consumer, your doctors and other providers, the insurance companies and your broker.