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CMS Releases Final Rule on Short-Term, Limited-Duration Health Plans

August 3, 2018

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PRESS CONTACTS
Mary Mullaney, Director, Hospital Payment Policies

The Centers for Medicare and Medicaid Services (CMS), the Internal Revenue Service (IRS), and the Department of Labor (DOL) Aug. 1 released the final rule outlining changes to short-term, limited-duration insurance.

The final rule states that consumers will be able to purchase short-term, limited-duration plans for a maximum duration of up to one year and will be able to renew these policies for up to a total of three years. These plans are not subject to Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) requirements and therefore do not afford patient safeguards, including exclusions for pre-existing conditions, a minimum set of benefits, and annual lifetime limits. The final rule does require a consumer disclosure to alert individuals of the exclusions or limitations of the coverage; however, it does not include how it is communicated to consumers.

The AAMC’s comments on the proposed rule outlined concerns that because these plans are not subject to minimal essential coverage requirements under the ACA, many individuals could be left with inferior health insurance coverage, potentially limiting access to care [see Washington Highlights, April 27]. Due to limits in coverage, providers that treat these patients may be either underpaid or not paid at all.

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