Nominee for CMS secretary could affect billing, collections

Feb 17, 2017 | Health Insurance Billing, Healthcare Industry News

As a new White House administration takes its shape, some government agencies remain without leaders, including the Center for Medicare and Medicaid Services. Seema Verma, President Donald Trump's pick to head the department overseeing federal health benefits and the Affordable Care Act, appeared before the Senate Feb. 16, 2017, in the first session of her confirmation hearings.

Verma has stated beliefs that could, if incorporated into policy, affect how the financially disadvantaged pay for government health benefits. That in turn could complicate matters for health care providers and facilities when handling their accounts receivable management processes and collections. In anticipation of this, providers may want to consider outsourcing their collections tasks.

Verma's history in the field
Seema Verma gained attention working with former Indiana governor and current Vice President Mike Pence, implementing and overseeing the state's Healthy Indiana Plan. Verma, as president and CEO of health policy consultancy SVC, devised the measure so that Medicaid participants had to pay to maintain benefits, according to Becker's Hospital Review. While the payments were fairly nominal – no higher than $27 per month – recipients who missed a single installment would lose benefits for six months if above the poverty line. If below it, they'd be moved to a less comprehensive health plan but not kicked out of the program.

The source noted Verma's reputation for bipartisan cooperation and thoughtfulness. Yet by contrast, the Huffington Post reported that at a 2013 Congressional hearing, the prospective CMS secretary expressed an arguably stern opinion of those undergoing financial hardships, saying the poor were ideal beneficiaries of the HIP because they "are perhaps the best consumers of a dollar. They've had experience stretching a dollar." Additionally, Verma's initial proposal for the HIP would've required recipients to prove they were employed or actively seeking employment.

Trump administration pick for CMS secretary could affect billing, collectionsVerma's beliefs, if incorporated into policy, could affect how the financially disadvantaged pay for health benefits.

Questions at Verma's confirmation hearing
In her hearing with the Senate Finance Committee, Verma faced questions not only about her work with the HIP, but also regarding efforts she made on behalf of private Medicaid contractors. McClatchy Newspapers correspondent Tony Pugh reported that Verma stated her intention to recuse herself from CMS matters regarding companies her firm used to serve, if confirmed as secretary.

While forthcoming regarding that issue and questions about her HIP program – the successes of which have been cited by many Indiana legislators, independent of party affiliation – Verma would not answer questions about the Trump administration's proposed ACA overhaul, claiming she hadn't been able to review the plans being devised by White House officials. Also, The Associated Press stated that Verma would not necessarily make maternity coverage mandatory in any program that ended up replacing the ACA, based on a statement made in her hearing.

How could this affect providers?
Any law that makes it more difficult for low-income sick Americans and recipients of health benefits to pay will, eventually, hurt health care facilities' bottom lines and healthcare claims processing. Patients who rack up bills they can't afford are more likely to duck payments altogether if they feel cornered by their financial predicament and have nothing to lose, and that amounts to revenue that hospitals and health care providers aren't getting.

In light of this, providers should strongly consider outsourcing their collections and claims management to a third party with proven expertise in these specific tasks. Collections professionals can work out reasonable payment plans with patients, so that hospital staff can focus on more pertinent tasks.