AFC Fact Sheet Summarizes Health Reform Payer of Last Resort Issues for Providers

October 25, 2013

On January 1, 2014, the full implementation of the Affordable Care Act (ACA) in Illinois will revolutionize access to health care for thousands of people with HIV in Illinois.

While Medicaid expansion and access to health insurance plans through the marketplace provide an opportunity to dramatically improve health care for people with HIV, the Ryan White HIV/AIDS Program will continue to play an essential role in HIV care in Illinois and across America.

Since the early days of the Ryan White program, providers have successfully navigated the payer of last resort requirement, which mandates that all other funding sources be exhausted by a client before the Ryan White Program will pay for his/her services. However, the advent of health care reform means there are new sources of payment to maximize, potentially increasing the complexity of providing care.

The purpose of this document is to provide guidance regarding ACA implementation and recommendations for providers.

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Categorized under Health insurance.

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