The ACA’s Pre-Existing Condition Insurance Plan (PCIP) program is a temporary high-risk health insurance program for uninsured individuals who have been denied health insurance because of a pre-existing condition. While the PCIP was intended to serve as a “bridge” until Affordable Insurance Exchanges are operational in 2014, the Department of Health and Human Services (HHS) suspended acceptance of new enrollment applications earlier this year due to funding limitations. HHS has now determined that additional adjustments to PCIP provider payment rates are needed to ensure there is sufficient funding to cover currently-enrolled individuals until the program ends. Payment rates for covered services (with the exception of covered prescription drug, organ/tissue transplant, dialysis, and durable medical equipment benefits) will be capped at Medicare payment rates, with special rules when Medicare payment rates cannot be implemented. Facilities and providers also will be prohibited from “balance billing” enrollees in the federally-administered PCIP for the difference between the PCIP plan allowance and their charges to other patients for those covered services, effective for dates of service beginning on June 15, 2013. CMS will accept comments on the rule until July 22, 2013.