The Centers for Medicare and Medicaid Services (“CMS”) issued an interim final rule which requires insurers to provide coverage effective January 1, 2014 through the health insurance exchanges to any individual who selects coverage through December 23, 2013.  In the preamble to the interim final rule, CMS stated that “ an effective coverage date of January 1, 2014 means that the individual must receive coverage for any services received on or after that date, even if the payment and enrollment are not processed by that time.”  As a result, providers may have difficulty verifying insurance coverage during the month of January for individuals obtaining coverage through the exchanges, since at least initially they may not have insurance identification cards, and may not even have their payment or enrollment processed by their insurer.  Providers should be prepared for administrative uncertainty and frustration in the month of January as a result of the movement of the deadline and the likelihood that insurers will be struggling to keep up with enrollment volume.  There is no assurance that the provider will be paid by an insurance company for the care rendered in that the patient may not have coverage or the provider may not be in the network. The provider will then be left to seek payment from the patient.  As providers are aware, this is neither an effective nor comfortable position to be placed in.