CMS Designates $100M For Navigators To Aid 2025 Open Enrollment
The Centers for Medicare and Medicaid Services will distribute the money to 44 organizations in 28 states that work on outreach and help people to sign up for health insurance during open enrollment for the Affordable Care Act exchanges.
Modern Healthcare:
Insurance Navigators To Receive $100M Ahead Of Open Enrollment
The Centers for Medicare and Medicaid Services will grant $100 million to 44 organizations tasked with helping people sign up for insurance coverage during open enrollment on the exchanges. The agency plans to distribute up to $500 million over the next five years. (Early, 8/26)
More health insurance news —
Modern Healthcare:
Where Medicare, Medicaid DSH Payment Lawsuits Stand
Hospitals and the federal government have been engaged in years of back-and-forth legal battles over billions of dollars in Medicare and Medicaid payments meant to support providers that treat large numbers of low-income patients. These disputes about Medicare and Medicaid disproportionate share hospital, or DSH, payments have found their way to the Supreme Court before and will again as different judges reach different conclusions. (Early, 8/26)
KFF Health News:
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” from the industry, newly released court filings show. The Centers for Medicare & Medicaid Services published the draft regulation in January 2014. The rule would have required health plans, when examining patient’s medical records, to identify overpayments by CMS and refund them to the government. (Schulte, 8/27)
KFF Health News' 'An Arm and a Leg' Podcast:
Don’t Get ‘Bullied’ Into Paying What You Don’t Owe
In this episode of “An Arm and a Leg,” host Dan Weissmann speaks with Caitlyn Mai, a woman in Oklahoma who received a six-figure bill for a surgery her insurance promised to cover. This episode is an extended version of the “Bill of the Month” series, produced in partnership with NPR. (Weissmann, 8/27)
Health insurance updates from Florida and Texas —
WGCU:
NCH May Become Out Of Network Without A New Agreement With Florida Blue
Florida Blue has alerted patients in second region of the state about the potential of them losing coverage Oct. 1 due to an impasse with a major health system. Florida Blue is telling patients the Naples-based NCH be out of network if a new insurer-hospital agreement can’t be reached. This would include hospitals, physician groups and other specialty care services. (Barbor, 8/26)
AP:
Judge Orders Pause On Biden Program That Offers Legal Status To Spouses Of US Citizens
A federal judge in Texas on Monday paused a Biden administration policy that would give spouses of U.S. citizens legal status without having to first leave the country, dealing at least a temporary setback to one of the biggest presidential actions to ease a path to citizenship in years. ... One of the states leading the challenge is Texas, which in the lawsuit claimed the state has had to pay tens of millions of dollars annually from health care to law enforcement because of immigrants living in the state without legal status. (Gonzalez, 8/26)
