Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Wants To Limit Non-Standard Policies On Insurance Exchanges
Modern Healthcare: CMS Proposes Changes To ACA Network Adequacy, Standardized Plans Rules
The Centers for Medicare and Medicaid Services aims to reduce the number of non-standard policies offered on the health insurance exchanges while boosting the availability of providers in carriers' networks, according to a draft regulation released Monday. (Tepper, 12/12)
In other Medicare and Medicaid updates —
KHN: How Medicare Advantage Plans Dodged Auditors And Overcharged Taxpayers By Millions
In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud. Medicare had paid the Blue Cross plan more than $20,000 to cover the care of 11 patients seen by Aggeus Healthcare, a chain of podiatry clinics, in 2011. (Schulte and Hacker, 12/13)
Missouri Independent: Another State Settles Medicaid Fraud Allegations With Centene
Oregon last week became the latest state to settle fraud claims with Medicaid managed-care giant Centene. The Clayton-based company, the largest Medicaid managed-care provider in the United States, agreed to pay Oregon $17 million, according to a statement from the state’s attorney general and its insurance commissioner. (12/12)
More health care industry news —
Modern Healthcare: Oscar Health Stops Accepting New Florida Exchange Members
“This temporary pause in Florida is the result of proactive steps Oscar took in light of other market exits to ensure that our projected membership does not exceed the company’s targets for 2023 and allows us to maintain our strong financial position,” the spokesperson wrote. Oscar Health aims to achieve profitability in its insurance arm next year and overall profitability by 2024, the company previously advised investors. (Tepper, 12/12)
Atlanta Journal-Constitution: Atlanta OB/GYN Office Merges Technology And Medicine To Expand Maternity Care
Moms-to-be can monitor their vitals and attend virtual appointments with their doctor from the comfort of their own house, thanks to a program by Northside Women’s Specialists. Launched as a pilot program last year, Virtual Obstetrics accommodates a hybrid schedule, with the first appointments — until 20 weeks — in person, then transitioning into virtual appointments until the last month of pregnancy. (Ramakrishnan, 12/12)
