House Republican Leaders Demand Investigation Of Alleged ACA Fraud

The Washington Post: GOP Leaders Call For Probes Into Alleged Affordable Care Act Fraud 
House Republican leaders are asking government watchdogs to investigate health insurance sign-ups through the Affordable Care Act, citing reports that allege insurance brokers are fraudulently enrolling customers into some ACA health plans and that millions of Americans may be wrongly benefiting from federal insurance subsidies. ... The allegations center on a report from the Paragon Health Institute, a conservative think tank, which concluded that as many as 5 million Americans may be wrongly receiving ACA insurance subsidies. The allegations also are driven by recent KFF Health News reports about unscrupulous brokers falsifying information to enroll customers or wrongly switching customers between plans without their knowledge or consent, a development that has stirred bipartisan anger. (Diamond, 6/29)

Catch up on the recent KFF Health News stories by Julie Appleby into alleged fraud:

• Biden Team’s Tightrope: Reining In Rogue Obamacare Agents Without Slowing Enrollment (5/8)
• When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow (4/15)
• Rising Complaints of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern (4/8)

In Medicare news —

The Washington Post: It Was A $6.6B Deal For 9 Years. Then The Feds Reneged. Did Politics Play A Role?
On the surface, 1-800-MEDICARE is a government success story: a free, popular service helping tens of millions of older Americans understand their health insurance and options for care. The call line boasts a 95 percent satisfaction rate, according to federal officials. But behind the scenes, the multibillion-dollar job of running the Medicare call line and similar services for the Affordable Care Act — one of the richest service contracts offered by the federal government — has sparked a bitter battle between a powerful labor union, a prominent federal contractor and politicians who are now accusing the White House of delivering an election-year favor for its union allies. (Diamond, 6/28)

Stat: Big Medicare Test Of Kidney Dialysis Care Isn’t Working, Studies Say
A few years ago, the Centers for Medicare and Medicaid Services launched a big experiment. The agency wanted to see if financial incentives and penalties would improve care for people with end-stage kidney disease. So far, it hasn’t worked, a new study finds. (Cueto, 6/30)

CNBC: Medicare-Related Stocks Rise After Poor Biden Debate Performance
One group of health insurance stocks appeared to be rallying on the notion that President Joe Biden’s poor debate performance on Thursday night would bring another term for former President Donald Trump. RBC analyst Ben Hendrix chalks up Friday’s rally in Medicare Advantage stocks on the thesis that “a second Trump term would ease regulatory and reimbursement headwinds weighing on the managed care stocks, particularly the Medicare Advantage leaders,” such as UnitedHealth, Humana and CVS Health. These shares have faced pressure because of regulatory changes in reimbursement for Medicare Advantage at a time when medical costs among seniors have seen a resurgence. (Coombs, 6/28)

Also —

KFF Health News' 'What The Health?' Podcast: SCOTUS Ruling Strips Power From Federal Health Agencies
In what will certainly be remembered as a landmark decision, the Supreme Court has overruled a 40-year-old precedent that gave federal agencies, rather than judges, the power to interpret ambiguous laws passed by Congress. ... Alice Miranda Ollstein of Politico, Victoria Knight of Axios, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News chief Washington correspondent Julie Rovner to discuss these stories and more. (Rovner, 6/28)