Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare Probes Whether Health Care Providers Steered Patients To Private Plans
The Wall Street Journal: U.S. Opens Probe Into Concerns Over Health-Provider Payments
The Obama administration has launched a probe into whether health-care providers such as dialysis centers are steering patients eligible for Medicare and Medicaid benefits into insurance plans offered on the health law’s exchanges. The Centers for Medicare and Medicaid Services on Thursday said it sent warning letters to all dialysis centers that participate in the federal Medicare program. The agency also said it is weighing financial penalties on providers who are found to have directed people eligible for Medicare into Affordable Care Act plans instead. “We are concerned about reports that some organizations may be engaging in enrollment activities that put their profit margins ahead of their patients’ needs,” said CMS Acting Administrator Andy Slavitt in a news release. (Armour and Wilde Mathews, 8/18)
Morning Consult: CMS Investigating If Providers Steered Patients Away From Public Insurance Programs
The Centers for Medicare and Medicaid Services said on Thursday it is investigating whether some providers or affiliated groups have improperly steered people who would be eligible for Medicare or Medicaid toward individual market plans. The agency has concerns that such actions are resulting on issues on the federal exchanges. Providers would steer patients toward individual marketplaces, either on or off the exchanges, to obtain higher reimbursement rates, the CMS release suggests. (McIntire, 8/18)
Reuters: U.S. Health Agency Weighs Rules On Outside Payments For Obamacare
A U.S. government health agency on Thursday said that it was considering new rules to prevent healthcare providers or related groups from steering patients into Obamacare individual insurance plans instead of Medicare or Medicaid in order to receive higher payments for medical services. The Centers for Medicare & Medicaid Services on Thursday said it is seeking public comment and considering rules including prohibiting or limiting premium payments or cost-sharing for the individual marketplace plans, monetary penalties and limits on such payments. (Humer, 8/18)
