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Federal regulators provided more specifics about why they suspended two private sector Affordable Care Act enrollment sites, including concerns about potential overseas accessing of consumer data and suspicions of involvement in Obamacare enrollment and switching schemes. The companies reject the assertions.
A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.
The Centers for Medicare & Medicaid Services said it has received more than 200,000 complaints in the first six months of the year about people being signed up for Obamacare plans or switched to new plans without their consent.
Though the Trump administration established a voluntary, temporary program lowering insulin costs for some older Americans on Medicare, the mandatory price caps implemented through Biden’s Inflation Reduction Act go significantly further.
The initiative targets the biggest incentive driving fraudulent sign-ups and plan switches: the commissions that rogue agents or large call centers seek.
A Supreme Court ruling restricting federal power will likely have seismic ramifications for health policy. A flood of litigation — with plaintiffs like small businesses, drugmakers, and hospitals challenging regulations they say are too expensive or burdensome and not authorized by law — could leave the country with a patchwork of disparate health regulations.
The nursing home industry — as well as a healthy number of Congress members — are all pushing back on the Biden administration’s new rules on nursing home staffing. Industry officials say that there are not enough workers to meet the requirements and that the costs would be prohibitive. Meanwhile, Democrats on Capitol Hill are trying to force Republicans to explain their exact positions on assuring access to contraceptives and in vitro fertilization. Rachel Cohrs Zhang of Stat, Alice Miranda Ollstein of Politico, and Sandhya Raman of CQ Roll Call join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature about a free cruise that turned out to be anything but.
With tens of thousands of Americans already affected by enrollment scams that leave some without doctors or treatments, Oregon Sen. Ron Wyden wants increased enforcement against rogue agents or other perpetrators and legislation to allow for criminal penalties.
KFF Health News and California Healthline staff made the rounds on national and local media in recent weeks to discuss topical stories. Here’s a collection of their appearances.
The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesn’t go far enough. Labor unions welcomed the requirement.
The lawsuit filed in federal court alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.
Some tax filers’ returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
KFF Health News gives readers a chance to comment on a recent batch of stories.
The state canceled Beverly Likens’ coverage — days before surgery — without considering other ways she qualified for Medicaid, which experts say violated federal regulations.
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