HealthSherpa and Insurers Team Up To Curb Unauthorized ACA Enrollment Schemes
The initiative targets the biggest incentive driving fraudulent sign-ups and plan switches: the commissions that rogue agents or large call centers seek.
CMS
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The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.
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.
Nursing Home Staffing Rules Prompt Pushback
Episode 350The nursing home industry as well as a healthy number of Congress members are all pushing back on the Biden administrations 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 窪蹋勛圖厙 News Julie Rovner to discuss these stories and more. Also this week, Rovner interviews 窪蹋勛圖厙 News Bram Sable-Smith, who reported and wrote the latest 窪蹋勛圖厙 News-NPR Bill of the Month feature about a free cruise that turned out to be anything but.
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Exclusive: Senator Urges Biden Administration To Thwart Fraudulent Obamacare Enrollments
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.
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Journalists Demystify Bird Flu, Brain Worms, and New Staffing Mandates for Nursing Homes
窪蹋勛圖厙 News and California Healthline staff made the rounds on national and local media in recent weeks to discuss topical stories. Heres a collection of their appearances.
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Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Dont Meet Them.
The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesnt go far enough. Labor unions welcomed the requirement.
By Jordan Rau -
Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers
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.
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When Rogue Brokers Switch Peoples ACA Policies, Tax Surprises Can Follow
Some tax filers returns are being rejected because they failed to provide information about Affordable Care Act coverage they didnt even know they had.
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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
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. Theres a way out.
By Susan Jaffe -
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Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
窪蹋勛圖厙 News gives readers a chance to comment on a recent batch of stories.
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Lost in the Mix of Medicaid Unwinding: Kentucky Cut Off Her Health Care Over a Clerical Error
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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Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
By Susan Jaffe -
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. Theyre Failing to Deliver.
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations even as its sued thousands of patients for unpaid bills.
By Brett Kelman and Samantha Liss -
Biden Administration Proposes New Standards to Boost Nursing Home Staffing
The proposal would require major hiring at the most sparsely staffed homes. But the proposal is already badly received by the nursing home industry, which claims it cant boost wages enough to attract workers.
By Jordan Rau