Policy and Legislation
Many co-op plans were priced low, and customers poured in. But these new customers had high health costs, so the co-ops had to start paying a lot of bills. The math didn't add up
CMS is requesting comment on whether health plans should designate network strength, such as indicating whether a plan has a broad number of doctors or health facilities in the network or not.
Many said they anticipate the federal government will act to forestall widespread departures, particularly because continued withdrawals could be politically explosive during an election year.
Consumers have received more than $2.4 billion in Affordable Care Act premium rebates since 2011, but the number of people owed refunds by insurers decreased by more than a million this year compared to last, according to a report released Thursday by the Centers for Medicare and Medicaid Services.
UnitedHealth Group may exit the insurance exchange market, as the deterioration in product performance has weakened its financial outlook, the company said in an earnings update released Thursday.
Week two of open enrollment saw another 500,000-plus consumers select plans in the federal marketplace, bringing the total for the first two weeks to over 1 million, according to the Centers for Medicare and Medicaid Services.
OIG will determine the extent to which Centers for Medicare & Medicaid Services validated hospital inpatient quality reporting data.
Under the model, hospitals in 67 geographic areas will receive additional payments if quality and spending performance are strong, or if not, have to potentially repay Medicare for a portion of the spending for care for a lower extremity joint replacement procedure.
The nonprofit co-op Health Republic Insurance of New York owes hospitals within the Greater New York Hospital Association more than $150 million, according to a November 11 letter from President Kenneth Raske to member CEOs.
Republican said he would curtail the state's expansion of Medicaid by seeking a waiver for a more restrictive version of the program.