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.
Category: CMS
When Rogue Brokers Switch People’s 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 didn’t even know they had.
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. There’s a way out.
Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
KFF Health News gives readers a chance to comment on a recent batch of stories.
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.
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.
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re 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 it’s sued thousands of patients for unpaid bills.
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 can’t boost wages enough to attract workers.
Exclusive: CMS Study Sabotages Efforts to Bolster Nursing Home Staffing, Advocates Say
Research commissioned by the Centers for Medicare & Medicaid Services analyzed only staffing levels lower than the current federal standard. Patient advocates have been pushing for more staff to improve care.
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
