Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
Category: CMS
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Rural NC County Is Set To Reopen Its Shuttered Hospital With Help From a New Federal Program
One rural North Carolina county is on track to be among the first where a hospital reopens owing to a new federal hospital classification meant to help save small, struggling facilities.
ACA Enrollment Platforms Suspended Over Alleged Foreign Access to Consumer Data
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.
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
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.
Biden Administration Tightens Broker Access to Healthcare.gov To Thwart Rogue Sign-Ups
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.
Trump Is Wrong in Claiming Full Credit for Lowering Insulin Prices
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.
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.
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.
