Category: Health Insurance

‘Dreamers’ Can Enroll in ACA Plans This Year — But a Court Challenge Could Get in the Way

Nineteen states are seeking to stall a Biden administration rule that would allow recipients of the Deferred Action for Childhood Arrivals program to enroll in ACA coverage and qualify for subsidies. DACA provides work authorization and temporary deportation protection to people brought to the U.S. as children without immigration paperwork.

Vance Wrongly Blames Rural Hospital Closures on Immigrants in the Country Illegally

Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.

Pharmacy owner sentenced in $41 million insurance fraud case

A Dallas pharmacy owner who routinely billed insurance companies for headache sprays, pain creams and scar creams never dispersed to patients has been sentenced to 10 years in federal prison, according to the U.S. Department of Justice.

CHS reports losses due to hurricanes, payer denials, increased workforce expenses

Community Health Systems took a financial hit for the third quarter due in part to the continuation of high payer denials, higher workforce expenses and the unanticipated setback of back-to-back hurricanes.

AMA files lawsuit alleging price-fixing by MultiPlan

The American Medical Association and the Illinois State Medical Society (ISMS) filed a lawsuit last week against MultiPlan claiming the data analytics agency is at the center of an alleged price-fixing conspiracy with commercial health insurance compan…

Black Americans Still Suffer Worse Health. Here’s Why There’s So Little Progress

The United States has made almost no progress in closing racial health disparities despite promises, research shows. The government, some critics argue, is often the underlying culprit.

Change Healthcare cyberattack affected PHI of 100 million

The Change Healthcare cyberattack compromised the protected health information of at least 100 million people, according to The HIPAA Journal.
This represents a third of the population in the United States and makes the data breach the largest known br…

Molina beats financial expectations on higher premium revenue

Unlike Q3 earnings reports from insurers more heavily in the Medicare Advantage market, Medicaid-based Molina Healthcare on Thursday released third quarter financials that beat expectations.

Presidential Election Puts Affordable Care Act Back in the Bull’s-Eye

The outcome of the upcoming presidential election could affect the number of insured Americans, the fate of premium-reducing subsidies, the shape of Medicaid, and the cost of coverage for tens of millions of people.

Lawsuit accuses Anthem Blue Cross Blue Shield of New York of harboring a ‘ghost network’

A new lawsuit filed in the Southern District of New York accuses Anthem Blue Cross Blue Shield of New York of maintaining a “ghost network” of doctors, with patients pursuing pricey out-of-network care and experiencing care delays due to inaccurate pro…