Author: Scott Welch
ACA Marketplace insurers are proposing a median premium increase of 14% for 2027 — indicating a likely second consecutive year of double-digit increases. If these hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.
The sudden death of Sen. Lindsey Graham has removed a longtime opponent of the Affordable Care Act’s major medical insurance provisions from the Senate and changed the gameboard for efforts to pass “Reconciliation 3.0” legislation this year. Graham, 71, died Saturday shortly after returning home from a trip to Ukraine. The cause of death was ...
The federal watchdog for the Department of Health and Human Services (HHS) generated $5.56 billion in expected recoveries and projected savings over a six-month period, according to a report issued Monday, and it barred just more than 1,200 individuals and companies from federal programs. The HHS Office of Inspector General (OIG), in a semiannual report to ...
Sen. John Kennedy of Louisiana is taking aim at California’s Medicaid program for providing housing assistance, food, and other social services to high-need, low-income patients who tend to rack up big healthcare costs and, he argued, strain taxpayer funds. The Republican blasted California during back-to-back political attacks in May, saying the heavily Democratic state is ...
A trade group representing nearly 5,000 independent pharmacies has filed a lawsuit alleging that Prime Therapeutics entered into an anticompetitive agreement with Cigna’s Express Scripts to fix pharmacy reimbursement rates and fees. The complaint was filed last week in federal court in Washington, D.C., by Protecting Access to Retail Pharmacy, which operates under the name ...
More insurers are filing lawsuits in an attempt to hike their Medicare Advantage quality scores after a court decision earlier this year exposed federal regulators to a new line of legal attacks. SCAN Health Plan and Alignment Healthcare both sued the CMS in D.C. district court last week, arguing regulators robbed them of higher star ...
Insurers expect to issue $759.2 million in medical loss ratio rebates this year, according to a new analysis. The report is based on data reported by payers to states and compiled by analytics firm Mark Farrah Associates. An analysis of the data from KFF projects that total rebates paid out since their 2012 launch will rise to ...
Want to sleep better at night? It starts with what you choose to eat for breakfast in the morning. We know this thanks in part to research carried out by Marie-Pierre St-Onge, a professor of nutritional medicine at Columbia University Irving Medical Center. St-Onge has conducted dozens of studies examining the relationship between diet and ...
One issue will decide Steven Cohen’s vote for Nevada governor this fall: Which candidate can best protect him from getting kicked off Medicaid? Cohen is a 38-year-old Las Vegas resident with autism and has dual enrollment in Medicaid and Medicare. He said he’s very concerned that he could lose his Medicaid coverage once work requirements ...
All Nevada hospice and home health providers are set to be reviewed over the next six months due to what officials call “elevated fraud risk.” A temporary pause on hospice and home-health care licenses issued by the state and a six-month moratorium on new enrollments for Nevada Medicaid was officially approved and implemented on June ...