March 3, 2014
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(1) An estimated 65% of small employers are expected to get increased premiums as a result of new rating requirements under the Affordable Care Act (ACA), while the remaining 35% will see reduced rates, according to a Feb. 21 report by CMS. Those costs are expected to be passed on to employees. Roughly 11 million people out of the 17 million who receive coverage on the small-group health market will see higher premiums as a result of the ACA, and about 6 million individuals will have lower premiums, CMS said in its report to Congress. The agency added that any premium changes in the large-group market are “expected to be negligible.” But the agency also said there is a “rather large degree of uncertainty” associated with its new estimates. The impact could vary significantly depending on the mix of firms that decide to offer health coverage, CMS said. Republicans quickly jumped on the report to slam the ACA. “The fact that two-thirds of Americans who work at small businesses will see premium increases because of the health law is devastating news,” said House Small Business Committee Chairman Sam Graves (R-Mo.). (Reprinted from AIS’s Health Reform Week's e-News Alert)
(2) The biggest news on star ratings in the 2015 Medicare Advantage and Part D Call Letter that CMS released late Feb. 21 is that there is no big news — except for things that aren’t going to happen .... (more)
(3) The Department of Justice alleges a CFO lied about his hospital’s certified electronic health records to swindle $785,655 from Medicare in meaningful use money .... (more)
(4) Roughly 4 million people have signed up for a private plan through the federal and state-based health insurance exchanges since Oct. 1, 2013, CMS Administrator Marilyn Tavenner said in a Feb. 25 blog posting on the HHS website. The full enrollment report for February will be released in mid-March, she added. “We continue to see strong demand nationwide from consumers who want access to quality, affordable coverage,” she said. “Our outreach efforts are in full force with community partners and local officials participating in hundreds of events each week, and enrollment assistors are helping more and more people enroll in coverage.” Tavenner added that the system error rates on HealthCare.gov are low and response times are consistently less than half a second. The call center has handled more than 12 million calls so far, she said, adding that it is open 24/7 and that people can receive assistance in English, Spanish and more than 150 languages. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(5) The Stark law part of the Halifax Hospital Medical Center and Halifax Staffing case goes to trial on March 3 in the U.S. District Court for the Middle District of Florida .... (more)
(6) Ben Taub Hospital in Houston was overpaid $818,967 for outpatient dental services, the HHS Office of Inspector General said .... (more)
(7) Health fraud enforcement and prevention netted $4.3 billion in fiscal year 2013, up from $4.2 billion in 2012 .... (more)
(8) Maryland has ended its $193 million contract with Noridian Healthcare Solutions, the company that was hired to build and operate the state’s health insurance exchange that has been riddled with problems since its launch last fall. The state also said it reserves the right to take the company to court for damages, according to a Feb. 24 article in the Baltimore Sun. The website is so flawed that state officials are considering abandoning it after open enrollment ends next month, the article said. North Dakota-based Noridian, a unit of Noridian Mutual Insurance Co., which also does business as Blue Cross Blue Shield of North Dakota, was hired to build and host the exchange for the next five years. The state said it will rely on Optum/QSSI, a Columbia, Md.-based unit of UnitedHealth Group that was hired in December to help fix the exchange. In a statement, Noridian President and CEO Tom McGraw said, “Throughout the past four months, Noridian has complied with its contractual obligations under tremendous pressure and constant changes by the state,” according to the Sun. (Reprinted from AIS’s Health Reform Week's e-News Alert)
(9) On Feb. 18, U.S. District Judge James S. Moody Jr. in Tampa, Fla., ruled that former WellCare Health Plans, Inc. executives cost Florida $11 million via Medicaid fraud .... (more)
(10) The Arkansas House of Representatives on Feb. 18 failed to pass a bill that would continue the state’s widely watched Medicaid expansion program .... (more)
(11) In California, state Senate President Pro Tem Darrell Steinberg (D) introduced legislation to bring “interested parties together” to find a compromise solution on efforts to change California’s medical malpractice law and possibly avert a November ballot initiative leaving the issue up to voters .... (more)
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