“Cover Oregon will hold a special open enrollment period for 1,400 Oregonians who were incorrectly enrolled into the low-income Oregon Health Plan by the state’s troubled health insurance exchange.
Starting Aug. 31, the people affected will have no coverage through the OHP, the state’s version of Medicaid. However, they will have the option to sign up for coverage from private insurers and to qualify for tax credits through Cover Oregon to bring down premiums.
Meanwhile, Cover Oregon is contacting at least 700 people who should have been enrolled in the Oregon Health Plan, but were incorrectly enrolled in a commercial health plan instead.
If they were receiving tax credits for private plans, those will go away immediately, though they can keep their plan.
Cover Oregon is currently negotiating with the federal government over whether those people will have to refund to the IRS all the tax credits they received incorrectly, said Amy Fauver, Cover Oregon communications director. She said the exchange is optimistic that they won’t.”

“Noridian Healthcare Solutions, the company fired by Maryland officials after the disastrous launch of the state’s health insurance exchange, received a request from federal auditors last month to turn over documents related to the troubled project, chief executive Tom McGraw said Tuesday.
McGraw said in a statement that Noridian was “cooperating fully” with the July 30 request by the inspector general’s office for the Department of Health and Human Services, which has been auditing the use of federal funds in creating the Maryland Health Benefit Exchange.
McGraw’s statement came after Rep. Andy Harris (R-Md.), a fierce critic of the exchange and the federal health-care law that led to it, said that federal auditors had issued subpoenas as part of their review.
“The Office of Inspector General has moved this from an audit into a full-blown investigation,” he said in a statement. “Now we know that fraud may have occurred.””

“The Oregon Department of Justice jousted for nearly two months with Oracle America over the state’s demand for documents from the California software giant relating to the health exchange debacle.
In fact, Oracle flouted state law and stymied the demand, according to DOJ.
The state filed papers in federal court Friday that provide a glimpse into high-stakes jockeying that for months took place largely out of public view.
DOJ filed its federal papers shortly after the state’s lawyers sued Oracle in Marion County Circuit Court on Aug. 22.
In its federal filing, DOJ accuses Oracle of “stalling” and attempting to manipulate the legal system by filing its own federal lawsuit against Oregon on Aug. 8.”

“As federal officials wrestle over whether HealthCare.gov will withstand the weight of millions of new customers and re-enrollees this fall, state brass with Your Health Idaho are looking to detach from the federal health insurance portal.
But they’re going to need help from Idahoans.
The state-run insurance marketplace has begun setting up state-based accounts through its own technology for the 76,000 residents who signed up for health care last year, said spokeswoman Jody Olson.
Idaho used HealthCare.gov’s Web system in its inaugural year, as officials believed accounts could easily be transferred. The federal government, however, continues to “drag its feet, and we still don’t have the data we were told we’d get,” Olson wrote in a release.”

“Responding to ongoing problems at the Washington Healthplanfinder insurance exchange, state Insurance Commissioner Mike Kreidler on Monday instituted a limited special enrollment period for consumers who want to obtain coverage outside the exchange.
From Aug. 27 to Nov. 14, those who have had problems with enrolling or making payments through Healthplanfinder can enroll in coverage outside the exchange either by selecting a different plan with the same carrier or by changing carriers.
“This is a problem that has been around since the end of December,” Kreidler said in an interview. “I am cautiously optimistic that the exchange is doing a much better job right now to resolve the problems, but there is no guarantee that they’re going to be gone as we go into open enrollment.””

“From Halbig to Sovaldi, this summer was a busy one for health policy and politics. We’ve made it easy to catch up, collecting all of the top stories you clicked on over the past few months. Together, they tell a story about the state of healthcare in the U.S., and offer clues as to where things may be headed when Congress returns in the fall.
Among them: The political battle over Obmacare has become more complicated for Republicans since the government cleaned up the Healthcare.gov mess, and with midterm elections around the corner, the focus will be on how much either party continues to attack or ignore the law. There are policy, legal and business matters to be settled as well – the employer mandate is under attack from the left and the right, the courts have been a wildcard for the health law to this point and could continue to be so, and employers and employees are finding themselves wading through the on-the-ground impacts of the law. That doesn’t even get to our top three storylines of the summer, so be sure to click through to find out what tops the list.”

“Health insurance companies in California may not refuse to cover the cost of abortions, state insurance officials have ruled in a reversal of policy stemming from the decision by two Catholic universities to drop elective abortions from their employee health plans.
Although the federal Affordable Care Act does not compel employers to provide workers with health insurance that includes abortion coverage, the director of California’s Department of Managed Health Care said in a letter to seven insurance companies on Friday that the state Constitution and a 1975 state law prohibits them from selling group plans that exclude the procedure. The law in question requires such plans to encompass all “medically necessary” care.
“Abortion is a basic health care service,” department director Michelle Rouillard wrote in the letter. “All health plans must treat maternity services and legal abortion neutrally.”
Jesuit-run Santa Clara University and Loyola Marymount University notified employees last fall that they planned to stop paying for elective abortions, but said faculty and staff members could pay for supplemental coverage that would be provided through a third party. The two schools said their insurers, Anthem Blue Cross and Kaiser Permanente, had cleared the move with the state.”

“The state of Oregon filed a lawsuit Friday against Oracle America Inc. and several of its executives over the technology company’s role in creating the troubled website for the state’s online health insurance exchange.
The lawsuit, filed in Marion County Circuit Court in Salem, alleges that Oracle officials lied, breached contracts and engaged in “a pattern of racketeering activity.”
Oracle was the largest technology contractor working on Oregon’s health insurance enrollment website, known as Cover Oregon. The public website was never launched, forcing the state to hire hundreds of workers to process paper applications by hand. The website’s failure became a political problem to Democratic Gov. John Kitzhaber, who is running for re-election.
A related project to modernize functions for social services also was scrapped. The state paid Oracle $240 million for both projects.”

“When the Obama administration in November 2013 decided to allow states to decide if individuals could keep noncompliant insurance plans, speculation began about what effect that decision would have on premiums and enrollment for plans that did comply with provisions of the Patient Protection and Affordable Care Act. Subsequently, the administration this March gave states the option of a maximum two-year extension into 2016.
Early indications of how many individuals opted to keep those plans have begun to emerge as have signs of the effect on premiums. As with so much else related to the ACA, the results depend on what state is being discussed.
Twenty-five states are allowing noncompliant plans to continue through 2015, which creates a continuing impact for insurers attempting to formulate premium levels in 2014, according to data compiled by America’s Health Insurance Plans, an insurer trade group. Twenty-one states are taking the full extension option, through 2016, according to AHIP.
North Dakota has seen 61% of individual policyholders of noncompliant plans from insurers Sanford Health Plan and Medica opt to retain their plans, while 92% of group policyholders chose to stay on their noncompliant plans, said Rebecca Ternes, the state Insurance Department’s deputy commissioner.”

“The Affordable Care Act gives the president’s cabinet officers sweeping powers to implement the law, but the administration managed to overreach these powers by allowing people in 36 states to illegally access health insurance subsidies.
That was the conclusion of the D.C. Circuit Court of Appeals in July.
At issue is the ability of people who sign up for coverage through exchanges established by the federal government to receive credits to reduce the cost of their health insurance.
D.C. Appeals Court Judge Raymond Randolph said the statute was quite clear in repeating seven times that subsidies are available only “through an Exchange established by the State.”
When the health law was passed, its authors apparently believed they had sufficiently cajoled the states. Jonathan Gruber, a chief architect of the law, said in early 2012, “if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits.”
But when it became clear that most states would not be coerced, the White House called on the Internal Revenue Service to write a regulation that would allow the subsidies to flow through the default federal exchanges as well.
In Halbig v. Burwell, the D.C. court held that subsidies — as well as the coverage mandates that travel with them — apply only in states that have established their own exchanges.”