During Fiscal Year (FY) 2017, the Federal Government won or negotiated over $2.4 billion in health care fraud judgments and settlements, and it attained additional administrative impositions in health care fraud cases and proceedings. As a result of these efforts, as well as those of preceding years, in FY 2017 $2.6 billion was returned to…

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A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country.  Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices. The Minnesota Legislature offered…

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Congress has been unable to agree on “market stabilization” for the Affordable Care Act (ACA), and it was left out of the recently passed omnibus. Yet, a key discussion has been missing from the conversation, the need to rethink the single risk pool in the ACA. Throwing money at the status quo will simply slow…

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The Centers for Medicare & Medicaid Services (CMS) plans to “wind down” support for the federal exchanges by the time open enrollment hits in 2019 and shift funding to states. For that strategy to work, the agency is relying on Congress to do something it failed to do several times last year: Pass an ACA repeal. CMS…

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Since the managed care debacle of the 1990s, billions of dollars have been spent in time and resources to improve and measure the quality of patient care. However, measuring the quality of care in the effort to improve it in a cost-efficient manner is showing evidence of being counter-productive, particularly for small physician practices and…

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Congress in 2017 failed to “repeal and replace” the Affordable Care Act. But the health law has been changed in many other ways over the past year and a half. Some changes were made by Congress, some by President Donald Trump and his administration and some by state officials. Here is a timeline of the…

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Maryland lawmakers on Wednesday finalized a bipartisan measure to collect $380 million in taxes from health insurers next year to help curtail surging premiums for 150,000 Marylanders and prevent the state’s Obamacare marketplace from a potential collapse. The legislation was a quiet, one-year compromise between the Democratic-controlled General Assembly and Republican Gov. Larry Hogan, who…

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After years of being a central political question, health care is on the back burner. Both parties contain experts and activists who want to make major changes to health policy. But for now, both parties’ politicians are wary. Democrats are, as usual, more interested in the subject than Republicans, but they are somewhat divided about…

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It’s the pragmatists versus the idealists in California’s latest quest for universal health care. Increasing numbers of lawmakers and advocates are pushing for policy goals that realistically can be accomplished this year. But there’s an unrelenting camp clinging to single-payer-or-bust. The Golden State, which has been pushing back against the Trump administration on multiple fronts,…

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California is indeed the Golden State where Medicaid is concerned. The HHS Office of Inspector General (OIG) has found that, by exploiting Obamacare’s expansion of the program, California has enrolled hundreds of thousands of ineligible adults in Medicaid. Consequently, the state has bilked the federal government out of more than $1 billion in funding to…

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