A project of the Galen Institute
Cole Avery, NOLA.com
Fri, 2014-09-19
"Lawmakers told officials with the Department of Health and Hospitals on Wednesday they needed to provide more complete information going forward about Bayou Health, Gov. Bobby Jindal's Medicaid privatization program. The Legislative Audit Advisory Council heard testimony from DHH and the Legislative Auditor's Office about an audit that raised a number of questions about the program. Auditors testified 74 percent of the transparency report was based on self-reported data with no corroborating documentation."
Meredith Cohn, Baltimore Sun
Fri, 2014-09-19
"A day after Maryland committed to a gradual launch of its health exchange, state officials are still working out some key details — including where the opening day sign-up will be held — but experts say it could be a way to avoid a repeat of last year's botched rollout. Several health experts said the approach that limits enrollment in the first few days could allow Maryland to "kick the tires" on its new website. "It's a controlled way to open enrollment," said Karen Pollitz, senior fellow at the Kaiser Family Foundation. "They can work with a controlled number of people for the first couple of days to see how this works in practice. I'm assuming there is some plan at the end of the day when people gather in a room and compare notes and say we need to fix this or that.""
Margot Sanger-Katz and Amanda Cox, NY Times
Fri, 2014-09-19
"If you bought health insurance at an Affordable Care Act marketplace this year, it really pays to look around before renewing your coverage for next year. The system is set up to encourage people to renew the policies that they bought last year — and there are clear advantages to doing so, such as being able to keep your current doctors. But an Upshot analysis of data from the McKinsey Center for U.S. Health System Reform shows that in many places premiums are going up by double-digit percentages within many of the most popular plans. But other plans, hoping to attract customers, are increasing their prices substantially less. In some markets, plans are even cutting prices."
Mchael Ramlet, Morning Consult
Wed, 2014-09-17
"Morning Consult’s healthcare poll finds that while a majority of voters (54%) are concerned about security breaches in the health exchange websites, 52% currently believe that the information on the exchange websites is secure. Further, a plurality of voters would choose to sign up for health insurance online over a paper application or over the phone. This poll was conducted from September 12-13, 2014, among a national sample of 2,188 registered voters. The margin of error is plus or minus 2.1 percentage points. You can see the full results here (http://bit.ly/1BMkPRm). A majority of voters (54%) are concerned about security breaches in the health exchange websites— Interestingly, a majority of both voters who approve of President Obama and those who disapprove of the President indicate they are concerned about security breaches in the exchange websites."
http://www.insidehealthpolicy.com/vermont-takes-exchange-offline-repairs-until-open-enrollment
Wed, 2014-09-17
"Vermont Gov. Peter Shumlin (D) said Tuesday (Sept. 16) that the state has shut down its exchange website as it scrambles to finish operational and other improvements by Nov. 15, but the state expects the site to be “restored to full, improved operation before the start of open enrollment.” The state made the decision to shut down the site after consulting with CMS, Shumlin said in a statement. The state also announced a number of management changes that will remove oversight of the exchange from the Department of Vermont Health Access and install Lawrence Miller, a senior advisor to the governor, as the person responsible for operational leadership of Vermont Health Connect. The Department of Vermont Health Access oversees the state's Medicaid program. “As all Vermonters know, we’ve had disappointment after disappointment with the Vermont Health Connect website,” Shumlin said. “I have been very frustrated that the website remains incomplete.
Amy Lotven, Inside Health Policy
Wed, 2014-09-17
"Congress' investigative arm said Tuesday (Sept. 16) that healthcare.gov continues to face security weaknesses, leaving the site subject to “increased and unnecessary” risk of unauthorized access, disclosure or modification of the information collected and maintained. CMS pledged to implement some of the fixes proposed by the Government Accountability Office, but GOP lawmakers used the opportunity to again blast the administration's handling of Obamacare. GAO recommended six ways CMS could put in place an effective information security program, and another 22 technical recommendations that could improve the effectiveness of information security controls."
Michelle Andrews, Kaiser Health News
Wed, 2014-09-17
"The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program. The Urban Institute's health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods."
Jennifer Haberkorn and Burgess Everett, Politico
Tue, 2014-09-16
"There are widespread instances of Obamacare insurance plans violating the rigid rules surrounding whether customers can use federal health care subsidies on insurance policies that cover abortion procedures, according to a Government Accountability Office investigation. The report, commissioned by House Republican leadership and obtained by POLITICO on Monday night, found that 15 insurers in a sample of 18 are selling Obamacare plans that do not segregate funds to cover abortion (except in cases of rape, incest or the mother’s life) from their Obamacare subsidies.
J.D. Tuccille, Reason
Tue, 2014-09-16
"Last year I wrote that Obamacare could leave doctors holding the bag for claims for patients who don't pay their insurance premiums. That's because the law includes a three-month grace period during which health insurers must continue to cover patients who sign up, but don't pay the price of their insurance. If the patients eventually make good, there's no problem. But if patients don't pay the owed premiums, the insurance company has to cover the cost of claims filed during the first month. Providers are stuck with the tab for any claims filed during months two and three. The piece I wrote last July was theoretical. The notification letter I'm holding in my hand, addressed to my wife's pediatric practice, is reality. And reality costs, in this case, over $600. That's the outstanding balance owed the practice by a patient insured by BlueCross BlueShield of Arizona. It's a balance that my wife might have to eat, or else try to collect herself."
http://insidehealthpolicy.com/brady-questions-hhs-authority-put-forward-hospital-appeals-settlement
Tue, 2014-09-16
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process." Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future." CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.

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