“Insurers Cigna and Blue Shield of California misled consumers about the size of their networks of doctors and hospitals, leaving enrollees frustrated and owing large bills, according to two lawsuits filed this week in Los Angeles.
“As a result, many patients were left without coverage in the course of treatment,” said Laura Antonini, staff attorney for Consumer Watchdog, a Santa Monica-based advocacy group that filed the case.
Both cases allege that the insurers offered inadequate networks of doctors and hospitals and that the companies advertised lists of participating providers that were incorrect. Consumers learned their doctors were not, in fact, participating in the plans too late to switch to other insurers, the suits allege, and patients had to spend hours on customer service lines trying to get answers. Both cases seek class action status.”
“Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of “provider,” loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care.
“To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs,” an NGA release states.”
“The administration finally released the Obamacare enrollment count this week.
Like everything else about their scorekeeping we got a number. Just one number. A number that was conveniently better than we had expected. And, we got no real context for the number or any of the back-up information.
I thought this quote in a Politico article was telling:
The figure is complex to unravel. The number came from the health insurers, who told the Obama administration every month how many people are covered by Affordable Care Act plans. A CMS official said Thursday that in prior monthly reports, the numbers varied widely, but recently stabilized.””
“California’s health insurance exchange is vowing to fix enrollment delays and dropped coverage for about 30,000 consumers before the next sign-up period this fall..
Covered California said it failed to promptly send insurance applications for 20,000 people to health plans recently, causing delays and confusion over their coverage.
Another group of up to 10,000 people have had their insurance coverage canceled prematurely because they were deemed eligible for Medi-Cal based on a check of their income, officials said.”
“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”
“Costs to buy coverage through Connecticut’s health insurance exchange won’t, on average, rise much next year. For some plans, the prices are dropping.
But some customers who get financial aid to buy their insurance could see price increases beyond the rise in sticker price if they stick with their current plans, according to an analysis by consultants for the exchange, Access Health CT.
As a result, some people might find lower prices by considering different plans, even if they bought the cheapest plan available this year, according to the analysis by Wakely Consulting Group.”
“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.””
“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.”
“RICHMOND — Republican leaders of Virginia’s House of Delegates, who have staunchly opposed Medicaid expansion all year, plan to put the question to a floor vote as early as Thursday in a special legislative session.
The GOP-dominated chamber is widely expected to shoot down the proposed $2 billion-a-year expansion, although a few conservative legislators have expressed fears that the measure might defy expectations and pass — just as a then-record tax hike did when Democrat Mark R. Warner was governor a decade ago.”
“Enrolling in Missouri’s Medicaid program has not been easy.
Many applicants have experienced a barrage of problems when trying to sign up for the program, including long delays until coverage kicks in, lost paperwork and a lack of one-on-one interaction with caseworkers. State officials have blamed a new computer system used to process Medicaid applications.
But there is another reason why some Missourians struggle to get help.
When Deborah Weaver, 28, had issues enrolling in the state’s Medicaid coverage for pregnant women, a switch from her Medicaid disability coverage, she was directed to use a toll-free number, 1-855-373-4636. When she called, Weaver endured long waits and received no guidance.”