James Swann
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The goal of all insurance plans is to provide the right services to the right patient population. Insurance eligibility is a big factor, and companies spend a lot of time and effort determining if their patients qualify for coverage. The question of eligibility is also critical to the operation of the Affordable Care Act’s insurance marketplaces, and a recent OIG report found problems within the New York state marketplace that potentially led to ineligible enrollees.

James Swann
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