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Record Number of Americans Sign Up for ACA Health Insurance

Kaiser Health News

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans. The previous marketplace enrollment record was 12.7

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10 Charged Over BEC Scams Targeting Medicare, Medicaid, and Private Insurance Programs

HIPAA Journal

million being defrauded from Medicaid, Medicare, and private health insurance programs. According to the FBI, more than $43 billion was lost to these scams between June 2016 and December 2021, and in 2021 alone, the FBI Internet Crime Complaint Center received reports of losses of $2,395,953,296 to BEC scams.

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California Handed Its Medicaid Drug Program to One Company. Then Came a Corporate Takeover.

Kaiser Health News

Prescription drug costs for California’s massive Medicaid program were draining the state budget, so in 2019 Gov. The new Medicaid drug program debuted this January, with a private company in charge. Centene was already a big player in state Medicaid drug programs — but one with a questionable record. SACRAMENTO, Calif.

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One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy

Health Populi

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Health Populi’s Hot Points: U.S. One-half of U.S. households.

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2020 Medicaid Managed Care Rule Summary

C&M Health Law

On November 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule , demonstrating long-awaited efforts to streamline the regulatory framework governing the Medicaid and Children’s Health Insurance Program (“CHIP”) managed care programs. Actuarial Soundness.

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Key Healthcare Compliance Examples To Understand Its Importance

MedTrainer

Advocate Health Care HIPAA Breach (2016) In August 2016, Advocate Health Care Network —one of the largest healthcare systems in Illinois—agreed to settle potential violations of Privacy and Security Rules for $5.55 Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid.

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White House looks to CMMI to test new ways to lower drug prices

C&M Health Law

CMMI has broad statutory authority not only to test, design, and implement health care payment and delivery models for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) but in certain instances, can implement such models without Congressional action.