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Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

Kaiser Health News

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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Doctors’ Offices Morph into Bill Collectors As Patients Face Growing Out-Of-Pocket Costs

Health Populi

This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. In the U.S.,

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Study Finds ACA Plans Have a Third Fewer Providers than Employer-Based Plans

The Health Law Firm

A new study found that consumers who bought insurance on health exchanges last year had access to one-third fewer doctors and hospitals than people with traditional employer-provided insurance. The study revealed more limited doctor and hospital choices in plans offered on marketplaces created by the Affordable Care Act (ACA).

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Her First Colonoscopy Cost Her $0. Her Second Cost $2,185. Why?

Kaiser Health News

So when her primary care doctor suggested she be screened for colorectal cancer in September, Melville dutifully prepped for her colonoscopy and went to New London Hospital’s outpatient department for the zero-cost procedure. The former generally incurs no cost to patients under the ACA; the latter can generate bills.

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Medical Debt in the U.S. Greater in States That Did Not Expand Medicaid

Health Populi

The highest turquoise blue line shows medical debt in collections in states that never expanded Medicaid with the ACA. If you had to choose between keeping the lights on and paying your mortgage and paying some doctor you’re never going to see again, I think a lot of us would make the same decision.”. This was highest in the South U.S.

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The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

Health Populi

While Millennials were least likely to visit a doctor’s office in the past year, they had the most likelihood of making a visit to a mental health provider, to seek chiropractic care, urgent care, and acupuncture — all services delivered outside of traditional medical home settings.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

They paid bribes, kickbacks, set up phony jobs in doctors’ offices. Sellinger commented, “These defendants admitted taking part in an elaborate and years-long scheme to use their specialty pharmacy to rip off Medicare, Medicaid and private insurers.

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