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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.

ACA 138
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Medical Debt in the U.S. Greater in States That Did Not Expand Medicaid

Health Populi

Furthermore, the flow of medical debt was greater among health citizens living in states that did not expand Medicaid as part of the Affordable Care Act, compared with patients who reside in Medicaid expansion states, according to an original research essay, Medical Debt in the US, 2009-2020 published in JAMA on 20 July 2021.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. They paid bribes, kickbacks, set up phony jobs in doctors’ offices. Bribes included payment by check, wire transfer, cash, and expensive meals.

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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.

ACA 106
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Wellth Announces $20M Series B for Continued Growth of Behavioral Science-Based Platform

Healthcare IT Today

In my own family, my Uncle Roy struggled to manage his type 2 diabetes—he constantly missed doctor appointments, failed to take his medications, and never checked his blood sugars. Most things we “should do” don’t give us immediate gratification (eating right, exercising, taking medications, going to the doctor).

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Health Provider News

Hall Render

ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M Newsom announces distressed hospital loan program Kaiser Permanente frontline workers strike could begin Oct.

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More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Health Populi

Consumers make personal clinical decisions that can be against “doctor’s orders” and shop for health care at another provider site that can be less costly and/or have better consumer reviews or word-of-mouth (with 4 in 5 consumers traveling past the closest hospital to one further away due to a better reputation).