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Ending CSRs would increase premiums, federal deficit
Premiums would spike an additional 20 percent next year and 25 percent by 2020 if the Trump Administration ends CSRs, according to a CBO report. CBO also found halting CSR payments would increase the federal deficit by $196 billion through 2026. The Administration has been making payments on a monthly basis, causing great uncertainty in the market and prompting insurers to ask for more assurances.
Centene enters empty Nevada exchanges
Centene will offer ACA plans in 14 Nevada counties that lacked an insurer for 2018. Roughly 8,000 Nevadans from those counties had enrolled in ACA plans in 2017. The insurer agreed to enter the exchange after negotiations with state officials. The move means fewer than 400 people nationally will live in an area without an ACA insurer.
CMS refocuses auditing efforts
In an effort to combat Medicare fraud more effectively, CMS has announced it will focus its audits on suppliers and providers with high error rates or abnormal billing practices. Currently, CMS audits provider claims randomly. In 2016, CMS disbursed more than $38 billion in overpayments, accounting for more than 10 percent of all payments.
CMS ends bundled-payment models
CMS is scrapping two bundled-payment models and scaling back the number of providers required to take part in a third. The change comes in response to providers asking to have more input in the design. CMS has reduced the number of geographic areas participating in the Comprehensive Care for Joint Replacement model and has proposed to exclude low-volume hospitals as well. The agency also plans to cancel the Episode Payment Models and the Cardiac Rehabilitation incentive payment model.
Companies move to destigmatize mental health days for employees
More companies are working to destigmatize mental health issues in the workplace by encouraging workers to use their sick days for mental health and take advantage of employer-sponsored programs. Many workers feel they cannot share about mental health conditions at work. A 2014 survey by market-research firm Ipsos found 73 percent of workers with depression did not tell their employer and half thought it would put their job in jeopardy, even though legal experts say the law protects workers with mental illness. Companies like Ernst & Young, American Express Co. and Prudential Financial offer programs for on-site access to mental health professionals, free counseling and flexible work arrangements.