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Kentucky has federal approval for changes to exchange
Kentucky has permission from the Centers for Medicare and Medicaid Services (CMS) to shift its state-based insurance exchange Kynect to a marketplace that uses the federal platform. CMS has expressed concerns about how the change might affect exchange plan purchasers, Medicaid enrollees and the Children’s Health Insurance Program, reports Mary Ellen McIntire from Morning Consult.
Americans are missing a tax credit by purchasing independent coverage
Roughly 2.5 million Americans are not taking advantage of a tax credit designed to make insurance plans more affordable because they are purchasing insurance independently rather through a state or federal exchange. The credit is supposed to lower the cost of insurance for individuals who are not covered by an employer and who are ineligible for Medicaid, explains Jayne O’Donnell of USA Today.
Clinics not associated with hospitals could deny care
Free-standing emergency clinics are growing in popularity, raising questions about how they will affect cost, access and quality of care. Unlike hospital emergency departments, which are legally required to treat all patients, free-standing clinics can deny uninsured customers care. Many states have implemented rules mandating clinics accept all customers; the regulations do not guarantee care, as they tend to not be enforced as strictly as the federal law. Harris Meyer at Modern Healthcare has the story.
Software malfunction transfers pregnant patients to Medi-Cal
From October 2015 to May 2016, about 2,000 pregnant women were automatically enrolled in Medi-Cal, California’s Medicaid program, and dropped from Covered California plans. The switch in insurance was due to a computer program error and happened without patients’ knowledge or consent. Many women missed prenatal appointments or had to change physicians due to the transfer. Covered California fixed the malfunctioning software in late September. Emily Bazar at California Healthline reports.
Government hesitates to pay ACA insurers
The federal government declares it is not obligated to pay insurers selling plans on the exchanges. According to three Department of Justice briefs, only profitable insurers need to provide funding for the risk corridor program and the government is not responsible for the financial shortfalls. Jeff Overley at Law360 shares the Department of Health and Human Services recently expressed being open to settling law suits associated with the risk corridor program (subscriber’s content).
Some nursing homes risk patient needs for profits
Vulnerable patients are being discharged to unlicensed assisted-living facilities that are often inadequate and sometimes dangerous. Industry insiders assert patients are discharged when they do not have sufficient income to pay in order to protect employees’ salaries. Zoe Sagalow and Joe Antoshak of the Associated Press report advocates are questioning the discharge protocol at nursing homes.