The government estimates that it loses some $60 billion a year to Medicare fraud and waste, and as it gears up to launch its giant health care reform program to provide affordable coverage for every American, putting a stop to this is at the top of the agenda. One of the ways Medicare officials hope to do this is by turning the 50 million beneficiaries of the senior health insurance program into fraud fighters. This summer, Medicare redoubled its efforts to get them involved by redesigning a claims statement, known as the Medicare Summary Notice, with larger print and a…
This Kaiser Health News article answers all of your basic questions about the individual mandate — yes, there is an individual mandate in the ACA and it does require you to have health insurance. If you or someone you know are part of the 26 percent of Americans who don't know about the individual mandate, read this article before October 1. (Note: If you already have health insurance through work or a federal or state policy, you are not affected.)
HHS Secretary Kathleen Sebelius released a new report that finds premiums in the Health Insurance Marketplace will be nearly 20 percent lower in 2014 than previously expected. The Affordable Care Act requires health insurers in every state to publicly justify any premium rate increases of 10 percent or more. Health insurance companies now generally have to spend at least 80 cents of every premium dollar on health care or improvements to care, or provide a rebate to their policy holders. In addition, when the Health Insurance Marketplace opens for enrollment on October 1, 2013, consumers will be able to make…
CMS released a proposed rule outlining program integrity guidelines for the Health Insurance Marketplace (Marketplace) and premium stabilization programs. Through the Affordable Care Act, consumers and small businesses will have access to new Marketplaces where they can access quality, affordable private health insurance. Consumers in every state will be able to buy insurance from qualified health plans directly through these Marketplaces and may be eligible for tax credits to lower the cost of their health insurance. “In just a few months, consumers across the country will have access to a new Marketplace in their state where they can easily…
CMS released a proposed rule outlining standards that Navigators (organizations that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program) in federally facilitated and State Partnership Marketplaces must meet, and clarifying earlier guidance about the Navigator program. To be assured consideration, comments must be received no later than 5:00pm on 30 days after date of publication in the Federal Register.
Maryland has received conditional approval by the federal government to operate a state-based health insurance exchange in 2014, Lt. Gov. Anthony Brown announced. Maryland is among the first six states to get the approval. The Centers for Medicare and Medicaid Services has certified the Maryland Health Connection to operate for the first plan year in 2014. The agency in the U.S. Department of Health and Human Services is responsible for overseeing the Medicare and Medicaid programs, the nation's largest health insurance programs. "Our progress has been the result of insurance producers, carriers, third-party administrators, health care providers, advocates, and consumers…
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