HHS: O-Care customers will pay more if they don’t shop around
December 4, 2014
Federal health officials are warning people with health insurance under ObamaCare that they could face rate hikes of nearly 10 percent if they don’t shop around for other plans. About 65 percent of existing customers can get coverage for $100 or less next year if they browse their options on the marketplace, according to a new report from the Department of Health and Human Services (HHS). But if they choose to automatically re-enroll on the marketplace, it’s less likely they will receive a deal on premiums. “For the vast majority of people, if they stay in the same plan, they’ll see rate increases in high single digits,” Kevin Counihan, CEO of the federal insurance marketplace, said in a conference call. “These are really important savings,” Counihan added. “We strongly, strongly encourage people to come back to the website and shop.”
Federal health officials have doubled down on efforts to bring existing customers back into the marketplace. If all returning consumers switched to the lowest-cost plan available to them, they would save more than $2 billion in premiums, the report said.
Obamacare Sign-Ups Top 765,000 in First Two Weeks
December 3, 2014
Just two weeks into Obamacare's second open-enrollment period, more than 765,000 people have selected insurance plans through the Affordable Care Act's exchanges, the Health and Human Services Department said Wednesday. That total is split about evenly between people signing up for the first time and people who were already enrolled. It only covers the 35 states that are relying on HealthCare.gov for enrollment because they did not establish their own exchanges. It's a pretty good start for this year's open-enrollment period, which poses the dual challenges of bringing new consumers into the insurance market while keeping last year's enrollees covered—and happy. HHS has signed up roughly 367,000 new customers in the two weeks since the enrollment began, putting it on track to end up with nearly 2.5 million total sign-ups even without any deadline-driven enrollment surges.
Can tax pros prepare for Obamacare?
December 2, 2014
The Internal Revenue Service is ramping up to figure out who has health insurance and who doesn’t under Obamacare — but for now it is giving people the benefit of the doubt. For the first time, come January, people will have to indicate on their 2014 tax forms whether they have health coverage. The IRS will have to figure out who is covered and who is fibbing to avoid the Affordable Care Act’s penalty for not holding insurance. Congressional scorekeepers expect about 4 million individuals to owe the fee in 2016. A key question is — how many will be honest and pay it voluntarily? Professional tax preparers — used by more than half of Americans — will be the first line of defense. The IRS tells the preparers to use current standards and common sense — just as they always have. But some are worried that won’t be enough to guide them through this new world of coverage, mandates and penalties.
50,000 Fewer Deaths Caused by Hospitals
U.S. News and World Report
December 2, 2014
Efforts aimed at curbing medical errors have reduced the number of patients who get sick, harmed or killed in U.S. hospitals, says a new report from the federal government. Though health officials aren't sure why this is, they attribute it in part to the the government-launched Partnership for Patients, a public-private initiative paid for by the Department of Health and Human Services. Various initiatives like this are supposed to tie into health care reform, one of whose main goals is to make health care more efficient and less expensive. "For the past three years, instead of working in siloes, we've partnered with hospitals that represent 80 percent of the American population. As a result, we've been able to achieve dramatic improvements in patient safety," Department of Health and Human Services Secretary Sylvia Burwell said during a conference in Baltimore Tuesday. According to the Agency for Healthcare Research and Quality, which wrote the report, from 2010 to 2013 the country saw 1.3 million fewer hospital-acquired conditions – a 17 percent decrease – and saved 50,000 lives. By doing so, about $12 billion was saved in health care costs during the three-year time span, assuming that rates would remain steady. According to Burwell, hospital incidents have included pressure ulcers, central line associated infections, falls and trauma.
Hospital Errors Drop, Saving 50,000 Lives: Government
December 2, 2014
Hospitals are making fewer mistakes, from giving patients the wrong medications to giving them infections, according to a government report issued Tuesday. As a result, 50,000 people are alive today who otherwise would have died, the Health and Human Services Department says in its report. It's not clear why rates are down, but hospitals and HHS have made a concerted effort to try to stop the enormous rate of mistakes, which kill as many as 180,000 people a year, according to government estimates. "Preliminary estimates for 2013 show that the national hospital-acquired condition rate declined by 9 percent from 2012 to 2013 and was 17 percent lower in 2013 than in 2010," the Center for Medicare and Medicaid Services, part of HHS, said in a statement. "We estimate that approximately 800,000 fewer incidents of harm occurred in 2013 than would have occurred if the rate of hospital-acquired conditions had remained steady at the 2010 level. Cumulatively, approximately 1.3 million fewer incidents of harm occurred in 2011, 2012, and 2013 (compared to 2010)."
CMS limits ACO risk — Abortion rates reach historic low — Origination lawsuit before circuit court today
December 2, 2014
CMS wants Medicare accountable care organizations to take on more risk, so it wants to allow ACOs to renew their participation in the program for an additional three years without exposing themselves to financial losses. ACOs were one of the most significant delivery reforms included in the ACA, but so far just five groups out of hundreds participating in the program have chosen to risk the losses that will follow if they don’t hit certain benchmarks. The others are sharing only in savings for three years. In a proposed rule that was posted Monday, CMS acknowledged concerns that three years is likely not enough time for some ACOs to get the necessary experience to take on that financial risk. The proposed rule will give ACOs greater freedom than other Medicare providers to use reimbursable telemedicine, but it stops short of waiving Medicare requirements on telemedicine entirely, our colleagues at Pro eHealth report. CMS could issue a waiver of certain telemedicine requirements, such as those that require patients to be located in rural areas. Waivers would be limited to patients assigned to the ACO, and providers could expect additional requirements to ensure transparency and reduce the possibility of fraud.
In the House’s Health-Care Lawsuit, High Stakes Over Subsidies
The Wall Street Journal
December 2, 2014
Most coverage of House Republicans’ lawsuit against the Obama administration has focused on the latter’s delay implementing Obamacare’s employer mandate. But five of the eight counts of the lawsuit focus on another issue–one that, depending on the outcome of the suit, could cause insurers to re-assess their involvement in the health-care exchanges. The issue revolves around the law’s cost-sharing subsidies, a program I analyzed in a June blogpost. The administration had said it was combining the law’s premium subsidies and cost-sharing subsidies–which provide lower co-payments and deductibles to certain low-income individuals—into one set of payments to insurers. “The problem with this? That’s not what the law says,” I wrote, based on a previous analysis showing that the law structured the two types of subsidies very differently.
A ‘solid’ start for ACA open enrollment
December 1, 2014
A week after the Affordable Care Act’s open-enrollment period last year, it was painfully obvious that something was horribly wrong. Fast forward a year, and Emma Margolin reported, it’s a very different story. The closer one looks at the data, the more encouraging the figures appear – not just as compared to the disaster last fall, but as statistics on their own. Sarah Kliff, for example, emphasized that 48% of the consumers who selected “Obamacare” plans during the first week of open enrollment are new customers. That number will obviously change as the process continues, but it’s a positive, early indication “suggesting that the law could widen its reach to more uninsured Americans in year two of coverage expansion.”
What’s more, let’s not forget that the 462,000 figure doesn’t include many more – exactly how many is unclear – who enrolled in state-based exchanges. There are 16 states, plus the District of Columbia, which have their own marketplaces, and since that’s roughly a third of the country, it’s a reminder that the 462,000 figure is understating the bigger picture.
HHS: More than 450K chose plan on HealthCare.gov in first week
The Washington Times
November 26, 2014
The Health and Human Services Department said Wednesday that 462,000 people selected a health plan through the Obamacare exchanges during the first week of open enrollment, and that roughly half were customers renewing existing plans. HHS Secretary Sylvia Mathews Burwell and her top lieutenants said the numbers only reflect activity on the federal exchange known as HealthCare.gov, which serves 37 states, and not the state-run portals. Fifty-two percent of users from Nov. 15 to Nov. 21 were returning to HealthCare.gov to renew coverage they got last year, while 48 percent were new customers, according to the agency. About 3.7 million unique users viewed or interacted with the website, and more than 95,000 checked out the Spanish-language site. “We had a solid start, but we have a lot of work to do every day between now and February 15,” Mrs. Burwell said, referring to when open enrollment closes. The healthy amount of activity marks a break from last year’s first week of enrollment, when software glitches and capacity issues caused HealthCare.gov to crash in its opening days. The website is built to handle 250,000 users at the same time, which should hold up when the expected rush of consumers use the site in mid-December — to be covered in the new year — and shortly before the enrollment ends on Feb. 15, said Andy Slavitt, principal deputy administrator for the Centers for Medicare and Medicaid Services.
CMS extends due date for Medicare EHR incentive programs — 21st Century Cures lays out what’s next
November 25, 2014
CMS has extended the deadline for eligible hospitals and critical access hospitals to attest to meaningful use for 2014 Medicare EHR incentive programs through Dec. 31, adding a month to the current deadline. “This extension will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment,” the agency said in a statement. A spokesperson said the deadline was extended in response to stakeholder requests. Dec. 31 is now also the due date for hospitals and critical access hospitals to electronically submit clinical quality measures. The extensions don’t cover Medicaid EHRs. Industry players were glad to hear it, for the sake of eligible hospitals and critical access hospitals struggling to attest, but a bit wary. The biggest problem in the industry’s eyes — a 365 day reporting period for 2015 — hasn’t changed. HIMSS, CHIME, ONC and AHA did not ask for this particular delay and don’t know who did. But. said Dr. John Halamka, CIO of Beth Israel Deaconess Medical Center, “any delay is a good delay.” Given that 17 percent of hospitals attested to meaningful use Stage 2 in 2014, it’s clear that more time is needed.
New FDA Calorie Label Rules Include Pizza, Popcorn
November 25, 2014
Pizza, popcorn and salad bars all will have to list calorie counts under long-awaited rules to be published later Tuesday by the Food and Drug Administration. As expected, the rules require chain restaurants to list clear calorie information on menus. But they don’t require anything else, such as fat content, up front, and they exempt some, but not all, prepared grocery store products. Pizza delivery chains get a little flexibility on counting the calories in toppings, but you’ll be able to see just how many calories are in movie theater popcorn, in vending machines and at the salad bar, as well. It’s been one of the most contentious issues the FDA has ever had to weigh in on, commissioner Dr. Margaret Hamburg has said. “We tried to be flexible and realistic as we put together these final rules,” Hamburg told reporters. The hope is that people will see just how many calories they're about to swallow down, make wiser choices, and that fast-food chains and other retailers will revise their offerings to meet a new consumer demand for more healthful foods.
New FDA Rules Will Require Calorie Labeling On Chain Restaurant Menus
The Huffington Post
November 24, 2014
The U.S. government will publish sweeping new rules on Tuesday requiring chain restaurants and large vending machine operators to disclose calorie counts on menus to make people more aware of the risks of obesity posed by fatty, sugary foods. "Obesity is a national epidemic that affects millions of Americans," Food and Drug Administration Commissioner Margaret Hamburg told reporters on a conference call on Monday. "Strikingly, Americans eat and drink about a third of their calories away from home." The FDA's new rules, which are part of the 2010 Affordable Care Act, set a national standard for restaurant chains with 20 or more outlets and will pre-empt the patchwork of state laws. Under the rules, calories must be displayed on all menus and menu boards. Other nutritional information - including calories from fat, cholesterol, sugars and protein - must be made available in writing upon request. The new calorie rule covers meals at sit-down restaurants, take-out food, bakery items, ice cream from an ice-cream store and pizza, which will be labeled by the slice and whole pie. Seasonal menu items, such as a Thanksgiving dinner, daily specials and standard condiments will be exempt.
House files Obamacare lawsuit
November 21, 2014
The House of Representatives filed a long-awaited lawsuit Friday, alleging that the Obama administration ignored key aspects of its health care reform law when implementing the sweeping new government program. The litigation, authorized by the House in July, addresses only the Affordable Care Act and makes no mention of immigration. However, the filing of the suit the morning after Obama unveiled his major executive actions on immigration was clearly intended to underscore GOP lawmakers’ desire to paint the president as a chief executive intent on overstepping his legal bounds. “Time after time, the president has chosen to ignore the will of the American people and rewrite federal law on his own without a vote of Congress. That’s not the way our system of government was designed to work,” House Speaker John Boehner said in a statement. “If this president can get away with making his own laws, future presidents will have the ability to as well. The House has an obligation to stand up for the Constitution, and that is exactly why we are pursuing this course of action.”
House Files Lawsuit Against Administration Over Obamacare
November 21, 2014
House Republicans filed their long-anticipated lawsuit against the Obama administration on Friday, claiming the White House abused executive authority by acting independently of Congress on parts of the Affordable Care Act. The complaint alleges the administration unlawfully delayed the implementation of a mandate that large employers provide health insurance to their employees and will illegally give $175 million over the next 10 years to insurance companies under a cost-sharing program. "Time after time, the president has chosen to ignore the will of the American people and rewrite federal law on his own without a vote of Congress," Speaker John Boehner said in a statement. "If this president can get away with making his own laws, future presidents will have the ability to as well. The House has an obligation to stand up for the Constitution, and that is exactly why we are pursuing this course of action." The suit, filed against the secretaries of Health and Human Services and the Treasury, alleges that Obama's decision to twice waive the employer mandates start date and waive penalties on employers was not in accordance with the language of the law.
Administration admits Obamacare enrollment numbers error
November 21, 2014
The Obama administration has admitted that it inflated Obamacare enrollment numbers twice this year — including in testimony to Congress — thanks to an error in the way health insurance numbers were conflated with dental insurance figures. The exaggeration, which HHS Secretary Sylvia Mathews Burwell said was an “unacceptable” mistake, inflated the reported number enrolled in Obamacare by 400,000. House Republicans first spotted the issue, and say that blaming the bad numbers on mistaken data “strains credulity.” If you take the dental insurance customers out of the latest administration Obamacare report, the enrollment number is closer 6.7 million now. Burwell and HHS officials did not publicly explain how the mistake happened. But one administration official told POLITICO a topline number for paid enrollment — different data than HHS usually uses in its enrollment reports — was used for Medicare chief Marilyn Tavenner’s testimony on the Hill in September.
More Obamacare troubles: Enrollment numbers inflated
November 21, 2014
The Department of Health and Human Services said Thursday it made a mistake in how it calculated enrollments under the Affordable Care Act, including 380,000 dental plans in its figures for medical plans. Those stand-alone dental plans allowed the Obama administration to claim more than 7 million paid enrollments — the "magic number" that would allow the new health insurance exchanges to be sustainable. The discrepancy was first reported by Bloomberg News, citing data obtained through the House Oversight and Government Reform Committee. In testimony to that committee Sept. 18, a top HHS official made no mention of dental plans when she gave enrollment numbers. Dental plans had previously been accounted for separately from medical plans. "As of Aug. 15th this year, we have 7.3 million Americans enrolled in the health insurance marketplace coverage, and these are individuals who've paid their premiums," Centers for Medicare and Medicaid Services Marilyn Tavenner testified. Health and Human Services Secretary Sylvia Burwell repeated the number at the Brookings Institution the next week, saying 7.3 million had "signed up for marketplace plans, paid their premiums and have access to affordable care."
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