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The CMS is manipulating Obamacare again. This time they are forgoing $13.9 billion in a healthcare tax on insurers to attempt to keep premiums low for a year. The tax usually accounts for about 3%-4% of the premium raise per year. The feds expect both the exchanges and the Medicare Advantage plans to tamp down on fee increases.
The administration that does not back down is doing some backpedaling. Besides the story above they also have said the insurers will not have minimum quantitative standards for next year. All also thought that the Obamacare insurers in the federal exchange will only be allowed to have networks that have hospitals and physicians within certain travel times from its members, however, CMS again bowed to the insurers and put no guidelines out on this for next year.
CMS is saying they have gotten to their 30% threshold of paying providers on alternative models not per item 10 months earlier than they had budgeted. They continue to push the ACO, bundled payment and medical homes.
California has now said that physician assisted suicide can begin on June 9. Top
The Indiana House has passed a law to up the payment cap for injury in increments up to a max of $2.25 million. Top
Texas is shutting down the largest psychiatric hospital in Dallas, Timberlawn Mental Health System. The reason is patient safety. The big one was a suicide of someone who was supposed to be on suicide watch. there have also been fights between patients.
CMS has fined Tenet and Health Net for their Medicare Advantage programs. Tenet was fined $127,200 for for pharmacy problems and problems with their appeal process. Health Net was fined $458,250 for the same things.
Humana has also been fined $3.1 million for delaying or denying pharmacy benefits to people in their Medicare Advantage area. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.