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How 10 former NFL players allegedly committed $3.9M in health care fraud

December 16, 2019


The Department of Justice on Thursday announced that it has charged 10 former NFL players with fraud for allegedly submitting false claims for medical equipment totaling $3.9 million to a health benefits program for former players.

Are these 5 types of medical billing 'fraud by any other name'?

December 13, 2019


Elisabeth Rosenthal, a physician and editor-in-chief of Kaiser Health News, in a New York Times opinion piece recalls her husband's recent experience navigating the U.S. health care system and argues that "[m]uch of what we accept as legal in medical billing would be regarded as fraud in any other sector."

With just 3 days left in open enrollment, CMS data shows federal exchange signups are lagging

December 12, 2019


CMS on Wednesday released federal exchange plan signup figures for the sixth week of the Affordable Care Act's current open enrollment period, as well as data on the number of U.S. residents who were enrolled in federal and state exchange plans during the first six months of 2019.

CBO: Pelosi's Rx drug pricing bill would save feds a net $5B—and slow down drug development

December 12, 2019


A provision in House Speaker Nancy Pelosi's (D-Calif.) drug pricing bill that would allow the HHS secretary to negotiate prescription drug prices would save the federal government about $456 billion from 2020-2029, but the bill would raise federal spending in other areas, according a Congressional Budget Office report released Tuesday.

SCOTUS hears arguments in ACA risk corridors case

December 12, 2019


The Supreme Court on Tuesday heard oral arguments in a case that centers on whether the federal government owes health insurers $12 billion in risk corridors payments under the Affordable Care Act, and observers say a majority of the justices appeared likely to rule in the insurers' favor.

The House has another new proposal to address 'surprise' medical bills

December 12, 2019


The House Ways and Means Committee on Wednesday announced new legislation, which is still being finalized, to address so-called "surprise" medical bills—just days after the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee announced their own bipartisan plan to address surprise bills, likely setting up Congress to resolve the issue in 2020.

1 in 4 Americans have delayed care due to cost. (But many are still happy with their health care.)

December 11, 2019


A record number of U.S. adults say they have put off receiving medical care due to cost, yet many say they are satisfied with their overall costs for health care, according to Gallup's annual Health and Healthcare poll.

With opposition from industry, the future of surprise billing legislation remains uncertain

December 10, 2019


The White House on Monday expressed support for a new, bipartisan agreement to address so-called "surprise" medical bills, but the proposal's future is uncertain, as it faces opposition from the provider industry and has yet to receive an endorsement from congressional leadership.

Senate, House lawmakers announce a deal to fix 'surprise' medical bills

December 9, 2019


Three federal lawmakers on Sunday announced that the Senate Health, Education, Labor and Pensions Committee and the House Energy and Commerce Committee have reached a bipartisan agreement in principle on legislation to address so-called "surprise" medical bills that could be attached to a year-end spending bill.

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