Amy Lotven, Inside Health Policy
"Congress' investigative arm said Tuesday (Sept. 16) that healthcare.gov continues to face security weaknesses, leaving the site subject to “increased and unnecessary” risk of unauthorized access, disclosure or modification of the information collected and maintained. CMS pledged to implement some of the fixes proposed by the Government Accountability Office, but GOP lawmakers used the opportunity to again blast the administration's handling of Obamacare.
GAO recommended six ways CMS could put in place an effective information security program, and another 22 technical recommendations that could improve the effectiveness of information security controls."
Michelle Andrews, Kaiser Health News
"The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.
The Urban Institute's health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods."
Jennifer Haberkorn and Burgess Everett, Politico
"There are widespread instances of Obamacare insurance plans violating the rigid rules surrounding whether customers can use federal health care subsidies on insurance policies that cover abortion procedures, according to a Government Accountability Office investigation.
The report, commissioned by House Republican leadership and obtained by POLITICO on Monday night, found that 15 insurers in a sample of 18 are selling Obamacare plans that do not segregate funds to cover abortion (except in cases of rape, incest or the mother’s life) from their Obamacare subsidies.
J.D. Tuccille, Reason
"Last year I wrote that Obamacare could leave doctors holding the bag for claims for patients who don't pay their insurance premiums. That's because the law includes a three-month grace period during which health insurers must continue to cover patients who sign up, but don't pay the price of their insurance. If the patients eventually make good, there's no problem. But if patients don't pay the owed premiums, the insurance company has to cover the cost of claims filed during the first month. Providers are stuck with the tab for any claims filed during months two and three.
The piece I wrote last July was theoretical. The notification letter I'm holding in my hand, addressed to my wife's pediatric practice, is reality. And reality costs, in this case, over $600. That's the outstanding balance owed the practice by a patient insured by BlueCross BlueShield of Arizona. It's a balance that my wife might have to eat, or else try to collect herself."
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process."
Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future."
CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.
Amy Lotvin, Inside Health Policy
"This week exchangers could get data on enrollment in the small business exchanges operated by the federal government as Mayra Alvarez, director of CCIIO's State Exchange Group, will testify at a House Small Business Committee hearing Thursday on SHOP exchange implementation. CMS Administrator Marilyn Tavenner will also return to the House to face the Oversight Committee on Thursday on healthcare.gov security concerns, one day after the Government Accountability Office's planned Sept. 17 release of a report on that controversial subject.
Academics and researchers are also diving into new data out Tuesday (Sept. 16) from the Centers for Disease Control and Prevention and the U.S. Census Bureau on the number of uninsured. The CDC's early release of data from the National Health Interview Survey found that the uninsured rate for adults ages 18 to 64 had dipped from 20.4 percent in 2013 to 18.4 percent in the first three months of 2014.
Daniel Chang, Miami Herald
"At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question.
Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees?
“We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System."
Lena Sun, Washington Post
"Federal health officials said Monday that more than 100,000 immigrants who bought health-care plans through the federal insurance exchange will have their coverage cut off at the end of the month, because they failed to provide proof by the Sept. 5 deadline that their citizenship or immigration status makes them eligible for insurance on the marketplace.
Those individuals can still send in the needed information to the federal exchange and if they are found eligible, they will be able to regain coverage, officials said. They will be considered under a special category reserved for people who have experienced a major life change, such as having a baby or getting divorced or losing a job with health insurance."
"It’s been nearly a year since the national health care law officially took effect, and voter attitudes about its impact on the cost and quality of care remain basically unchanged and negative.
The latest Rasmussen Reports national telephone survey finds that 57% of Likely U.S. Voters think the cost of health care will go up under the law. Only 19% expect those costs to go down, while 17% say they will stay about the same."
Tampa Bay Times Politifact
"When it comes to claims about Medicare, some political talking points just never die.
In Iowa and Virginia, Republicans have accused Democrats of cutting Medicare to pay for Obamacare. In Florida, a Republican was slammed for ending the Medicare "guarantee." Other Medicare-related attacks have been deployed in Arkansas and Kentucky Senate races. The point of all the attacks is to convince midterm voters that one side or the other won't protect the program.
Take this one, used in a recent ad aired by the National Republican Senatorial Committee in the hotly contested Iowa Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst:
"Bruce Braley voted to cut $700 billion from Medicare to support Obamacare," the ad says. "That's just not fair. We paid in. We paid for it. That should be there for us.""