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Morning Briefing

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Thursday, Sep 17 2020

Full Issue

Health Insurance Brokers Misled Customers About Preexisting Conditions, Undercover Audit Reveals

Employees of the nonpartisan Government Accountability Office posed as customers looking for health insurance. Some of the sales representatives refused to let GAO employees see the policy documents before they agreed to buy it.

Some health insurance brokers provided misleading or false information to potential customers about whether their plans covered preexisting conditions, according to an undercover audit completed by the nonpartisan Government Accountability Office.聽The聽audit, requested by Senate Democrats, sought to determine whether companies selling health plans exempt from Affordable Care Act coverage requirements were being honest about the limitations of the plans, which tend to be cheaper but aren鈥檛 comprehensive and typically don鈥檛 cover preexisting conditions like cancer or diabetes. (Hellmann, 9/16)

In other hospital industry news 鈥

Santa Clara County health officials announced a newly revised health order on Wednesday that enacts fines of up to $5,000 per violation for private health care providers that do not make coronavirus testing accessible and fast enough for their patients. The revised order, which takes effect Sept. 25, adds to the county鈥檚 previous June health order that requires large health care providers, including Kaiser Permanente and Sutter Health, to increase testing. (Ho, 9/16)

New Orleans residents living near Children鈥檚 Hospital have been unhappy for months about the hospital鈥檚 decision to move its helicopter operations from one side of the Uptown campus to another during its $300 million renovation. Now a City Hall decision that made the move permanent has further upset them, enough to consider legal action, a lawyer hired by the Audubon Riverside Neighborhood Association said. (Woodruff, 9/16)

The Greater Houston region had the highest number of uninsured residents in the country in 2019, with nearly one in five people in the metropolitan area lacking health coverage, according to the Census Bureau. Houston led Texas 鈥 which has both the highest rate and number of uninsured residents among states 鈥 with 1.4 million uninsured people, or 19.7 percent of residents, without health coverage. Approximately 5.2 million Texans were uninsured last year, or about 18.4 percent of the state鈥檚 population. (Wu and Lamm, 9/17)

A federal commission tasked with figuring out the best way to improve care in nursing homes during the coronavirus pandemic called on CMS to be a leader and make changes to improve safety for residents and staff. ...The commission made 27 recommendations, which included the development of a national strategy with a quick turnaround of tests; creation of a process to ensure nursing homes can maintain a three-month supply of safe personal protective equipment; and recognition of visitation as a resident's right, among other recommendations. (Christ, 9/16)

The federally appointed Physician-Focused Payment Model Technical Advisory Committee said Tuesday it has recommended HHS consider a payment model focused on asthma care. The payment model, if approved by HHS, would provide allergists, immunologists and pulmonologists a value-based payment option. A longstanding complaint of the movement to alternative payment models is it has excluded many specialists from participating because quality metrics don't apply to their practice. The model can also be used by primary care doctors who also treat patients with asthma. (Castellucci, 9/16)

Navicent Health is the latest health system to raise its minimum wage.The Macon, Ga.-based health system announced Wednesday it has upped its minimum wage from $7.25 to $10 per hour. Navicent said the change means it's investing an additional $1.2 million in its employees.Navicent CEO Ninfa Saunders said in a statement that the change moves hundreds of employees to a living wage. (Bannow, 9/`6)

Kaiser Health News: Urban Hospitals Of Last Resort Cling To Life In Time Of COVID聽聽

Victor Coronado felt lightheaded one morning last month when he stood up to grab an iced tea. The right side of his body suddenly felt heavy. He heard himself slur his words. 鈥淭hat鈥檚 when I knew I was going to have a stroke,鈥 he said. Coronado was rushed to Mercy Hospital & Medical Center, the hospital nearest his home on Chicago鈥檚 South Side. Doctors there pumped medicine into his veins to break up the clot that had traveled to his brain. Coronado may outlive the hospital that saved him. Founded 168 years ago as the city鈥檚 first hospital, Mercy survived the Great Chicago Fire of 1871 but is succumbing to modern economics, which have underfinanced the hospitals serving the poor. In July, the 412-bed hospital informed state regulators it planned to shutter all inpatient services as soon as February. (Rau and Huetteman, 9/17)

The Federal Trade Commission is issuing a strong warning about a pair of proposed hospital sales in Texas, arguing they could lead to higher costs, lower quality and diminished access to services for local residents. That's about all the federal antitrust regulator can do when it comes to these proposed deals, as Texas lawmakers passed a state law last year that grants such transactions immunity from a federal challenge. Still, in its analysis, the FTC suggested that if not for Texas' new Certificate of Public Advantage law, it would have sued to stop the deals. (Bannow, 9/15)

The patients who answered the ads felt desperate, living with pain, and the company promised medical miracles.Now the state鈥檚 attorney general has accused Elite Integrated Medical, a Sandy Springs-based stem cell clinic chain, of using deceptive sales tactics to inject hundreds of vulnerable patients with an unproven drug. (Edwards, 9/15)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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