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Morning Briefing

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Friday, Jun 26 2020

Full Issue

Job Losses Drive Nearly A Half-Million Americans To Sign Up For ACA Exchange Plan Since Open Enrollment

CMS announced Thursday that 487,000 people signed up for an Affordable Care Act exchange plan since the last open enrollment period closed in December. Losing job-based health coverage is one of the life events that qualifies someone for HealthCare.gov special enrollment. Meanwhile, more issues with short-term health plans are reported.

Roughly 487,000 people signed up for an Affordable Care Act exchange plan after losing other health coverage since the last open enrollment period ended in December, CMS said Thursday. That's about 46% higher than sign-ups during the same period last year. Sign-ups through a special enrollment period for people who lost minimum essential coverage rose sharply during April and remained high in May, suggesting that the enrollments were related to job losses due the COVID-19 pandemic. (Livingston, 6/25)

Short-term health plans routinely refuse to pay the costs of treating beneficiaries, but have seen a surge in enrollment as a result of Trump administration policies, according to a new report released Thursday from House Democrats. Short-term plans don't have to comply with ObamaCare's coverage rules. The Energy and Commerce Committee investigation found that most plans will deny coverage or charge more for people with pre-existing conditions.聽The plans will also charge women more than men, and deny women basic health services, like preventive screening procedures and routine tests, including pelvic exams. (Weixel, 6/25)

In related health care industry news 鈥

A nonpartisan government watchdog on Thursday said it plans to examine HHS' distribution of $175 billion in COVID-19 relief grants to healthcare providers. The Government Accountability Office noted in a report on COVID-19 relief spending that it will be important for HHS to ensure it has robust internal controls to make sure funds go to eligible providers. (Cohrs, 6/25)

And in other insurer and health system news out of California, Georgia and Texas 鈥

California Attorney General Xavier Becerra asked a San Francisco Superior Court judge on Thursday to deny a request from Sacramento-based Sutter Health to delay finalizing a $575 million antitrust lawsuit settlement reached in December 2019. In a news release issued about the filing, Becerra stated: 鈥淲e are in the midst of a global pandemic, so it is more important than ever that we make health care more accessible and affordable for patients who need it.鈥 (Anderson, 6/25)

Piedmont Healthcare has agreed to pay $16 million to settle a whistleblower lawsuit that claimed the system overbilled Medicare and Medicaid for cardiac care and illegally paid kickbacks to practitioners who referred heart patients to its hospitals, the Justice Department announced Thursday. To get higher payments from the federal health programs, Piedmont over a five-year period admitted thousands of patients to its hospitals for cardiac procedures that could have been performed on an outpatient basis, according to the original complaint filed in federal court in Atlanta. (Hart and Teegardin, 6/25)

A former executive of an Addison surgical company that was bought by Tenet Healthcare is claiming in a federal lawsuit that he was fired after trying to 鈥渂low the whistle鈥 on attempts to hide a significant financial liability from stockholders. (Krause, 6/25)

Blue Cross Blue Shield of Texas and its president Dr. Dan McCoy have parted ways, according to the company. In a statement, Chicago-based Health Care Service Corp. said it鈥檚 pursuing a 鈥渄ifferent leadership approach鈥 in Texas and confirmed McCoy is no longer with the company. HCSC executive Jeff Tikkanen will take on McCoy鈥檚 role as interim president until a permanent replacement is named, according to the company. (DiFurio, 6/25)

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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