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CMS is requesting comment on whether health plans should designate network strength, such as indicating whether a plan has a broad number of doctors or health facilities in the network or not. MORE
While CMS said it was "pleased to report that claims are processing normally," it's worth keeping in mind that the government agency has taken several temporary steps to smooth the transition to ICD-10 which may be masking problems that could manifest themselves down the road. MORE
Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients. MORE
People with hepatitis C who sought prescriptions for highly effective but pricey new drugs were significantly more likely to get turned down if they had Medicaid coverage than if they were insured by Medicare or private commercial policies, a recent study found. MORE
A new report by The Commonwealth Fund has found that a quarter of working-age adults struggle to pay for their healthcare in 2015 in the wake of rising deductibles and out-of-pocket costs. MORE
As beneficiaries explore options during the current Medicare enrollment period, there are only 227 such plans from which they can choose next year, 20 percent fewer than this year, and the lowest number since the drug benefit was added to Medicare in 2006, according to the Centers for Medicare & Medicaid Services. MORE
UnitedHealth Group may exit the insurance exchange market, as the deterioration in product performance has weakened its financial outlook, the company said in an earnings update released Thursday. MORE
Many said they anticipate the federal government will act to forestall widespread departures, particularly because continued withdrawals could be politically explosive during an election year. MORE
A selloff of UnitedHealth Group stock on Friday pushed other major healthcare stocks lower following the insurer's warning that it may exit the Obamacare marketplace exchange business. MORE
Under the contract, the younger members of Aetna commercial plans in the five-county Philadelphia area and Burlington County, New Jersey, who receive care from The Children's Hospital physicians, became part of the program. MORE
The State of Michigan on Tuesday denied a request by Henry Ford Health System's health plan to allow it to keep two regions, including Detroit, to its approved contract for the state's Medicaid program. MORE
Consumers have received more than $2.4 billion in Affordable Care Act premium rebates since 2011, but the number of people owed refunds by insurers decreased by more than a million this year compared to last, according to a report released Thursday by the Centers for Medicare and Medicaid Services. MORE
Week two of open enrollment saw another 500,000-plus consumers select plans in the federal marketplace, bringing the total for the first two weeks to over 1 million, according to the Centers for Medicare and Medicaid Services. MORE
The goal is to increase the approximately 59 percent of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75 percent by the end of 2017. MORE
To encourage more people to sign up in Florida, Obamacare assisters are handing out flyers at food truck festivals, farmers' markets and health fairs. MORE
The Centers for Medicare and Medicaid Services on Monday announced a $32 million initiative to drive down the number of uninsured children by supporting outreach to get families with children eligible for Medicaid and the Children's Health Insurance Program enrolled. MORE
Under the model, hospitals in 67 geographic areas will receive additional payments if quality and spending performance are strong, or if not, have to potentially repay Medicare for a portion of the spending for care for a lower extremity joint replacement procedure. MORE
The news comes as more health plans move from broad networks and straightforward reimbursement approaches to narrow networks and value-based payments. MORE
The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016, a small increase from $1,260.00 in 2015. MORE
Over 1.1 million applications were submitted to from Nov. 1 through 7, CMS reported. MORE
The nonprofit co-op Health Republic Insurance of New York owes hospitals within the Greater New York Hospital Association more than $150 million, according to a November 11 letter from President Kenneth Raske to member CEOs. MORE
A judge in New Jersey is expected to hear a complaint by Saint Peter's University Hospital that it was illegally excluded from a new discounted health plan offered by the state's largest health insurer because it and other independent, Catholic hospitals serve low income residents, according to the health system. MORE
In 31 states and the District of Columbia, silver-level plans cover fewer than seven of the 10 most common drug treatment options or charge consumers more than $200 a month in cost sharing, according to an analysis of 2015 silver plans by consultant group Avalere Health. MORE
The investigation is spurred by dramatic drug price increases, often on older, off-patent drugs, after the acquisition or merger of pharmaceutical companies. MORE
Though healthcare systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging. MORE
Cancer patients insured by California's health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers. MORE
The Centers for Medicare and Medicaid Services is developing a new model for how it pays dual-eligible health plans after an analysis showed it was underpaying these plans. MORE
Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, and those cutbacks will affect customers in 37 states, according to the foundation. MORE
Healthcare spending grew by 3.4 percent in 2014, a new report by the Health Care Cost Institute found, even though overall utilization declined. MORE
The Massachusetts hospitals follow the exit of Dartmouth-Hitchcock Medical Center in New Hampshire last month. MORE
The Centers for Medicare and Medicaid Services will pay for end-of-life services, bringing to a close a debate that started with false "death panel" claims during negotiations over the Affordable Care Act and is ending with coverage for families so they can discuss the care patients receive when they are dying. MORE
The average 2016 premium for a 40-year-old in Anchorage is $719 a month - more than double the national average, according to an analysis by the Kaiser Family Foundation. MORE
Montana has become the 30th state to expand Medicaid, with federal officials on Monday signing off on a plan to expand coverage to low-income residents through a federal waiver that requires beneficiaries to pay premiums of up to 2 percent of their income. MORE
HealthPlus of Michigan is merging with Health Alliance Plan, forming a larger, competitive plan while bailing out the struggling HealthPlus business. MORE
As the open enrollment period for health insurance through the state and federal marketplaces got underway on Nov. 1, Kaiser answers plan questions. MORE
The budget eliminates a mandate of the Affordable Care Act requiring large employers to automatically enroll new employees in health plans. MORE
The Centers for Medicare and Medicaid Services on Thursday lowered the amount it plans to cut payments to home health agencies to $260 million compared the $350 million it proposed earlier this year. MORE
About 10 percent of claims filed under ICD-10 have been denied since the coding vocabulary became the norm on October 1, the Centers for Medicare and Medicaid Services said on Thursday, though only a small number of those denials were due to coding errors. MORE
Aetna has signed accountable care organization agreements with systems affiliated with Trinity Health, the benefits company announced Tuesday. MORE
Premiums will increase an average of 7.5 percent for the second-lowest-cost silver insurance plan to be offered next year in the 37 states where the federal government operates health marketplaces, according to an analysis by the Department of Health and Human Services. MORE
Turing Pharmaceuticals chief Martin Shkreli will face new competition for Daraprim, the AIDS drug he recently hiked 5,000 percent in price, after competitor Imprimis Pharmaceuticals said it would market a similar drug for just $1 a tablet. MORE
The House has approved a budget reconciliation bill that repeals parts of the Affordable Care Act, including the individual and employer mandates, the "Cadillac tax," and the medical device tax. MORE
Under the health law, health plans are required to cover preventive services that are recommended by the U.S. Preventive Services Task Force, a nonpartisan group of medical experts, without charging consumers anything out of pocket. MORE
The medication therapy management model is being tested in five regions as an incentive to boost adherence for stand-alone Part D plans not connected with Medicare Advantage. MORE
America's Health Insurance Plans on Wednesday called former Secretary of State Hillary Clinton's stance against major insurance company consolidation misguided, and suggested that the presidential candidate focus on other issues plaguing healthcare instead. MORE
A key strategy for Medicare is encouraging doctors, hospitals and other health care providers to form accountable care organizations (ACOs) to coordinate beneficiaries' care and provide services more efficiently. MORE
CMS has approved Dartmouth-Hitchcock's application for Next Generation and will receive its dollar target this fall. That will determine whether they sign the contract. MORE
Aetna said it expects the transaction will be completed in the second half of 2016 pending conditions, federal review and regulatory approval. MORE
Four companies running urgent care centers in New York have agreed to disclose more fully which insurance plans they accept, following an inquiry by the state's attorney general that found unclear or incomplete information on their websites that could result in larger-than-expected bills for consumers. MORE
Opponents of the tax fear that more out-of-pocket costs for consumers will add to the difficulty many Americans already have paying their medical bills, now that high-deductible health plans are commonplace. MORE

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