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Kaiser Health News

Anti-Fraud Efforts Meet Real-World Test During ACA Enrollment Period

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kffhealthnews.org – Julie Appleby, KFF Health News – 2024-11-25 04:00:00

SUMMARY: Unauthorized switching of Affordable Care Act (ACA) plans has decreased, with complaints dropping by a third, according to federal regulators. The Centers for Medicare & Medicaid Services (CMS) has implemented measures to combat fraud, such as requiring three-way calls for certain policy changes and suspending 850 agents involved in improper switching. Despite these efforts, concerns remain about increased complexity in the enrollment process, with potential delays for consumers. Some rogue agents are finding workarounds, and agent groups advocate for two-factor authentication to further prevent fraud. The CMS reports success in reducing unauthorized switches, but challenges remain.

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Kaiser Health News

Readers Embrace ‘Going It Alone’ Series on Aging and Chastise Makers of Pulse Oximeters

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kffhealthnews.org – – 2024-11-22 04:00:00

SUMMARY: Letters to the Editor discuss various healthcare concerns. Gail Daniels shares her struggles caring for a mother with dementia, while Shava Nerad reflects on the challenges faced by those without family support. Gloria Rankin suggests using pen pals to combat social isolation. Zoe Joyner Danielson recalls racial bias in pulse oximeter development, while Suzann Lebda questions fluoride’s impact on dental health. Readers also address issues like Medicare Advantage, high drug costs for seniors, and the financial burden of prepaying for baby deliveries. Liviu Steier advocates for fluorescence in dental care, emphasizing its diagnostic benefits.

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Georgians With Disabilities Are Still Being Institutionalized, Despite Federal Oversight

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kffhealthnews.org – Sam Whitehead – 2024-11-22 04:00:00

SUMMARY: Lloyd Mills, a 32-year-old with autism, cerebral palsy, and kidney disease, has faced prolonged hospitalization due to inadequate community support in Georgia. After being admitted to Grady Memorial Hospital for mental health issues, Mills waited over eight months for appropriate housing, highlighting the systemic failures of a state still grappling with the consequences of a 2010 Department of Justice lawsuit regarding care for people with developmental disabilities. Despite significant investments and improvements in services, challenges like workforce shortages and inadequate funding persist, often leaving individuals like Mills in hospitals, impacting their mental and physical well-being.

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TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead

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kffhealthnews.org – Darius Tahir – 2024-11-21 18:01:00

SUMMARY: President-elect Donald Trump nominated celebrity doctor Mehmet Oz to head the Centers for Medicare & Medicaid Services (CMS). Oz, known for his investments in healthcare, tech, and food companies, holds significant stakes in UnitedHealth Group, CVS Health, Amazon, and other companies involved in health insurance and pharmaceuticals, raising potential conflicts of interest. His financial ties include hospital stocks and pharmaceutical investments. Oz has expressed support for Medicare Advantage and criticized the food and healthcare industries. Critics question whether Oz can separate his financial interests from his role, particularly with companies doing business with the federal government.

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