SUMMARY: In May, Mandi Rokx, a Florida mother, received a notice that she and her baby would be cut from Medicaid despite being eligible. Florida’s 2021 law promised 12 months of continuous coverage post-birth, but a computer glitch in the state’s eligibility system, run by Deloitte, led to wrongful cuts. This error, along with others during Florida’s Medicaid review process, has affected many new mothers. A class-action lawsuit highlights how these errors led to loss of coverage for eligible individuals. While Rokx regained coverage after legal intervention, the broader issues persist, impacting thousands across multiple states.

Read the full article

The post Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid appeared first on kffhealthnews.org

SUMMARY: Two rival hospitals in Terre Haute, Indiana, withdrew their merger application just before a state ruling amidst public backlash against hospital monopolies. The proposed merger of Union Health and Terre Haute Regional Hospital, the only acute care providers in the area, would have created a single hospital operator for 58,000 residents. Although federal laws block monopolies, the hospitals sought approval under a state “Certificate of Public Advantage” (COPA) law. Concerns raised included reduced access, higher prices, and fewer choices. Union Health intends to resubmit a revised application by a July 2026 deadline after addressing regulators’ feedback.

Read the full article

The post Indiana Hospitals Pull Merger Application After Pushback Over Monopoly Concerns appeared first on kffhealthnews.org

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.

Read the full article

The post Anti-Fraud Efforts Meet Real-World Test During ACA Enrollment Period appeared first on kffhealthnews.org