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Wednesday, Oct 5 2016

Full Issue

DOJ Asks Judge To Dismiss $338M Suit Over Risk-Corridor Payments

As the administration faces a growing number of similar suits, the move could signal a stronger stance against the insurers.

The U.S. Department of Justice wants to escape two insurer lawsuits accusing it of shorting them of hundreds of millions of dollars in the Affordable Care Act's much-maligned risk-corridor program by claiming they weren't guaranteed the massive payouts in the first place. The DOJ asked the U.S. Court of Federal Claims to dismiss similar lawsuits from Moda Health and Blue Cross and Blue Shield of North Carolina that demand a combined $338 million in risk-corridor payments for 2014 and 2015. (Teichert, 10/4)

In other health law news —

Individuals who obtained insurance through Obamacare in 2014 were much more likely to receive preventive services and have a usual source for obtaining medical care compared with the remaining uninsured, according to a new study by government researchers. About one in four (27 percent) previously uninsured people who did not have a regular source for care in 2013 gained one after obtaining exchange coverage, according to findings published Tuesday in Health Affairs. Similarly, 18 percent of previously uninsured individuals reported obtaining a regular care provider after signing up for Medicaid in 2014. (Pradhan, 20/4)

Getting surprise bills from doctors and other providers who are outside your health-insurance network is one of the more unpleasant trends in coverage these days, especially for plans purchased through the Affordable Care Act’s marketplaces. But a new study published Tuesday in Health Affairs makes clear that so-called narrow networks of physicians do come with lower premiums: 6.7 percent lower, on average. (Sapatkin, 10/4)

Iowans in 13 rural counties who want to buy subsidized health insurance under the Affordable Care Act will have just one option for 2017, the state insurance division reported Tuesday. Medica, a relatively small carrier based in Minnesota, is the only health insurer that has agreed to sell individual policies in all of Iowa's 99 counties, via the Affordable Care Act’s online marketplace. The marketplace is the sole place where consumers can buy individual health insurance that qualifies for subsidies under the federal law, also known as Obamacare. (Leys, 10/4)

Covered California has fixed its computer system to prevent pregnant women in a certain income range from being transferred into Medi-Cal without their knowledge or consent. The fix comes nearly a year after the problem began. Between October 2015 and May of this year, about 2,000 pregnant women were automatically dropped from their Covered California plans and placed into Medi-Cal, even though they had the right to stay with the state insurance exchange. (Bazar, 10/5)

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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