Proposing a rule to amend risk adjustment methodology for exchange plans, the Centers for Medicare and Medicaid Services (CMS) aims to improve the accuracy and effectiveness of the Affordable Care Act (ACA)-era program. The agency seeks to refine the program's error rate calculation and risk adjustment data validation (HHS-RADV)...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) released the final payment notice for 2021 last week as the Trump administration finalized a string of regulatory changes to Affordable Care Act (ACA) marketplace. The agency's rule outlines ACA plan regulations that impact qualified health plans (QHP) for the 2021 coverage...Arizona News
Earlier in the year payers and providers worried that putting an end to the practice of silver-loading would destabilize Affordable Care Act (ACA) exchanges. The Trump administration announced last week that it would continue to allow the practice on the individual market for the next year.
Silver-loading enabled insurers to...Arizona News
This enrollment period marks the first where individuals will not incur penalties for failing to purchase health insurance coverage and compared to last year's numbers, Affordable Care Act (ACA) enrollment has declined by eight percent in its first two weeks.
With more insurers entering the individual marketplace and incumbents...Arizona News
Last week on Oct. 12, 33-year-old Nicholas White and 60-year-old Jeffrey White, father and son duo pleaded guilty to defrauding Affordable Care Act (ACA) programs out of $27 million across at least 12 states--including Arizona. Both were healthcare professionals out of Twin Peaks, California.
According to the Department of Justice...