Just saw this tweet from a reporter at the Hill: Durbin tells me it's ok for Dems to meet with Cassidy/Collins on healthcare b/c those 2 are "beyond repeal" https://t.co/F0RBQb8GvR pic.twitter.com/recMUqHDm3 — Peter Sullivan (@PeterSullivan4) May 16, 2017 When I read through Cassidy-Collins in January, my impression was that this was the contours of a …
Good news everybody
In other news, 9% of Americans were uninsured in 2016, down from 16% in 2010 (pre-ACA) and the lowest rate ever.https://t.co/sFOVlUi1Cc — Larry Levitt (@larry_levitt) May 16, 2017 Open thread
Medicare Advantage aggressive coding or fraud
The New York Times has a good story from the 15th on a False Claims Act lawsuit filed by a former United Healthcare employee. It alleges UHC systemically defrauded the US government of billions from up-coding its Medicare Advantage claims to get bigger risk adjustment payments. This is a big deal. Medicare knows that the …
Medicare Advantage aggressive coding or fraudPost + Comments (20)
Revisiting Cassidy Collins
On Sunday, Politico reported that there are back-channel discussions in the Senate on healthcare between Democrats and Republicans. Cassidy’s and Collins’ efforts haven’t limited their talks to the handful of red-state Democrats whom the GOP once eyed as possible converts on health care. Sen. Tom Carper (D-Del.), for one, spoke to Cassidy in March about …
Anthem’s actuarial assumptions on CSR
Cost Sharing Reduction (CSR) sabotage could lead to the situation of significantly increasing the average actuarial value purchased on the Exchanges depending on what assumptions are made by the actuaries at various insurers. Reading Anthem’s VA filing again – it sounds like if they go the “No CSR” rate route, they will only allocate the …
A response to Medicare Advantage for All
Billy Wynne has written a Health Affairs essay on the desirability of a Medicare Advantage for All design. I am methods agnostic towards the goal of universal coverage at a decent actuarial value level and reasonable costs. I think Medicare Advantage for All is a good concept. It is a concept that, if all of …
A response to Medicare Advantage for AllPost + Comments (18)
Mulvaney and the deserving sick
I don’t like the Kimmel test. Republicans have an easy out if they shovel twenty or thirty billion dollars at presumptive eligibility for birth to three months or birth to six months. It also feeds into the idea of the deserving and underserving poor. I meant to say the deserving or undeserving unwell. OMB Director …