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Jan. 3, 2019: Health insurers want more time for Trump's HRA proposal

Stiff penalties under the False Claims Act can paralyze healthcare providers Insurance Business Magazine
In 2017, the U.S. government recovered $2.4 billion from the healthcare industry as a result of actions under the False Claims Act (FCA), a law that originated in the 1800s with the intent of imposing liability on those that defraud government programs. Over recent decades, healthcare and procurement fraud cases have made up the majority of all FCA actions, according to reporting in Today's Wound Clinic. Meanwhile, specialist insurance provider CFC Underwriting notes that healthcare providers have been forced to navigate reimbursement guidelines that are challenging and confusing, which has in turn seen the rate of billing errors increase over 30 percent.

Idaho lawmakers favor work rule for Medicaid Argus Observer
Proposition 2, the Medicaid expansion measure which Idaho voters passed in November currently faces a conservative group's lawsuit challenging it, and beyond that a slew of potential changes from state lawmakers involved in the measure's implementation. Meantime, a statewide network of organizations fighting for the Medicaid expansion is calling for the law to be put in place without any significant changes. Although Proposition 2 passed with more than 60 percent of the vote statewide, the majority of Idaho state senators and representatives did not support the ballot initiative.

Medicare's bundled payment experiment for joint replacements shows moderate savings Science Daily
Medicare's randomized trial of a new bundled payment model for hip and knee replacement surgeries led to $812 in savings per procedure, or a 3.1 percent reduction in costs, when compared with traditional means of paying for care, according to new research from Harvard T.H. Chan School of Public Health and Harvard Medical School. The study found that the bundled payment model was also associated with a reduction in use of skilled nursing care after the hospitalization, but had no effects on complication rates among patients.

$10 million penalty in Wells Fargo California case, can't do new business until at least 2020 Insurance Journal
Wells Fargo has agreed to pay a $10 million penalty as part of a settlement agreement with the California Department of Insurance. The settlement with the CDI, announced recently, resolves the department's accusation alleging improper insurance sales practices related to Wells Fargo's online insurance referral program. The improper practices reportedly resulted in consumers being signed up and charged for insurance products without their consent.

39,000 Kansas children lacked health coverage in 2017, thousands more than year before Wichita Eagle
Kansas had 5,000 more children without health insurance in 2017 than it did the year before, placing the state slightly above the national average as lawmakers prepare to again debate Medicaid expansion in the coming year. Supporters of expansion say it would help lower the rate of children without coverage, which dropped to record lows just a few years ago. Nearly 40,000 Kansas children lacked coverage in 2017, up from 34,000 in 2016, according to a report by Georgetown University's Health Policy Institute.

Pre-Medicare years bring health insurance worries for many, poll finds Medical Xpress
With the dawn of a new year, most Americans have just started a new health insurance coverage period — whether they receive their coverage through a job, buy it themselves or have a government plan. But a new national poll suggests that many people in their 50s and early 60s harbor serious worries about their health insurance status, now and in the future. Forty-five percent say they have little or no confidence that they'll be able to afford the cost of health coverage once they retire.
Health insurers want more time for Trump's HRA proposal Health Leaders Media
Commercial payers are urging the federal government to delay by at least a year-and-a-half proposed rules to expand the use of Health Reimbursement Arrangements. "As with any change of this size and complexity, adequate planning time is required," Keith Fontenot, executive vice president, Policy and Strategy, at America's Health Insurance Plans said in his letter to the secretaries of Treasury, Labor, and Health and Human Services.

New House rules to allow Democrats to defend Obamacare CNN
House Democrats are moving quickly to defend the Affordable Care Act once they retake control of the chamber. As part of its rules package for the 116th Congress, the party is granting itself authorization to intervene in the lawsuit that threatens to bring down the landmark health reform law. It directs the House's Office of General Counsel to represent lawmakers in any litigation involving the act and authorizes hiring of outside counsel.

Jeff Sopko