House G.O.P. Leaders Outline Plan to Replace Obama Health Care Act

By ROBERT PEAR and THOMAS KAPLAN WASHINGTON — House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Affordable Care Act, leaning heavily on tax credits to finance individual insurance purchases and sharply reducing fe
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HHS nominee Dr. Tom Price’s 2nd confirmation hearing: 5 things to know

By Emily Rappleye Rep. Tom Price, MD, R-Ga., faced another four hours of cross-examination Tuesday, this time with the Senate finance committee. Grilled by Democrats and lauded by Republicans, Rep. Price’s second hearing comes ahead of a vote that will determine his nomination.
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Trump vows ‘insurance for everybody’ in replacing Obamacare

Reuters U.S. President-elect Donald Trump aims to replace Obamacare with a plan that would envisage “insurance for everybody,” he said in an interview with the Washington Post published on Sunday night. Read more…
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OIG recovers $5.6B from providers in FY 2016

By Ayla Ellison HHS’ Office of Inspector General recovered more than $5.66 billion from healthcare providers and programs in fiscal year 2016, including about $953 million in non-HHS matters resulting from the OIG’s work in areas such as Medicaid restoration, according to
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Massive change coming to state health care for poor

By Priyanka Dayal McCluskey The federal government on Friday approved a sweeping overhaul of the state’s health care program for poor and low-income residents, pushing medical providers to better coordinate the care of nearly 2 million people. Read more…
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Obamacare Hits a Pothole

By Paul Krugman For advocates of health reform, the story of the Affordable Care Act, a.k.a. Obamacare, has been a wild roller-coaster ride. First there was the legislative drama, with reform seemingly on the edge of collapse right up to the moment of passage. Then there was the initi
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Former MetroHealth COO indicted for fraud, accepting bribes

By Ayla Ellison The former COO of Cleveland-based MetroHealth System, Edward Hills, DDS, and three others have been arrested and charged for their involvement in a RICO conspiracy, according to Crain’s Cleveland Business. Read more…
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DaVita encouraged some low-income patients to enroll in commercial plans

By Samantha Liss Internal emails from DaVita HealthCare Partners Inc. show the Denver-based company targeted some patients in a campaign to get them to buy insurance they didn’t necessarily need, saying their monthly premiums would be paid by a nonprofit foundation. Read more…
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Audit says home health care companies overbilled Mass. Medicaid by $23m

By Priyanka Dayal McCluskey The state’s Medicaid program was routinely billed for home health care services that were never provided or were not medically necessary. Providers submitted documents with missing dates and signatures. Sometimes basic information like a patient’s medical h
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CMS offers solutions as improper Medicaid payments skyrocket

By Virgil Dickson Improper Medicaid payments hit $30 billion last year, according to the CMS. Now, the agency is giving states tools to address the issue. Medicaid’s improper payment rate was 9.8% for 2015, nearly double what it was in 2013. The agency is anticipating the rate t
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