What We're Reading: Health Insurance Coverage and Unecessary Procedures


What we're reading on October 12, 2015: health insurance marketplaces may have challenges keeping customers they already have, but in California, consumers leaving the state insurance exchange are gaining coverage elsewhere, and the government is increasingly pursuing cases of potentially unnecessary procedures.

Insurance Dropouts Present a Challenge for Health Law

Health insurance marketplaces getting ready for the next open enrollment period, which starts November 1, will have the added challenge of keeping customers they already have, reports New York Times. The last open enrollment period ended in February and by the end of June there had been a drop of about 15% in the total number of people enrolled in the federal and state marketplaces.

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Cincinnati Hospital to Pay $4.1 Million to Settle Claims for Unnecessary Surgeries

The government is increasingly pursuing cases of potentially unnecessary procedures, reports Modern Healthcare. A hospital in Cincinnati will pay $4.1 million to settle government allegations that the hospital was billing Medicare and Medicaid for unnecessary spine surgeries.

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Consumers Dropping Covered California Plans Gain Insurance Elsewhere

The vast majority (85%) of individuals who have dropped their health insurance coverage through Covered California, the state’s health insurance exchange, gain insurance elsewhere. Nearly half of those who do are opting for employer-based coverage, while others are turning to Medi-Cal and private coverage, FierceHealthPayer reports.

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