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What We’re Reading: ACA Plan Switching Lawsuit; Increase in Permanent Contraception; Potential Prior Authorization Rules
Large insurance sales agency call centers are accused of enrolling individuals in plans without consent; more young adults are choosing permanent contraception procedures; widespread frustration with prior authorization requirements hints at potential future measures.
Lawsuit Alleges Scheme of Unauthorized Health Insurance Enrollment
A lawsuit filed in US District Court for the Southern District of Florida alleged that large insurance sales agency call centers engaged in a moneymaking scheme by enrolling individuals into Affordable Care Act (ACA) plans or switching their coverage without their permission, according to Kaiser Health News. The lawsuit claimed that call centers purchased names of individuals from misleading advertisements, leading to unauthorized enrollment or coverage switches. Consumers affected by the alleged scheme, which the suit said targeted low-income individuals, faced disruptions in access to health care providers and medications, as well as financial costs.
Increased Tubal Ligations and Vasectomies Among Young Adults After Roe v Wade Reversal
There has been a significant rise in tubal ligations and vasectomies among young adults in the US following the reversal of Roe v Wade, according to CNN. Researchers observed a notable increase in both tubal ligations and vasectomies among individuals aged 18 to 30 years, with tubal ligations showing twice the rate of increase compared with vasectomies. Experts have expressed concerns about the pressure young people face in making decisions regarding permanent contraception and emphasized the importance of informed decision-making and supportive health care environments.
CMS Considers Further Action on Health Insurance Prior Authorization
CMS is evaluating additional steps to address dissatisfaction with prior authorization, while emphasizing the need for collaboration with the private sector, according to Modern Healthcare. CMS Administrator Chiquita Brooks-LaSure acknowledged the widespread frustration with prior authorization requirements at the American Hospital Association's annual conference in Washington, DC, on Monday. Brooks-LaSure indicated that the agency is open to further action, particularly in response to concerns regarding prescription drugs.
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
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CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
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