Two large healthcare plans in Florida will pay millions to settle allegations triggered by a whistleblower's complaint that they gamed the Medicare and Medicaid systems by providing inaccurate risk scores for reimbursement.
Insurers are finding it difficult to set premiums and plan for the future when key elements of healthcare reform are still up in the air. They are most concerned over subsidies for low income consumers and changes in how Medicaid is funded.
A group representing emergency room physicians says the list of approved medical diagnoses developed by Anthem Blue Cross Blue Shield violates the "prudent layperson" requirement of the Affordable Care Act.
AARP and the Catholic Health Association are urging Congress not to approve the modified American Health Care Act. The current bill would throw millions of people off insurance rolls and hit older Americans disproportionately, they say.