HHS Secretary Tom Price Resigns

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Health and Human Services Secretary Tom Price resigned his post Friday afternoon amid controversy over racking up hundreds of thousands in travel bills. Price’s department of the executive branch oversees the Centers for Medicare & Medicaid Services (CMS), and is the administrative body for the federal health insurance exchange. The New York Times reports

Special Enrollment Periods Available for Hurricane Victims

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All Medicare beneficiaries and qualifying individuals seeking coverage through the federal health insurance marketplace who were affected by Hurricanes Harvey, Irma, or Maria are eligible for special enrollment periods this fall. Medicare According to CMS, the Medicare special enrollment period “will allow individuals affected by these hurricanes to enroll, disenroll or switch Medicare health…

Highmark and UPMC in Disagreement Once Again

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If you thought Highmark and UPMC’s embattled relationship was finally set straight by a state-brokered consent decree, you may have been too optimistic. The five-year decree permitting Highmark members in-network access to UPMC physicians expires June 30, 2019. As usual, the two sides are in disagreement once again – this time over interpretation of what…

PinnacleHealth Buys 4 Central Pennsylvania Hospitals

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Harrisburg-based PinnacleHealth System completed its purchase of four mid-state hospitals over the weekend. The non-profit acquired Lancaster Regional Medical Center and Heart of Lancaster Regional Medical Center in Lancaster County, Memorial Hospital in York County, and Carlisle Regional Medical Center in Cumberland County. The sale expands the system’s presence beyond its three current hospitals in…

Comparing Health Care Bills

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How does the health bill being debated in the Senate compare to the one that narrowly passed the House last month? How do they compare to the Affordable Care Act’s rules currently in place? Here’s a breakdown of how these bills handle the main tenets of health care reform. Medicaid Expansion The Senate bill…

2018 Maximum Broker Commissions for Medicare Advantage & Medicare Part D

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For the third year in a row, CMS has raised maximum broker commissions for Medicare Advantage and Medicare Part D initial enrollments. Note, insurance providers are NOT REQUIRED to pay the maximum commission rate. We’ll report when insurance companies’ release their 2018 filings in the coming months. Medicare Part D Maximum Broker Commissions Initial commissions increased…

HHS Cuts ACA Open Enrollment Period in Half

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The Department of Health and Human Services amended a few Affordable Care Act rules in an effort to stabilize the current marketplace. Among the major changes is a shrinking of the annual open enrollment period and more strict requirements surrounding special enrollment periods. Open Enrollment The annual open enrollment period for 2018 will begin earlier, opening…

LA Clarifies Restriction on Charging Consumers for Enrollment Assistance

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Late last week, the Commissioner of Insurance for the state of Louisiana, James Donelon, issued a directive clarifying a prohibition on charging consumers fees for enrollment assistance with individual health insurance plans. According to Donelon, there have been instances of producers charging fees directly to consumers purchasing individual health insurance policies which is in…