Category Archives: Insurance

Lawsuit claims UnitedHealthcare concealed Medicare Advantage enrollment fraud complaints

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Credit: Kaiser Family Foundation
UnitedHealthcare has 4.6 million Medicare Advantage members, 24 percent of the U.S. Medicare Advantage market.

A recently unsealed whistleblower lawsuit claims that UnitedHealthcare concealed from federal officials hundreds of complaints of enrollment fraud and other misconduct in its Medicare Advantage program.

Brought by two UnitedHealthcare sales professionals in Wisconsin, this suit is worth watching because it is the third in recent months that whistleblowers have brought using knowledge they gained while working for Minnetonka, Minn.-based health insurance giant. Continue reading

Report on Cruz amendment shows how one option would affect insurance market

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: Matt Johnson via Flickr

With efforts to repeal and replace the Affordable Care Act sidelined, for now, it may be a good time take a closer look at a Sen. Ted Cruz (R-Texas) proposal in case similar attempts to change insurance market regulation resurface when Congress returns from its August break.

Vox’s Dylan Scott has written that any significant reforms to Obamacare will not come until September at the very earliest, although some bipartisan discussion of ways to stabilize the individual market exchanges has begun. My AHCJ colleague Joanne Kenen in a recent blog post outlined various options going forward. Continue reading

ACA repeal efforts move to the next stage – whatever that may be

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

The Affordable Care Act last week survived yet another near-death experience – but the story isn’t over.

What’s next, though, is not yet clear. Here are a few possibilities, with the caveat that so much is in flux anything can happen: Continue reading

Repeal and replace: The chaotic Senate approach

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo: William Allen via Flickr

Confused about which bill the Senate is going to take up to begin its ACA repeal debate?

So is the Senate.

Remember the grief Nancy Pelosi took for saying, “we have to pass the bill so that you can find out what’s in it” during the Affordable Care Act debate? Continue reading

Newly covered Nev. residents face prospect of no insurer on exchanges

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Source: Kaiser Family Foundation analysis of insurer rate filings and news reports

Amy Goldstein of The Washington Post has a great look at a “bare county” in rural Nevada – a county that has benefited from the Affordable Care Act but now has no insurer willing to offer coverage there next year, no matter what ultimately happens to repeal in Congress.

She visited Lyon County, which includes “a stretch of highway that Life magazine once called the loneliest road in America.” Continue reading