Briefs

Modern Healthcare - - LATE NEWS -

Some im­mi­grants who signed up for in­sur­ance cov­er­age via Health­Care.gov are on no­tice that they could lose their cov­er­age un­less they im­me­di­ately fur­nish proof that they are le­gally qual­i­fied for cov­er­age. The CMS sent out 310,000 let­ters giv­ing the en­rollees un­til Sept. 5 to send copies of green cards, proof of cit­i­zen­ship or other doc­u­ments to show that they qual­ify for the cov­er­age. Oth­er­wise, their cov­er­age will end Sept. 30. Some of the dis­crep­an­cies the agency is con­cerned about in­clude in­stances where in­for­ma­tion re­ported in the ap­pli­ca­tion, such as a So­cial Se­cu­rity or per­ma­nent res­i­dent card num­ber, is in­com­plete or dif­fer­ent from in­for­ma­tion on file.

The CMS has an­nounced that its Open Pay­ments web­site regis­tra­tion for doc­tors is back in op­er­a­tion.

But ProP­ub­lica re­ported Fri­day that the CMS will with­hold about one-third of the records due to data in­con­sis­ten­cies. The agency is set to make data on med­i­cal de­vice and phar­ma­ceu­ti­cal man­u­fac­turer pay­ments to doc­tors avail­able to the pub­lic Sept. 30. Cur­rently, the web­site is in­tended to al­low physi­cians to check pay­ment data at­trib­uted to them and con­test any per­ceived er­ro­neous data. Ear­lier this month, two doc­tors with the same name but in dif­fer­ent states found their data had been comin­gled, prompt­ing the CMS to tem­po­rar­ily sus­pend regis­tra­tion to in­ves­ti­gate.

Sev­eral for-profit hos­pi­tals and in­sur­ers have booked im­proved fi­nan­cial re­sults thanks in part to health­care re­form, but providers and pay­ers still face head­winds to main­tain sus­tained prof­itabil­ity, Stan­dard & Poor’s an­a­lysts said. Hos­pi­tals and in­sur­ers are likely to con­tinue to ben­e­fit from the ex­changes and Med­i­caid ex­pan­sion for the rest of this year and into 2015, S&P said. But ex­change en­rollees and lower-in­come pa­tients will still rep­re­sent a mi­nor­ity of their busi­ness, cau­tioned S&P an­a­lyst David Pek­nay. “We have to keep it in per­spec­tive. The change in the num­ber of in­sured peo­ple has still not changed all that much over­all,” Pek­nay said, not­ing that Medi­care and em­ployer-spon­sored plans re­main the main pipe­lines for hos­pi­tals.

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