Efforts To Curb ACA Enrollment Fraud Face Real-World Test

The current Affordable Care Act open enrollment season is the first big test of new federal guardrails against fraud. The rules aim to head off unauthorized ACA plan enrollments or switches by rogue agents and entities looking to make money via enrollment commissions. Such sign-ups triggered more than 274,000 consumer complaints through August this year.…

Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits

Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that…

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