Tag: CMS

Health insurance companies can’t use AI for Medicare

Logan B.
Health insurance - Medicare and AI

Newly released federal guidelines say that artificial intelligence can’t make all the choices. The Centers for Medicare and Medicaid Services (CMS) have released new guidance for health insurance companies to protect Medicare Advantage (MA) against bias from artificial intelligence (AI). The CMS is the federal agency overseeing Medicaid, Medicare and other programs CMS oversees the Children’s Health Insurance Program (CHIP), the Health Insurance Marketplace, Medicare and Medicaid. It recently issued a policy memo to insurers in which it banned them from using algorithmic systems or AI exclusively to decide on…

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Record numbers of Texas residents enrolled in ACA health insurance plans this year

Logan B.
Health insurance plans - ACA enrollment Texas

The state’s total enrollment numbers were recently released, with over 1 in 9 Texans covered. The 2024 open enrollment period came with a record number of Texan sign-ups for health insurance plans through the Affordable Care Act (ACA). The data was released by the federal government as the state uses the federal HealthCare.gov marketplace. Over 1 in every 9 residents of the state are now covered by health insurance plans sold through the ACA in 2024. This is a notable record, as it was set in the state with the…

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New health insurance model to be tested in seven states

S.Vagus
U.S. Health Insurance

CMS announces that a new health insurance model will be tested to reduce the cost of medical care A new health insurance model is set to be tested in the United States, according to an announcement made by the Centers for Medicare & Medicaid Service (CMS). The model was designed to improve medical care while also cutting costs and the concept behind the model was designed over the course of 10 years at the University of Michigan. Called the Medicare Advantage Value-Based Insurance Design Model, the program is meant to…

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Health insurance exchanges may fall short on enrollment

S.Vagus
Health Insurance exchange marketplaces

Exchanges continue to struggle with technical problems Ongoing problems with the federal insurance exchange network in the U.S. may mean that the enrollment goals for HealthCare.gov may be impossible to meet. Exchanges throughout the country began operation on October 1, 2013, but relatively few people have been able to apply for coverage through exchanges managed by the federal government. Severe technical issues crippled HealthCare.gov in its early weeks, making it impossible for many people to apply for health insurance coverage through the federal exchange network. Agency lowers estimates concerning enrollment…

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Health insurance problems could cause coverage shortfalls

S.Vagus
health insurance deadline enrollment

Glitches may mean that certain insurance policies will not become active as scheduled The U.S. Centers for Medicare and Medicaid Services has announced that many people that have signed up for health insurance coverage through the federal HealthCare.gov portal may not actually be covered when the New Year starts. People throughout the U.S. have been trying to sign up for coverage through the federal insurance exchange but have been unable to due to technical problems. While the federal government is busy working to resolve these issues, those that did manage…

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Healthcare reform experts recommend double checking health insurance status

G. Turner
health care reform news

Now that HealthCare.gov is repaired, consumers who previously purchased plans are urged to verify enrollment. The White House has now declared the federal health insurance exchange to be fully up and running, but is also recommending that individuals who enrolled in this part of the healthcare reform ahead of the fixes, should check to ensure that they truly do have the coverage they believe that they purchased. Those who enrolled online through the exchange while the errors are still present may not be enrolled after all. Although the largest public…

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Official goals and challenges of U.S. health care reform – A hope for better care, delivery, and costs – Part I

The reforms to healthcare delivery being made by the Affordable Care Act are making an historic attempt to bring its costs under control by improving the quality and efficacy of the system. According to an official fact sheet, among the key reforms being made in this effort are as follows: Rewards for quality  Hospitals – this includes the first Hospital Value-Based Purchasing Program of its size, which will give funding to more than 3,500 hospitals across the country based on how much they have improved and whether or not they…

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