rich 9.com.ph

Julie Appleby | KFF Health News Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators . The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000 complaints this year through August. Now, the annual ACA open enrollment period that began Nov. 1 poses a real-world test: Will the changes curb fraud by rogue agents or brokerages without unduly slowing the process of enrolling or reducing the total number of sign-ups for 2025 coverage? “They really have this tightrope to walk,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “The more you tighten it up to prevent fraud, the more barriers there are that could inhibit enrollment among those who need the coverage.” CMS said in July that some types of policy changes — those in which the agent is not “affiliated” with the existing plan — will face more requirements, such as a three-way call with the consumer, broker, and a healthcare.gov call center representative. In August, the agency barred two of about a dozen private sector online-enrollment platforms from connecting with healthcare.gov over concerns related to improper switching. And CMS has suspended 850 agents suspected of being involved in unauthorized plan-switching from accessing the ACA marketplace. Still, the clampdown could add complexity to enrollment and slow the process. For example, a consumer might have to wait in a queue for a three-way call, or scramble to find a new agent because the one they previously worked with had been suspended. Given that phone lines with healthcare.gov staff already get busy — especially during mid-December — agents and policy analysts advise consumers not to dally this year. “Hit the ground running,” said Ronnell Nolan, president and CEO of Health Agents for America, a professional organization for brokers. Meanwhile, reports are emerging that some rogue entities are already figuring out workarounds that could undermine some of the anti-fraud protections CMS put in place, Nolan said. “Bottom line is: Fraud and abuse is still happening,” Nolan said. Brokers assist the majority of people actively enrolling in ACA plans and are paid a monthly commission by insurers for their efforts. Consumers can compare plans or enroll themselves online through federal or state marketplace websites. They can also seek help from people called assisters or navigators — certified helpers who are not paid commissions. Under a “find local help” button on the federal and state ACA websites , consumers can search for nearby brokers or navigators. CMS says it has “ramped up support operations” at its healthcare.gov marketplace call centers, which are open 24/7, in anticipation of increased demand for three-way calls, and it expects “minimal wait times,” said Jeff Wu, deputy director for policy of the CMS Center for Consumer Information and Insurance Oversight. Wu said those three-way calls are necessary only when an agent or a broker not already associated with a consumer’s enrollment wants to change that consumer’s enrollment or end that consumer’s coverage. It does not apply to people seeking coverage for the first time. Organizations paid by the government to offer navigator services have a dedicated phone line to the federal marketplace, and callers are not currently experiencing long waits, said Xonjenese Jacobs, director of Florida Covering Kids & Families, a program based at the University of South Florida that coordinates enrollment across the state through its Covering Florida navigator program. Navigators can assist with the three-way calls if a consumer’s situation requires it. “Because we have our quick line in, there’s no increased wait time,” Jacobs said. The problem of unauthorized switches has been around for a while but took off during last year’s open enrollment season. Brokers generally blamed much of the problem on the ease with which rogue agents can access ACA information in the federal marketplace, needing only a person’s name, date of birth, and state of residence. Though federal regulators have worked to tighten that access with the three-way call requirement, they stopped short of instituting what some agent groups say is needed: two-factor authentication, which could involve a code accessed by a consumer through a smartphone. Unauthorized switches can lead to a host of problems for consumers, from higher deductibles to landing in new networks that do not include their preferred physicians or hospitals. Some people have received tax bills when unauthorized policies came with premium credits for which they did not qualify. Unauthorized switches posed a political liability for the Biden administration, a blemish on two years of record ACA enrollment. The practice drew criticism from lawmakers on both sides of the aisle; Democrats demanded more oversight and punishment of rogue agents, while Republicans said fraud attempts were fueled by Biden administration moves that allowed for more generous premium subsidies and special enrollment periods. The fate of those enhanced subsidies, which are set to expire, will be decided by Congress next year as the Trump administration takes power. But the premiums and subsidies that come with 2025 plans that people are enrolling in now will remain in effect for the entire year. The actions taken this year to thwart the unauthorized enrollments apply to the federal marketplace, used by 31 states . The remaining states and the District of Columbia run their own websites, with many having in place additional layers of security. Related Articles Health | Feds suspend ACA marketplace access to companies accused of falsely promising ‘cash cards’ Health | US food supply still one of the safest in the world despite recent outbreaks, FDA says Health | More foods are making us sick: What to know as foodborne outbreaks hit Health | At least 19 people are sick in Minnesota from ground beef tied to E. coli recall Health | Which health insurance plan may be right for you? For its part, CMS says its efforts are working, pointing to the 30% drop in complaint casework. The agency also noted a 90% drop in the number of times an agent’s name was replaced by another’s, which it says indicates that it is tougher for rival agents to steal clients to gain the monthly commissions that insurers pay. Still, the move to suspend 850 agents has drawn pushback from agent groups that initially brought the problem to federal regulators’ attention. They say some of those accused were suspended before getting a chance to respond to the allegations. “There will be a certain number of agents and brokers who are going to be suspended without due process,” said Nolan, with the health agents’ group. She said that it has called for increased protections against unauthorized switching and that two-factor authentication, like that used in some state marketplaces or in the financial sector, would be more effective than what’s been done. “We now have to jump through so many hoops that I’m not sure we’re going to survive,” she said of agents in general. “They are just throwing things against the wall to see what sticks when they could just do two-factor.” The agency did not respond to questions asking for details about how the 850 agents suspended since July were selected, the states where they were located, or how many had their suspensions reversed after supplying additional information.Why Aston Villa still miss Douglas Luiz ahead of his return with Juventus in the Champions League - despite playing just 312 minutes since his £42m summer move to Italy Douglas Luiz returns to Villa Park for the first time since his transfer to Juventus The Brazilian helped guide Aston Villa to the Champions League last campaign Liverpool correspondent LEWIS STEELE tells all on bombshell chat with Mo Salah - LISTEN NOW to It's All Kicking Off! New episodes every Monday and Thursday By TOM COLLOMOSSE Published: 17:49 EST, 26 November 2024 | Updated: 17:50 EST, 26 November 2024 e-mail View comments It sums up Aston Villa 's tumultuous summer window that there will be no trace of their most significant transfer deal when they meet Juventus in the Champions League on Wednesday. Knowing they needed a big sale in June to avoid a possible 10-point deduction for breaking Premier League spending rules, Villa allowed key midfielder Douglas Luiz to join Juventus in a £42million agreement that included Samuel Iling Jr and Enzo Barrenechea, who were fringe players for the Serie A side. Iling Jr and Barrenechea were despatched on loan to Bologna and Valencia respectively, with boss Unai Emery believing neither can deliver in the Premier League this season. Luiz misses this clash through injury but even if he had been fit, the Brazilian would probably not have played a major role. Luiz has played only 312 minutes under new Juventus coach Thiago Motta, starting just twice. It is understood he has struggled with the intensity of some of Motta's training sessions, especially the drills on defensive positioning. Indeed, Luiz has been pushed to the fringes in Italy to such an extent that supporters have wondered whether he might return to Villa Park – though Emery batted away that idea on Tuesday. 'He must meet the challenge there with his quality and help them to get their objective collectively,' he said. 'I am not thinking about him wanting to leave there, but I don't know. I think he is now injured.' The irony is that Luiz might have come in extremely handy for Villa right now. Douglas Luiz's 10 goals and 10 assists last season were key in Villa's march to fourth place But the Brazilian has played just 312 minutes under new coach Thiago Motta, starting just twice Luiz might have come in extremely handy for Unai Emery's stuttering Aston Villa right now His 10 goals and 10 assists last season were a key factor in Villa's march to fourth place but the relationship with boss Unai Emery had become somewhat tense by the end. Anyone who saw Emery bawling in Luiz's face during the first half of last season's Europa Conference League tie against Olympiacos at Villa Park, which Villa lost 4-2, would have realised that not everything in the garden was rosy. Emery orders his players to operate at maximum focus not just in games and training sessions, but during the long afternoon analysis meetings, too. 'Your lifestyle outside the club is reflected inside,' Emery has said. 'The mentality is to think football and show high commitment to your club and your team-mates.' While there is no suggestion Emery was uncomfortable with Luiz's lifestyle, he and his staff had started to believe the 26-year-old had taken his eye off the ball ever so slightly. That is why, when Villa knew they would need to make at least one big sale to meet profitability and sustainability regulations, Luiz was the man to go. For Juventus, it was a handy way to move Iling Jr and Barrenechea off the books. Expect Villa to try to do the same across the next two or three windows. While those reasons may have been sound, Villa have not come close to finding a central midfield pairing as effective as the Luiz-Boubacar Kamara axis. Each needed the other, with Luiz's levels dropping after Kamara was injured, but they dovetailed beautifully. With Kamara still struggling with injury, the current pairing of Youri Tielemans and Amadou Onana have not yet reached the heights of Kamara and Luiz. They gave Emery control in the middle and Villa have not rediscovered it. 'We must be stronger defensively in everything, starting with the ball and trying to dominate matches,' said Emery. 'But I have confidence because the players have showed the capacity to respond and react quickly.' While this is no time to panic, Villa are not what they were a year ago. In early December, Emery's men defeated Manchester City and Arsenal in the space of four days. Douglas Luiz returns to Villa Park for the first time since his summer move on Wednesday Tyrone Mings (left) and Ollie Watkins train ahead of Wednesday's Champions League tie This term, though they are only three points adrift of Chelsea in third spot, and well-placed in the Champions League, their only 'statement' victory was over Bayern Munich. They have lost to Arsenal, Tottenham and Liverpool, and only drew with a faltering Manchester United side in the final part of Erik ten Hag's reign. After tackling Juve, Villa travel to Chelsea on Sunday before they face winnable home matches against Brentford and Southampton. While they should have enough to see off those teams, it is tempting to wonder whether, under Emery, Villa will be capable again of reaching the heights of last season. Consider the evidence. Transfer chief Monchi has said publicly that Villa's best way of generating revenue is through player sales. Luiz's departure helped Villa fall on the right side of the line but his replacements have not yet reproduced his output. Read More Aston Villa had the Premier League's most effective offside trap but now it's being exposed Even if Villa qualify for the Champions League again, PSR guidelines may mean at least one more high-profile sale. If they not, there may be more. Then there is Emery's ultra-intense approach. Though successful, it wrings every last drop of mental and physical energy from the squad. Villa may well beat Juventus on Wednesday and will surely finish comfortably in the top half of the table again. Yet Villa's league performances across the year in 2023 were exceptional – 85 points from 42 games, a fraction more than two per match, with 48 goals conceded. Across 2024, their average is 1.5 per game and they have already let in 53 goals, which shows how difficult it is to maintain certain standards. Understandably, most Villa supporters will not hear of any doubts about the Emery regime, and there are surely more good times ahead but in six winless matches, tiny cracks have started to appear. Emery needs to fix them fast. Champions League Unai Emery Juventus Share or comment on this article: Why Aston Villa still miss Douglas Luiz ahead of his return with Juventus in the Champions League - despite playing just 312 minutes since his £42m summer move to Italy e-mail Add commentPublished 4:48 pm Tuesday, November 26, 2024 By Data Skrive The Duke Blue Devils and the Oklahoma Sooners hit the court for one of six games on the college basketball slate on Wednesday that include a ranked team. Watch women’s college basketball, other live sports and more on Fubo. What is Fubo? Fubo is a streaming service that gives you access to your favorite live sports and shows on demand. Use our link to sign up for a free trial. Catch tons of live women’s college basketball , plus original programming, with ESPN+ or the Disney Bundle.‘Rahul Gandhi Not the Leader of INDIA Bloc’: Samajwadi Party Leader Ram Gopal Yadav on West Bengal CM Mamata Banerjee’s Desire To Lead Multi-Party Alliance
None
None
- Previous: agent system rich9
- Next: rich09