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minecraft online game 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 Feds suspend ACA marketplace access to companies accused of falsely promising ‘cash cards’ Fatal drug overdoses in Denver and across Colorado show declines through first half of 2024 More foods are making us sick: What to know as foodborne outbreaks hit Cities, states say they’ll need more help to replace millions of lead pipes Denver senator’s resignation, endorsements rankle Democrats and spark reform calls 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.There are two NFL games being played on Wednesday. They are being streamed by Netflix. There is some consternation about this because Netflix had major issues when it was recently streaming the Jake Paul-Mike Tyson bout. Social media was flooded with complaints about the broadcast stalling. Netflix signed a three-year deal to televise NFL games on Christmas Day. If there are issues on Wednesday, I wouldn’t be surprised if the NFL revisited the deal. In the UPickem Football picks, I went 11-5 with my Week 16 UPickEm Football picks, while my Gazette colleague Adam Shinder also went 11-5. I am 173-67, and Adam is 168-72. You can play our UPickEm Football by clicking https://dailygazetteprofootball.upickem.net/#/registration/login . Here are my Week 17 picks. My just-for-fun survivor game selection is Buffalo over New England. WEDNESDAY Kansas City 21, Pittsburgh 14 Baltimore 31, Houston 20 THURSDAY Seattle 30, Chicago 10 SATURDAY L.A. Chargers 35, New England 13 Cincinnati 34, Denver 21 L.A. Rams 42, Arizona 20 SUNDAY Indianapolis 28, N.Y. Giants 10 Buffalo 35, N.Y. Jets 15 Jacksonville 17, Tennessee 14 New Orleans 21, Las Vegas 20 Tampa Bay 24, Carolina 21 Philadelphia 27, Dallas 20 Miami 17, Cleveland 7 Minnesota 31, Green Bay 28 Washington 24, Atlanta 21 MONDAY Detroit 41, San Francisco 17 WEEK 17 TV SCHEDULE (Subject to change) WEDNESSDAY Netflix — Kansas City at Pittsburgh, 1 p.m. (Ian Eagle, J.J. Watt and Nate Burleson); Baltimore at Houston, 4:30 p.m. (Noah Eagle, Greg Olsen, Jamie Erdahl and Steve Wyche). THURSDAY Amazon Prime Video — Seattle at Chicago, 8:15 p.m. (Al Michaels, Kirk Herbstreit, Kaylee Hartung). SATURDAY NFL Network — L.A. Chargers at New England, 1 p.m. (Chris Rose, Ross Tucker, Steve Wyche); Denver at Cincinnati, 4:30 p.m. (Kevin Harlan, Trent Green, Melanie Collins); Arizona at L.A. Rams, 8:15 p.m. (Rich Eisen, Kurt Warner, Jamie Erdahl). SUNDAY FOX23 (WXXA) — Indianapolis at N.Y. Giants, 1 p.m. (Kenny Albert, Jonathan Vilma, Megan Olivi); Green Bay at Minnesota, 4:25 p.m. (Kevin Burkhardt, Tom Brady, Erin Andrews and Tom Rinaldi). CBS6 (WRGB) and Paramount+ — N.Y. Jets at Buffalo, 1 p.m. (Jim Nantz, Tony Romo, Tracy Wolfson). NBC13 (WNYT) and Peacock — Atlanta at Washington, 8:20 p.m. (Mike Tirico, Cris Collinsworth, Melissa Stark). YouTube TV NFL Sunday Ticket — Tennessee at Jacksonville, 1 p.m. (Spero Dedes, Adam Archuletta, Aditi Kinkhabwala); L.A. Raiders at New Orleans, 1 p.m. (Adam Amin, Mark Sanchez, Kristina Pink); Carolina at Tampa Bay, 1 p.m. (Ian Eagle, Charles Davis, Evan Washburn); Dallas at Philadelphia, 1 p.m. (Joe Davis, Greg Olsen, Pam Oliver); Miami at Cleveland, 4:05 p.m. (Andrew Catalon, Tiki Barber and Jason McCourty, AJ Ross). MONDAY ABC10 (WTEN), ESPN and ESPN+ — Detroit at Sab Francisco, 8:15 p.m. (Joe Buck, Troy Aikman, Lisa Salters).

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Anti-fraud efforts meet real-world test during ACA enrollment period