New rule to halt insurance coverage brokers from fraudulently enrolling men and women in plans : Shots

VectorInspiration/Getty Photographs

VectorInspiration/Getty Pictures

Some insurance policies brokers are enrolling men and women into Economical Care Act wellbeing options with no their consent, potentially for the commissions, a shift that could set individuals in risk of owing back again the subsidies linked with the coverage. The hurt could be hundreds or even hundreds of dollars.

A consumer’s to start with hint that anything is incorrect is a major a person: a letter from the IRS or a hold off in their tax refund.

Though the exercise does not seem common, it has prompted the Department of Wellness and Human Products and services to find modifications to some oversight procedures influencing brokers. They would get started in 2023.

HHS needs the improvements, according to its proposal, for the reason that it “has observed several scenarios in which agents, brokers, and net-brokers have supplied inaccurate buyer domestic profits projections” and that “this is problematic in predicaments when consumers are enrolled without having their expertise or consent.”

The variations are component of a 400-web page proposed rule governing the federal well being insurance coverage marketplace and a handful of states that use the federal platform for their personal exchanges. The new broker provision aims to discourage fraudulent sign-ups by clarifying that candidates must attest that the revenue projections shown are right.

It also would bar brokers or services who enable people enroll in protection from working with “disposable” email addresses, which disappear following a set range of times, or listing the brokers’ mobile phone figures rather of the consumers’.

That there is a proposal at all “tells me they experienced a substantial number of scenarios on this” and that preceding actions have not accomplished ample to curb the problem of folks finding fraudulently enrolled, mentioned Tara Straw, director of well being insurance policies and marketplace plan at the Middle on Funds and Policy Priorities.

A spokesperson for the Facilities for Medicare & Medicaid Services mentioned in an electronic mail that the agency is not looking at a pervasive trouble, but he declined to present information on how typically this sort of scenarios arise or how the agents or brokers get the private information required to enroll unsuspecting people.

However, gurus in legislation, policy and enrollment say it has been a recurrent problem. Numerous cited examples commencing with a 2015 case in which an agent allegedly signed up hundreds of men and women

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Hospitalizations Skyrocket in Children Also Youthful for COVID Shots | Health and fitness News

By LINDSEY TANNER and MIKE STOBBE, AP Healthcare Writers

Hospitalizations of U.S. little ones below 5 with COVID-19 soared in the latest weeks to their highest stage since the pandemic started, according to governing administration facts released Friday on the only age team not still qualified for the vaccine.

The worrisome pattern in children too younger to be vaccinated underscores the want for more mature youngsters and grownups to get their pictures to aid safeguard those all around them, claimed Dr. Rochelle Walensky, director of the Centers for Ailment Manage and Prevention.

Due to the fact mid-December, with the remarkably contagious omicron variant spreading furiously around the region, the hospitalization price in these youngest youngsters has surged to much more than 4 in 100,000 kids, up from 2.5 for every 100,000.

The price amongst children ages 5 to 17 is about 1 for each 100,000, according to the CDC info, which is drawn from more than 250 hospitals in 14 states.

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Overall, “pediatric hospitalizations are at their greatest price as opposed to any prior place in the pandemic,” Walensky mentioned.

She mentioned that just about 50% of kids ages 12 to 18, and only 16% of these 5 to 11, are totally vaccinated.

The overall hospitalization price between small children and teens is nonetheless decrease than that of any other age team. And they account for much less than 5% of typical new day-to-day hospital admissions, in accordance to the CDC.

As of Tuesday, the normal variety of below-18 individuals admitted to the hospital for each day with COVID-19 was 766, double the determine documented just two months ago.

The craze amid the incredibly youngest young ones is becoming driven by significant hospitalization fees in 5 states: Georgia, Connecticut, Tennessee, California and Oregon, with the steepest raises in Georgia, the CDC mentioned.

At a briefing, Walensky said the quantities consist of kids hospitalized simply because of COVID-19 and individuals admitted for other reasons but located to be contaminated.

The CDC also mentioned the surge could be partly attributable to how COVID-19 hospitalizations in this age team are defined: a optimistic virus exam in just 14 days of hospitalization for any rationale.

The severity of health issues amongst small children in the course of the omicron wave appears decreased than it was with the delta variant, reported Seattle Children’s Hospital critical care chief Dr. John McGuire.

“Most of the

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Hospital offers parents $45,843-a-month installment plan for baby’s NICU stay : Shots

Baby Dorian Bennett arrived two months early and needed neonatal intensive care. Despite having insurance, mom Bisi Bennett and her husband faced a bill of more than $550,000 and were offered an installment payment plan of $45,843 per month for 12 months.

Zack Wittman for Kaiser Health News


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Zack Wittman for Kaiser Health News

Baby Dorian Bennett arrived two months early and needed neonatal intensive care. Despite having insurance, mom Bisi Bennett and her husband faced a bill of more than $550,000 and were offered an installment payment plan of $45,843 per month for 12 months.

Zack Wittman for Kaiser Health News

Close to midnight on Nov. 12, 2020, Bisi Bennett was sitting on the couch in her pajamas and feeling uncomfortable. She was about seven months pregnant with her first child, Dorian, and the thought that she could be in labor didn’t even cross her mind.

Then, she felt a contraction so strong it knocked her off the couch. She shouted to her husband, Chris, and they ran to the car to start the 15-minute drive to AdventHealth hospital in Orlando, Fla. About halfway through the trip, Bennett gave birth to Dorian in her family’s Mitsubishi Outlander. Her husband kept one hand on his newborn son’s back and one hand on the wheel.

Born breech, meaning his head emerged last, Dorian wasn’t crying at first, and the terrified new parents feared something was wrong. Chris Bennett turned on the SUV’s flashers and flagged down a passing emergency vehicle. The EMS team escorted the family to the hospital.

“He was still connected to me with the umbilical cord when they rolled the two of us together into the hospital,” Bisi says. “They cut the cord, and the last thing I heard was, ‘He has a pulse,’ before they wheeled me away.”

“I just cried tears of relief,” she says.

Dorian stayed in the neonatal intensive care unit until Jan. 7, 2021 — almost two full months. While Dorian was in the hospital, Bisi wasn’t worried about the cost. She works in the insurance industry and had carefully chosen AdventHealth Orlando because the hospital was close to her house and in her insurance network.

Then the bills came.

The Patient: Dorian Bennett, an infant born two months premature. He has health insurance through his mother’s employer, AssuredPartners, where she works as a licensed property insurance agent.

Medical

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COVID patients overwhelm hospitals in Colorado yet again : Shots

Longmont United Hospital nurse Brooke Schroeder holds a sign supporting nurses December 2, 2021. Nurses say the hospital is severely understaffed and they’re trying to form a union.

Hart Van Denburg/CPR News


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Longmont United Hospital nurse Brooke Schroeder holds a sign supporting nurses December 2, 2021. Nurses say the hospital is severely understaffed and they’re trying to form a union.

Hart Van Denburg/CPR News

Harold Burch lives in a home with a spectacular view in Paonia, a rural part of Colorado’s Western Slope. But that’s been little consolation to Burch, 60, as he’s battled a cascade of health problems during the pandemic.

“It’s been a real rodeo,” Burch says. “It’s been a lot of ups and downs and lately it’s been mostly just downers.”

Burch has battled chronic osteoarthritis, rheumatoid arthritis and had two major intestinal surgeries. One specialist he was seeing left her practice last year. Another wouldn’t accept his insurance. Then, Nov. 1, he started experiencing major stomach pain.

“When we talk terrible problems, I can’t leave the house,” he says. He says he hasn’t eaten anything substantial in three weeks.

Burch had to wait that long to be seen by a primary care doctor. He says the doctor told him: “‘If things were different, I would tell you to go to the hospital and be diagnosed, have some tests run and see what’s going on with you.’ But he says, ‘as of today, Delta County hospital is clear full. There are no beds available.'”

The COVID variant delta has overwhelmed the Colorado county of the same name. Hospitals on the Western Slope have been slammed for weeks, and the statewide picture is similarly grim. As of Monday, 1,294 patients were hospitalized with COVID-19, according to the state’s coronavirus website. Half of the state’s hospitals said they anticipated a staffing shortage in mid-December; more than a third of them anticipated ICU bed shortages at the same time.

And behind those numbers, patients — and health care workers — are feeling the impact.

Burch’s doctor told him he might have to wait hours in the ER, perhaps with people who have flu or COVID-19 symptoms. So Burch stayed home.

He’s fully vaccinated. But just 57% of people in Delta County have at least one dose of vaccine. And 84% of hospitalized COVID-19 patients in Colorado are not vaccinated.

“It’s really

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Francis Collins on medical advances, vaccine hesitancy and Americans’ ill health : Shots

National Institutes of Health Director Francis Collins served for 12 years under three presidents and presided over an expansion of the agency’s budget and efforts to develop new cures to diseases.

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Graeme Jennings/Pool/AFP via Getty Images

National Institutes of Health Director Francis Collins served for 12 years under three presidents and presided over an expansion of the agency’s budget and efforts to develop new cures to diseases.

Graeme Jennings/Pool/AFP via Getty Images

It’s Dr. Francis Collins’ last few weeks as director of the National Institutes of Health after 12 years, serving under three presidents.

Collins made his name doing the kind of biomedical research NIH is famous for, especially running The Human Genome Project, which fully sequenced the human genetic code. The focus on biomedicine and cures has helped him grow the agency’s budget to over $40 billion a year and win allies in both political parties.

Still, in a broad sense, Americans’ health hasn’t improved much in those 12 years, especially compared with people in peer countries, and some have argued the agency hasn’t done enough to try to turn these trends around. One recently retired NIH division director has quipped that one way to increase funding for this line of research would be if “out of every $100, $1 would be put into the ‘Hey, how come nobody’s healthy?’ fund.”

In a wide-ranging conversation, Collins answers NPR’s questions as to why — for all the taxpayer dollars going to NIH research — there haven’t been more gains when it comes to Americans’ overall health. He also talks about how tribalism in American culture has fueled vaccine hesitancy, and he advises his successor on how to persevere on research of politically charged topics — like guns and obesity and maternal health — even if powerful lobbies might want that research not to get done.

This interview has been edited for length and clarity.

Selena Simmons-Duffin: After you announced you’d be stepping down from the director role, you told The New York Times that one of your “chief regrets” was the persistence of vaccine hesitancy during the pandemic. How are you thinking about the role NIH could play in understanding this problem?

Francis Collins: I do think we need to understand better how — in the current climate — people make decisions. I don’t think I anticipated the

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Black tech founders work to improve health care for people of color : Shots

(from left) Kevin Dedner founded Hurdle, a mental health startup that pairs patients with therapists. Ashlee Wisdom’s company, Health in Her Hue, connects women of color with culturally sensitive medical providers. Nathan Pelzer’s Clinify Health analyzes data to help doctors identify at-risk patients in underserved areas. Erica Plybeah’s firm, MedHaul, arranges transport to medical appointments.

Kevin Dedner; Kolin Mendez Photography; Aaron Gang Photography; Starboard & Port Creative


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Kevin Dedner; Kolin Mendez Photography; Aaron Gang Photography; Starboard & Port Creative

(from left) Kevin Dedner founded Hurdle, a mental health startup that pairs patients with therapists. Ashlee Wisdom’s company, Health in Her Hue, connects women of color with culturally sensitive medical providers. Nathan Pelzer’s Clinify Health analyzes data to help doctors identify at-risk patients in underserved areas. Erica Plybeah’s firm, MedHaul, arranges transport to medical appointments.

Kevin Dedner; Kolin Mendez Photography; Aaron Gang Photography; Starboard & Port Creative

When Ashlee Wisdom launched an early version of her health and wellness website, more than 34,000 users — most of them Black — visited the platform in the first two weeks.

“It wasn’t the most fully functioning platform,” recalls Wisdom, 31. “It was not sexy.”

But the launch was successful. Now, more than a year later, Wisdom’s company, Health in Her Hue, connects Black women and other women of color to culturally sensitive doctors, doulas, nurses and therapists nationally.

As more patients seek culturally competent care — the acknowledgment of a patient’s heritage, beliefs and values during treatment — a new wave of Black tech founders like Wisdom want to help. In the same way Uber Eats and Grubhub revolutionized food delivery, Black tech health startups across the United States want to change how people exercise, how they eat and also how they communicate with doctors.

Inspired by their own experiences, plus those of their parents and grandparents, Black entrepreneurs are launching startups that aim to close the cultural gap in health care with technology — and create profitable businesses at the same time.

Seeing problems and solutions others miss

“One of the most exciting growth opportunities across health innovation is to back underrepresented founders building health companies focusing on underserved markets,” says Unity Stoakes, president and co-founder of StartUp Health, a company headquartered in San Francisco that has invested in a number of health companies led by people of color. He says those leaders have “an essential

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