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The Affordable Care Act (ACA) established the health insurance rate review program in order to protect consumers from unreasonable rate increases. [1] Through this program, proposed premium increases in the small group and individual markets that are above a threshold amount (ten percent or more, as of February 2014) are reviewed by states or the federal government to determine whether the ...
Since the passage of the Affordable Care Act (ACA), there have been numerous actions in federal courts to challenge the constitutionality of the legislation. [1] [2] They include challenges by states against the ACA, reactions from legal experts with respect to its constitutionality, several federal court rulings on the ACA's constitutionality, the final ruling on the constitutionality of the ...
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging ...
The federal Centers for Medicare & Medicaid Services (CMS), which tracks enrollment in health plans through the ACA, reported that 313,579 Wisconsin residents enrolled in insurance through the ...
The Wisconsin Department of Agriculture, Trade and Consumer Protection fielded over 10,000 consumer complaints in 2023, leading to settlements of over $3.3 million, according to a news release.
Insurance fraud poses a significant problem, and governments and other organizations try to deter such activity. Studies suggest that the greatest total dollar amount of fraud is committed by the health insurance companies themselves, intentionally not paying claims and deleting them from their systems, [2] and denying and cancelling coverage. [3]
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Wisconsin Physicians Service Insurance Corporation (WPS Health Solutions) is a not-for-profit service insurance corporation based in Madison, Wisconsin.WPS offers health insurance plans for groups and individuals and benefit plan administration for businesses.