Health Plan Weekly

ACA Risk Adjustment Transfers Total More Than $10B

Risk adjustment transfers reached $10.8 billion in the Affordable Care Act program for the 2019 benefit year, with the individual market accounting for about $7.98 billion, according to CMS. Among the 561 issuers th...
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News Briefs

✦ As of March 15, 10.7 million people had effectuated coverage in the Affordable Care Act exchanges, according to new data released by CMS on July 23. Total effectuated enrollment — encompassing people who selec...
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Execs Explain How Plans Can Better Serve LGBTQ+ Members

In June, when the Supreme Court ruled in Bostock v. Clayton County, Georgia that transgender people are protected by the Civil Rights Act of 1964 in matters of employment, it was just the latest of a decade-long wav...
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UnitedHealth Stresses Boost From Deferred Care Won’t Last

With COVID-19 cases and deaths surging in some U.S. states, it has become clear that the nation won’t be back to normal anytime soon. Still, the country’s largest health insurer is betting that health care utili...
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AHIP Takes Issue With Price Transparency Asks in CMS Inpatient Payment Rule

In a July 10 letter, America’s Health Insurance Plans (AHIP) criticized a Trump administration proposal that would effectively require hospitals to reveal median rates they negotiate with Medicare Advantage insure...
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Millions Have Lost or Will Lose Health Coverage in Recession

By the end of 2020, about 10.1 million Americans will lose employer-sponsored health insurance coverage due to COVID-19 pandemic-related job loss, projected a recent analysis by the Urban Institute and Robert Wood J...
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News Briefs

✦ Molina Healthcare Inc. said on July 17 that it entered a definitive agreement to buy certain assets of Passport Health Plan. The move comes after Kentucky awarded Molina a Medicaid managed care contract award, b...
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Guidelines Offer Little Clarity on Future of Vertical Deals

On June 30, the Trump administration released the first major update to regulators’ guidance on vertical mergers and acquisitions since 1984. The document from the Federal Trade Commission and Dept. of Justice (DO...
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Insurers Outline How They’re Helping PCPs Stay Afloat

The COVID-19 pandemic has caused visits to primary care providers (PCPs) to plummet, putting significant financial strain on those businesses. That crisis has been especially harmful to independent practices, and in...
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Insurers Aim to Help Providers Avoid Crisis-Driven Consolidation

Insurers are taking steps to help providers financially as the COVID-19 pandemic progresses, in part to help stave off more provider consolidation and demands for higher reimbursement, a recent survey from Robert Wo...
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