Health Plan Weekly

Lawmakers OK Two Surprise Billing Fixes, Seek Compromise

Legislation to protect patients against surprise medical bills is once again gaining momentum in Congress, with two key House committees voting to advance proposals. However, passage of competing bills by the House ...
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Interoperability Proposals Tee Up ‘Epic’ Battle in Health Care

Recently, medical records software vendor Epic Systems Corp. made headlines by threatening to sue HHS over its proposed regulations promoting interoperability and urging its clients to oppose the new requirements as...
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CVS Touts Value of Aetna; Molina Sees Exchange Woes

During a Feb. 12 presentation outlining its 2019 financial results, CVS Health Corp. touted a “successful first full year with Aetna,” saying the transaction produced “synergies above expectations” at approx...
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News Briefs

✦ In public remarks made Feb. 11, CMS Administrator Seema Verma hinted at possible regulatory changes to prior authorization. Verma says CMS has received more than 2,000 comments on the subject of prior authorizat...
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Blues Plans, California Move to Manufacture Generic Drugs

An earlier version of this article incorrectly stated that all Blue Cross Blue Shield affiliates joined a partnership with Civica Rx. As of Feb. 17, 18 Blues plans had joined the agreement. This version has been cor...
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Humana, Centene Miss on MLR; Cigna Beats Expectations in 4Q

Health insurers continued to struggle with their medical loss ratios in the fourth quarter of 2019, with Humana Inc. and Centene Corp. each posting MLRs that missed analysts’ expectations and indicated higher medi...
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Experts Question Proposed ACA Auto-Reenrollment Tweaks

The 2021 Proposed Notice of Benefit and Payment Parameters (NBPP) — which CMS released on Jan. 31 after insurers grew increasingly impatient to see the annual Affordable Care Act exchange regulations (HPW 2/3/20, ...
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Exchange Exec Deems Nevada Health Link’s Debut a Success

Nevada — which is the proverbial guinea pig among a host of states aiming to shift from the federal Affordable Care Act (ACA) exchange platform to their own state-run exchange — now has completed its first full ...
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Affordable Care Act Premiums See Slight Decline as Marketplaces Stabilize

The cost of the lowest-priced silver plan in the Affordable Care Act exchanges fell by an average of 3.5% from 2019 to 2020, according to a new analysis from the Robert Wood Johnson Foundation. The report also exami...
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News Briefs

✦ CVS Health Corp. said on Feb. 3 that former Aetna Inc. CEO Mark Bertolini, who led the health insurer when it was acquired by the pharmacy chain, will leave the CVS board once integration is complete. But in an ...
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