Michigan Governor Gretchen Whitmer (D) last week signed into law the Health Can’t Wait Act, which decreases wait times for health care services and prescriptions that require prior authorization. The bill also obligates insurers to provide its members with more information about the prior authorization process. Approximately 10.5 million people have full medical coverage in Michigan, with Blue Cross Blue Shield of Michigan (4,520,146 lives), Priority Health (1,138,268 lives) and UnitedHealthcare (756,330 lives) serving as the state’s three largest insurers.
Datapoint: CMS Expands Postpartum Medicaid Coverage
The Biden administration on April 1 unveiled a new Medicaid enhancement, allowing states to extend Medicaid and CHIP coverage to postpartum beneficiaries for an additional 12 months. The new plan could impact as many as 720,000 people, according to CMS. Louisiana is the first state to begin offering this form of coverage, estimated to impact about 14,000 people. The state currently serves 1,941,505 Medicaid beneficiaries, with 91.5% enrolled in a managed care plan. Nine other states are also working on implementing the program.
Datapoint: Intermountain, SCL Health Complete Merger
Two nonprofit health systems, Salt Lake City’s Intermountain Healthcare and Broomfield, C.O.-based SCL Health, have completed their planned merger, according to an April 5 press release. The combined $11 billion system operates 33 hospitals and 385 clinics in Utah, Idaho, Nevada, Colorado, Montana, Wyoming, and Kansas. Intermountain also operates Utah’s largest insurer, SelectHealth, which currently enrolls 32.2% of the state’s overall insurance market with 825,108 lives.
Datapoint: Georgia Passes Mental Health Parity Law
Georgia Governor Brian Kemp (R) on April 4 signed into law a bill that requires health insurers to cover mental health and substance abuse care as if it were traditional medical care. The new law will go into effect in July. More than 10 million people have full medical coverage in Georgia, with Anthem, Inc. (3,183,977 lives), Centene Corp. (1,406,039 lives) and UnitedHealthcare (917,764 lives) serving as the three largest insurers.
Datapoint: United to Purchase Major Home and Hospice Provider
Following Humana’s lead, UnitedHealth Group last week announced its health services arm Optum is set to acquire LHC Group, a large home care and hospice provider, for $5.4 billion. The deal is expected to close in the second half of 2022. UnitedHealth currently operates the largest commercial health insurer in the U.S., with 45,814,482 members.
Datapoint: Florida Blue Launches In-Home Primary Care
Florida Blue this week unveiled a new in-home primary care program for its Medicare Advantage members in partnership with Emcara Health. Florida Blue members in 17 counties, including the Orlando, Tampa and Miami metro areas, will be eligible for the new benefits, which include home-based primary care doctors, in-home nursing visits and community health workers who can facilitate transportation and meal benefits. Florida Blue parent company GuideWell currently serves 181,575 MA lives in the state.
Datapoint: Florida Suspends Centene’s Medicaid Plan
The state of Florida last week fined Centene Corp. $9.1 million and suspended enrollment in its Medicaid and long-term care plans following a spate of inappropriate claims denials caused by a computer error. The insurer has 30 days to pay the fine and submit a plan for how it will handle claims processing in the future. Centene currently enrolls 43% of Florida’s managed Medicaid market, with 1.81 million members.
Datapoint: CMS Launching New ACA Special Enrollment Period
CMS this week revealed to CNN that the agency has launched a new Affordable Care Act special enrollment period for low-income Americans. People with incomes at less than 150% of the poverty line are now eligible to select ACA plans with $0 premiums via Healthcare.gov. The special enrollment period will last throughout 2022. 13,272,600 are currently enrolled in ACA exchange plans, according to the latest update to AIS’s Directory of Health Plans.
Datapoint: Molina Brings Mobile Behavioral Health Venture to California Medicaid
Molina Healthcare last week unveiled a new partnership with WEconnect Health Management to bring the company’s mobile recovery platform to California Medicaid members. WEconnect provides appointment reminders, reward incentives and mobile recovery meetings for people struggling with substance use and mental health disorders. Molina is currently the seventh-largest managed Medicaid plan in California with 483,405 members, 4.0% of the market.
Datapoint: White House Says ACA Enrollment Up More Than 20%
New data from the White House shows 14.5 million Americans signed up for Affordable Care Act coverage during the 2021 Open Enrollment Period, a 21% increase over last year. The states with the largest increases were Texas (42%), Georgia (36%) and Arkansas (33%). As of the third quarter of 2021, 13,272,600 people were enrolled in ACA exchange plans.