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Lawmakers Propose HDHP Coverage for Chronic Disease Prevention

February 12, 2018 - A new bill introduced into the House and Senate would allow high-deductible health plans (HDHPs) to provide chronic disease prevention services before a patient meets his or her deductible, which could help to accelerate a growing HDHP market. The bill, entitled “The Chronic Disease Management Act of 2018,” states that HDHPs should be allowed to provide pre-deductible preventive...


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House Bill Retains Low-Quality Medicare Advantage Plans until 2027

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Update on 2/12/2018: Presdient Trump signed the spending bill into effect on Feburary 9th, 2018 which funds the government for two years and extends quality deadlines for Medicare Advantage plans.  The latest government spending bill to...

Amazon, JP Morgan, Berkshire Hathaway Form Healthcare Company

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Amazon, JP Morgan Chase & Co., and Berkshire Hathaway have announced a long-term partnership to form an independent company that focuses on cost-effective healthcare for employees. The company will aim to remove profit-making incentives for...

VA, HHS Announce Healthcare Fraud Prevention Partnership

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The Department of Veterans Affairs (VA), HHS, and CMS agreed to participate in a healthcare fraud prevention partnership that leverages data sharing to identify fraud and abuse within healthcare programs they collectively oversee. The organizations...

VA Awards Accenture $62M Benefits IT Infrastructure Contract

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Accenture received a one-year, $62 million contract by the VA’s Veterans Benefit Administration (VBA) division to improve the VBA’s technology infrastructure for delivering member benefits. Accenture Federal Services (AFS) will upgrade...

Humana Expands Long-Term Social Health Determinant Investments

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Humana, and its philanthropic arm the Humana Foundation, announced changes to their grant making processes that provide long-term investments into community programs that address the social determinants of health (SDOH). The new investment strategy...

Humana Becomes Latest Payer to End AHIP Membership

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Humana is the latest commercial payer to end its membership in AHIP, the nation’s largest health insurance trade organization. “Humana has not actively participated in AHIP since early 2017,” a Humana spokesperson told HealthPayerIntelligence.com....

VA Union: Investigate $90M in Third-Party Contractor Payments

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The American Federation of Government Employees (AFGE) has sent a letter to VA leadership proposing an investigation into $90 million of improper payments made to the third-party contractors of the Veteran’s Choice program. The inquiry...

MS Awarded 10-Year Extension of 1115 State Medicaid Waiver

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Mississippi will be the first state to receive a 10-year extension of a 1115 Medicaid waiver, CMS announced.  The waiver originally implemented in 2003, expands eligibility requirements for individuals who can receive family planning benefits....

Federal Tax Bill, Individual Mandate Repeal Passes House and Senate

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GOP lawmakers in both the House and Senate passed a federal tax bill that includes a repeal of the ACA’s individual mandate to purchase health insurance.  The bill now heads back to the House for a procedural vote and afterwards to...

Aetna to Waive Narcan Co-Pays, Combat Opioid Overprescribing

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Aetna will be the first national payer to waive Narcan co-pays for fully-insured members as part of a larger effort to address the nation’s opioid crisis, the payer announced in a press release. Narcan is considered a preferred branded...

Integrated Care Model Lowers Health System Medical Costs

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Cigna’s integrated care model partnership with Texas-based Catalyst Health helped reduce the health system’s total medical costs to 5.6 percent below industry averages, the organizations announced in a press release. The Cigna Collaborative...

Optum to Purchase DaVita Medical Group for $4.9B

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Optum, a subsidiary of UnitedHealth Group, has agreed to acquire DaVita Medical Group for $4.9 billion, expanding the health care services company’s footprint in the direct care delivery environment. The acquisition, expected to be finalized...

Senate Passes Tax Bill, Individual Mandate Repeal in 51-49 Vote

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The US Senate voted 51-49 to reform national tax policy and simultaneously repeal the Affordable Care Act’s individual mandate, major news outlets reported at the end of last week. GOP senators only lost one Republican vote and were able...

CVS Caremark Provides Real-Time Benefits Data to Pharmacies

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CVS Caremark, the pharmacy benefit manager (PBM) of CVS Health, will provide pharmacies and prescribers with real-time benefits data on patients as a way to reduce payer and patient drug costs, the organization announced in a press release. The...

Health Plan Partnership Aims to Boost Care for Native Americans

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A merger between Tribal First (a subsidiary of Alliant Specialty Insurance Services) and American Indian Health Services (AIHS) will combine two national leaders in providing quality care to Native Americans, the organizations announced in a...

ACA Individual Mandate Repeal Could Cut Insured Number By 13M

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As a potential repeal of the ACA’s individual mandate faces the US Senate, the Congressional Budget Office (CBO) and Joint Tax Committee (JTC) found that a repeal would cut the number of insured individuals by four million in 2019. In an...

Humana Adds Former ONC Chief Karen DeSalvo as Board Member

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Former National Coordinator for Health IT and Assistant HHS Secretary Karen DeSalvo, will join Humana’s board of directors, the payer announced in a press release. Humana believes that the addition of DeSalvo to the board will improve its...

Value-Based Care Outperforms Fee-for-Service Health Plans

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Health plans that include value-based care (VBC) principles are more cost-effective than fee-for-service (FFS) options and are starting to produce better patient outcomes, Humana asserts in a new report. The total healthcare costs associated...

Maine Referendum Expands Medicaid Despite Governor Opposition

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The state of Maine has become the first state to expand Medicaid through a ballot vote that overrides Governor Paul R. LePage’s (ME-R) previous decisions to block the expansion, according to national news outlets. On Tuesday, Maine residents...

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