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Two-Thirds of Physicians Disapprove of American Health Care Act

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Two-thirds of physicians in a new Merritt Hawkins survey reported having a negative impression of the American Health Care Act (AHCA).  This includes 58 percent of physicians who have a “strongly” negative take on...

Anthem Terminates Cigna Merger, but Refuses to Pay Out $1.8B

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After a court ruling in Delaware, Anthem has notified Cigna that their proposed $54 billion merger is off, but that doesn’t mean the two insurance companies are amicably parting ways. Anthem has stated that it will not pay Cigna a...

Cardiologists: Senate Must Ensure “Meaningful Insurance Coverage”

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In a letter sent to Senate leadership, American College of Cardiology President Mary Norine Walsh, MD, advised lawmakers to ensure access to “meaningful insurance coverage and quality, cost-effective care” for the...

Maine Medicaid Waiver Would Increase Patient Responsibility

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Maine will apply for a Section 1115 Medicaid waiver from the Centers for Medicare and Medicaid Services (CMS) to be granted flexibility to circumvent federal regulations and impose reforms on its Medicaid program. The state’s...

Aetna Will Abandon All Health Insurance Exchanges for 2018

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Aetna is ending participation in the Delaware and Nebraska ACA health insurance exchanges, completing its retreat from the public marketplace.   The company also made announcements earlier this year that it would be leaving the...

Humana Expands Orthopedic Bundled Payment Program to NC, VA

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Humana will bring its value-based orthopedic bundled payment program to 11 orthopedic specialty groups in North Carolina and Virginia.  The move follows a recent expansion into Kentucky and Indiana in 2017, and Ohio and Tennessee...

BCBS Moves into Vacant TN Health Insurance Exchange

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Blue Cross-Blue Shield (BCBS) has announced its plans to offer coverage options on Tennessee’s Affordable Care Act health insurance exchange in 2018.  The separate rating area consists of 16 counties in the greater Knoxville...

Medicaid Waiver Adds More Beds For Drug Addiction Treatment

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To circumvent an obscure Medicaid requirement, seven more states applied to join California, Maryland, Massachusetts and New York to receive a Medicaid waiver to expand drug addiction treatment.   Current federal policy prohibits...

MD Health Insurance Exchange Rates Up Double-Digits for 2018

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Patients in Maryland looking for insurance in 2018 may have bigger bills than they bargained for. The health insurance exchange rates for individual and group plans in the state have risen by up to 58 percent as payers try to cope with...

Are Health Insurance Subsidies Enough for Low-Income Patients?

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Despite financial penalties designed to prompt consumers to keep their health insurance, current efforts to subsidize care for low-income individuals may not be enough to incentivize patients, according to a recent study by economists at...

Healthcare Orgs React to House Vote on American Health Care Act

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The House vote to pass the American Health Care Act (AHCA) has drawn responses from across the healthcare industry.    The bill was passed 217-213, and immediately created a firestorm of commentary.  The passage of the...

Anthem Pursues Cigna Merger Up to the Supreme Court

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Just seven days after a court upheld the initial ruling which blocked Anthem’s acquisition of Cigna, the nation’s second largest insurer is not giving up.   Anthem has confirmed that it is filing a writ of...

Pharmacy Benefit Managers Help Reduce Payer Drug Spending

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Pharmacy benefit managers (PBMs) are instrumental in helping payers provide appropriate access to prescriptions, expand access, and rein in drug spending, according to a recent report from the Pharmaceutical Care Management...

House Passes AHCA To Repeal and Replace ACA By 1 Vote Margin

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The House has successfully passed the American Health Care Act (AHCA) to repeal-and-replace the ACA.  This was the House GOP’s second attempt to pass the bill, after the first vote was abruptly cancelled by Speaker Paul...

Aetna Posts Q1 Loss After ACA Withdrawal, Merger Collapse

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After a tumultuous 2016, Aetna announced a first-quarter 2017 net loss of $381 million, a significant  reversal from a $737 million profit a year ago. Aetna blamed the loss on costs associated with its attempted merger with...

AHIP Sees 28% Increase in Medigap Enrollment Among Seniors

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AHIP has released data showing that enrollment in the Medicare Supplement, Medigap, has seen a steady increase from 2014 to December 2015.   The data represents statistics from 11.8 million enrollees with policies from 305...

Chronic Care Management Fund Aids Underinsured Patients

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The HealthWell Foundation has launched the Movement Disorders Fund to provide financial support for those patients unable to pay insurance premiums or copays for necessary chronic care management. The fund is available to qualifying...

Aetna to Offer New HMO Option for Delaware State Employees

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Health insurer Aetna was recently awarded a three-year contract as a provider of Delaware’s health plan offerings for its employees and pensioners.  Aetna has chosen a coordinated care approach partnering with local innovators...

Tufts Health Plan Sees Opportunities as New RI Medicaid Option

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Rhode Island will add Tufts Health Plan (THP) as its first new Medicaid option in seven years, according to the Rhode Island Executive Office of Health & Human Services (EOHHS).  The new program, RITogether, will allow...

Court Upholds Antitrust Ruling Against Anthem-Cigna Merger

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On Friday, a federal DC district appeals court upheld a February 2017 decision which blocked the acquisition of Cigna by health insurance giant Anthem.  Antitrust concerns led 11 states and the District of Columbia to join the US...

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