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AHIP’s Policy Roadmap Aimed At Increasing Health Care Access, Affordability

55 mins ago Health/Employee Benefits News No comments.

Washington, D.C. – May 17, 2022 – Today, AHIP launched Healthier People through Healthier Markets, a new policy roadmap and…

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Don’t Fall For Joe Namath’s Ads

May 16, 2022

You probably have seen Joe Namath on television hawking Medicare Advantage plans. Commercial insurance companies such as United Health Care, Cigna, and Aetna make huge profits if they can sell their Advantage plans. In addition, the government subsidizes Advantage plans using Original Medicare funds, thereby making the Advantage plans even more profitable…

Health Insurance Can Now Help Some Californians Find Housing

May 16, 2022

Under the new approach, certain high-risk and low-income Medi-Cal recipients can use their insurance plans for more than doctor "s visits and hospital stays- they can get help finding affordable or subsidized housing, cash for housing deposits, help preventing an eviction and more. Margot Kushel, professor of medicine and director of the UCSF Center for…

$2.7B Settlement In CalPERS Long-Term Care Insurance Lawsuit Is Canceled

May 16, 2022

An agreement in which CalPERS would have paid up to $2.7 billion to settle a lawsuit over the cost of its long-term care coverage has been scrapped, creating new uncertainty for tens of thousands of policyholders. A group of policyholders with inflation protection benefits sued the California Public Employees’ Retirement System over an 85% rate hike that was…

Virginia Poised To Review Eligibility Of 2 Million In Medicaid ‘Safe Haven’

May 16, 2022

RICHMOND- It's just a question of when, but Virginia is poised to begin an exhaustive 12- month review of more than 2 million people in its Medicaid program for the elderly, disabled and low-income families. The federal-state program, supercharged by Virginia's expansion of eligibility in 2019 under the Affordable Care Act, has added more than a half-million…

Transamerica Introduces Workplace Emergency Savings Accounts

May 13, 2022

Transamerica announces the addition of emergency savings accounts as a new benefit for employers to help their employees. Through new…

May 13, 2022

NAHU CEO: ‘Medicare For All’ Moves From Congress To The States

Congress has backed off “Medicare for All” for the time being. But legislators in several states are now taking up the charge.

What Advisors Need To Know About Long-Term DI Costs

May 13, 2022

May is Disability Insurance Awareness Month. It’s the perfect time to highlight disability insurance to agents, brokers and advisors who may be interested in adding this relatively untapped product to their arsenal.

Commentary: Expanding ACA Is An Expensive Prescription

May 13, 2022

Last month, President Biden proposed fixing the so-called "family glitch," a quirk in Obamacare's text that has prevented millions of people from purchasing subsidized coverage through the exchanges. It's only the latest attempt to gift more people taxpayer-sponsored health coverage. According to the Kaiser Family Foundation, this could make an additional…

Connecticut Insurance Exchange Launches Enrollment Period For Low-Income Families

May 13, 2022

That’ s a household income of $26,130 for a family of two, $39,750 for a family of four or $46,560 for a household of five. “This new Special Enrollment Period is all about creating access for Connecticut residents with lower income to get the health insurance coverage they need at an affordable price,” James Michel, CEO of Access Health, said in a statement.“ And it is…

Should Health Insurers Cover Fertility Treatments?

May 11, 2022

While 17 states have laws that require health insurers to cover fertility treatments, most of which include in vitro, California does not. The debate over whether health insurance plans should provide fertility coverage isn’ t new to Sacramento, but even in a state where Democrats like to boast about their fight to advance reproductive health, these efforts…

COVID-19 Made A Mental Health Crisis Even Worse, EBRI Speakers Say

May 11, 2022

Workers were struggling with mental health before the pandemic hit, and found a lack of mental health support during that time. COVID-19 introduced new pressure to workers or exacerbated existing issues. Making things worse is that many people have experienced trauma, grief and loss as a result of the pandemic and resulting shutdown.

Guardian Life Develops New Dental Insurance Offerings

May 10, 2022

New York, New York (May 10, 2022) – The Guardian Life Insurance Company of America announced the launch of new,…

Fewer People Lost Postpartum Insurance During Pandemic

May 9, 2022

2022 MAY 09– By a News Reporter-Staff News Editor at Politics, Law& Government Daily– PROVIDENCE, R.I.- It’ s been the case for decades- high numbers of U.S. women who give birth lose or face changes to their health insurance afterward. The findings suggest that the Families First Coronavirus Response Act, which was signed into law in March 2020 and prevented Medicaid…

Long-Term Care Insurance Sector Struggling

May 8, 2022

WASHINGTON- The long-term care insurance industry is foundering, and attempts to address the issue have flummoxed lawmakers and regulators. Of the more than 100 companies offering long-term care insurance in 2004, according to the National Association of Insurance Commissioners, just about a dozen still operated in 2019. Between 1990 and 2015, the average…

Transamerica Adds Integrated DI And Absence Management Solution

May 6, 2022

Transamerica announces the addition of a full-service absence management solution for employers. The new service simplifies disability and absence administration,…

Transamerica Expands Employee Benefits Suite

May 6, 2022

"We are excited to introduce this new critical service to our employer clients," said John Stanley, Senior Managing Director of Workplace Employee Benefits at Transamerica. According to the Social Security Administration, one in four of today's 20- year-old workers will become disabled at some point in their careers before reaching full retirement age.

Connecticut Bill Mandating Insurers Expand Coverage Of Breast Cancer Passes

May 6, 2022

So Kritzman knew getting breast cancer“ wasn’ t a matter of if, but when.” When she was 65, she got a mammogram. Ten years later, Kritzman, of Newington, is alive and well and a prominent activist on behalf of people with breast cancer. She is rejoicing this week, as a bill that she helped promote was passed by the Connecticut General Assembly.

Medicare Drug Plan Prices Touted During Open Enrollment Can Rise Quickly

May 5, 2022

Something strange happened between the time Linda Griffith signed up for a new Medicare prescription drug plan during last fall’ s enrollment period and when she tried to fill her first prescription in January. “I didn’ t pick it up because I thought something was wrong,” said Griffith, 73, a retired construction company accountant who lives in the Northern…

Medicare Registration Hits Snag After Snag

May 5, 2022

To the editor: I retired on December 17, 2021. I filed for Medicare Plan B on November 8. I faxed it to the Ogden Social Security Administration office.

Opinion: Blue Cross Has A Big Pile Of Cash

May 5, 2022

The Mississippi Today website reported last week that Blue Cross "has accumulated far more than what regulators require to protect consumers, and perhaps the largest such surplus by percentage of any Blue Cross company in the country." That is about eight times the amount of backup cash that regulators require, and four times what Blue Cross requires from state…

Drug Plan Prices Touted During Medicare Open Enrollment Can Rise Quickly

May 3, 2022

Something strange happened between the time Linda Griffith signed up for a new Medicare prescription drug plan during last fall's enrollment period and when she tried to fill her first prescription in January. But instead of the $70.09 she expected to pay for her dextroamphetamine, used to treat attention-deficit/hyperactivity disorder, her pharmacist…

Prescription Drug Costs: Feds Delay Cost-Saving Revamp

May 3, 2022

Millions of U.S. seniors were supposed to get price relief soon on their prescription drugs under a revamp of Medicare fees by a federal agency. The Centers for Medicaid and Medicare Services delayed proposed changes until 2024 at least. The trade group for PBMs– the Pharmaceutical Care Management Association– applauded the deal.

Want Free, At-Home COVID-19 Tests From Insurers? It’s Not Always Easy

May 3, 2022

Some Illinois residents say they’ re still having trouble getting free at-home COVID-19 tests from pharmacies and insurance companies, more than three months after the White House began requiring insurers to cover them. But it’ s still not always that easy— a problem that comes as Illinois case numbers are again rising, prompting many people to again seek…

Aflac Adds Mental Illness, COVID-19 To Group Critical Illness Insurance

May 2, 2022

–Aflac Incorporated, a leading provider of supplemental insurance products in the U.S., today announced the launch of its newly redesigned Aflac Group Critical Illness Insurance to help employers better support the changing needs of their valued workers in a post-pandemic environment. Aflac's redesigned Group Critical Illness Insurance is a…

May 2, 2022
California will begin offering medical care to unauthorized immigrants this week.

HealthCalifornia Opens Medi-Cal To Older Unauthorized Immigrants

On Sunday, California will open Medi-Cal to older immigrants residing in the state without legal permission. Unauthorized immigrants over age 49 who fall below certain income thresholds will become eligible for full coverage.

Public Citizen: Medicare Advantage Denies Needed, Care To Pad Insurer Profits

April 29, 2022

WASHINGTON, April 29– Public Citizen issued the following statement:. The U.S. Department of Health and Human Services Office of Inspector General released a report today, which found that Medicare Advantage plans deny needed care that should be covered to tens of thousands of people a year. Eagan Kemp, health care policy advocate for Public Citizen, released the…

Texas Teacher Retirement Fund Gets $435M Boost

April 29, 2022

AUSTIN— Texas leaders announced Thursday that the state will direct $435 million of federal COVID-19 money to the Teacher Retirement System of Texas. During the session, the state allocated about $286 million to help cover COVID-related health claims and keep premiums down. Joan Huffman, chair of the Senate Finance Committee.

Florida Woman Pleads Guilty to Laundering More Than $700,000

April 29, 2022

A Florida woman pleaded guilty today to laundering $735,695 in money stolen from Medicare, Medicaid, and private health insurers as part of a sprawling health care fraud scheme in Miami. These companies– BF Distributors Corp, Timely Medical Services Corp., Ortho-Med Solution Inc., Expedited Medical Supplies Corp., and Prime Orthopedic Solutions Corp– were…

April 29, 2022
Ohio is delaying planned changes to Medicaid.

Rollout Of Most Ohio Medicaid Reforms Pushed Back To End Of 2022

Medicaid, government-paid health insurance for more than 3 million low-income or disabled Ohioans, is typically the state’s largest expenditure totaling billions of dollars.

Rollout Of New Ohio Medicaid Health Plans Delayed Until End Of The Year

April 28, 2022

"It seems like this new phased approach still allows them to move forward with everything, but in a way that is manageable… to maybe take smaller bites of the apple," said Loren Anthes, who chairs Community Solutions' Center for Medicaid Policy. According to the Ohio Department of Medicaid, one of those reforms will still be up and running in July.

Employers Believe Worsening Employee Mental Health Is Hurting Their Financial Performance

April 25, 2022

New research from The Hartford, a leading provider of workers’ compensation and disability insurance, finds 71% of employers feel the deteriorating mental health of their workforce is having a negative financial impact on their company. In addition, 34% of U.S. workers reported feeling depressed or anxious at least once per week in 2022– up from 20% in 2020..

COVID-19 Patients May Face More Costs As Assistance Programs End

April 24, 2022

New data obtained by The Gazette show costs for a COVID-19-related stay at the state's largest hospital— which likely has seen the highest number of hospitalized coronavirus patients in Iowa throughout the past two years— reached an average of tens of thousands of dollars. The average cost of care for a COVID-19 patient hospitalized at the University of Iowa…

April 22, 2022
California will begin offering medical care to unauthorized immigrants this week.

Hospitals Prepare To Pick Up Tab For Uninsured COVID-19 Patients

After sending some $19 billion to hospitals and other health care providers nationwide, the fund known as the Health Resources and Services Administration COVID-19 Uninsured Program has dried up.

April 21, 2022
A New Mexico woman is alleging she was discouraged from medical treatment by her insurer.

Medicaid Patient Alleges Blue Cross Stalled Pancreas Treatment

At a final hearing in front of a state agency Dec. 30, 2020, Blue Cross agreed to cover a complex treatment option in Virginia, the suit says. Although approval for the procedure finally was granted, says the complaint, filed last month in the First Judicial District Court on behalf of Medicaid patient Julie Graham, Blue Cross breached its contract, violated the…

April 21, 2022
A Florida man bilked clients trying to get free of addiction.

Florida Sober Home Operator Gets 6 Years In Prison In $31.3M Fraud

A 49-year-old Florida man who used people struggling with addiction to bilk insurers out of $31.3 million will spend six years behind bars, a federal judge decided Wednesday.

Anthem-Blue Cross Dispute Referred To Georgia Insurance Department

April 20, 2022

A Fulton County court has ruled Anthem Blue Cross Blue Shield patients are to remain in-network for Northside Hospital doctors and facilities inde? nitely, until the state Department of Insurance reviews the ongoing Northside- Anthem dispute. Recently, Fulton County Superior Court Judge Rachelle Carnesale extended an injunction keeping Anthem patients…

April 20, 2022
A New Mexico woman is alleging she was discouraged from medical treatment by her insurer.

10K Families Left With $50M In Unpaid Bills After Health Ministry Closes

Sharity Ministries, formerly known as Trinity HealthShare, filed for bankruptcy in late 2021 and began the liquidation process. With so many outstanding claims against the ministry, it is unlikely that its members will receive the reimbursements they are owed.

Many May Lose Medicaid Coverage If COVID Emergency Ends

April 20, 2022

Community Solutions' Center for Medicaid Policy. Under the declaration, Ohio and other states were unable to take people off Medicaid, even if they became ineligible. But the worry is underfunded and understaffed counties are facing the task of combing through the entire Medicaid population to disenroll ineligible people– all within a 90- day deadline…

Counseling Agency Owner, Manager Sentenced On Healthcare Fraud Charges

April 19, 2022

Owner of Counseling Agency and Supervising Manager Sentenced on Healthcare and Wire Fraud Charges. SHREVEPORT, La.- United States Attorney Brandon B. Brown announced that Marty T. Johnson and Keesha Dinkins were both sentenced today by United States District Judge Donald E. Walter in connection with a healthcare fraud and wire fraud scheme they were involved…

Main Street Must Rethink Workplace Benefits To Counter Worker Shortages

April 19, 2022

NEW YORK–(BUSINESS WIRE)–Despite a falling unemployment rate and increased job growth, Main Street is still experiencing a worker shortage –…

Sutter Heath Nurses, Staff To Stage Strike Monday In Santa Rosa, Calif.

April 19, 2022

Apr. 16— More than 8,000 nurses and other health care workers at 15 Sutter Health medical facilities across Northern California, including in Santa Rosa, are planning to strike Monday in hopes of moving along contract negotiations. "We're striking to try to keep our retirement and benefits, to make sure we're safe with enough protective equipment and to have the…

April 18, 2022
A New Mexico woman is alleging she was discouraged from medical treatment by her insurer.

Some Diabetics Can Get $0 Copay For Insulin Under Insurer’s Move

Dr. Michael Romano, chief medical officer for the Nebraska Health Network, said $0 insulin is a step in the right direction toward removing some of the barriers that can keep people from addressing chronic diseases like diabetes.

Maine Health’s Anthem Troubles Have Deep Roots

April 17, 2022

Maine Health claims $13 million in underpayments, by its lights, and $70 million in non-payments from Anthem, which controls 11% of the national market. It's also Maine's largest insurer, and Blue Cross franchisee. Its presence here dates to 2000, when it acquired the ailing Maine Blue Cross- Blue Shield, the state's largest health insurer– and non-profit, as most…

April 15, 2022
Ohio is delaying planned changes to Medicaid.

Brokers Need ‘Good Faith Effort’ On New Disclosure Rules: HAFA Speaker

The Consolidated Appropriations Act of 2021 requires most brokers and consultants providing services to ERISA-covered group health plans to disclose to plan fiduciaries (typically, the plan sponsor), in writing, any and all direct or indirect compensation they receive.

UnitedHealth Tops Q1 Forecasts, Raises 2022 Outlook

April 14, 2022

—UnitedHealth Group thumped Wall Street’ s first-quarter expectations and raised its 2022 forecast, as growing Medicare Advantage coverage and care delivery once again bolstered the health care giant. The nation’ s largest health insurance provider reported on Thursday adjusted earnings of $5.49 per share as total revenue grew more than 14% to $80.1…

April 13, 2022
A New Mexico woman is alleging she was discouraged from medical treatment by her insurer.

Medical Group To Pay $22.7M To Settle Medicare, Medicaid Fraud

The complaint alleges that Washington state doctors filed Medicare claims for surgeries that were never performed, and that at least two surgeries were performed that necessitated intervention by another surgeon to repair damage.

April 13, 2022
The NAIC executive committee recently approved a new process for long-term care rate review.

NAIC OKs LTC Insurance Rate Review Structure

The National Association of Insurance Commissioners approved a framework to bring consistency to long-term care insurance pricing, but carriers say the pilot program for the structure did not work.

April 12, 2022
Integrity Marketing Group is acquiring Ash Brokerage in a blockbuster deal.

Could The Uber Popular HSAs Be The Face Of Health Care Reform?

Average HSA balances increased once again to $3,622. New accounts had relatively smaller balances, while older accounts had higher balances.

HealthPlans To Curb California Insulin Costs Abound

April 12, 2022

This week in California, Gov. The other half would be used to set up an in-state insulin manufacturing facility, as outlined in a budget proposal by the state’ s Department of Health Care Access and Information. The initiative is unique for a state, and it comes as Congress debates its own insulin cost measures, including limiting what people pay out of pocket to $35 a…

Massachusetts Gov. Charlie Baker Makes Last Pitch On Health Plan Changes

April 11, 2022

In a last-ditch attempt to change the health care laws in the Bay State, Gov. Charlie Baker appeared before a joint legislative committee to sell them on a plan he first proposed in 2019.. Jay Livingstone, a Democrat from the Back Bay, asked Baker if this sort of proposal has a model or has been studied before.

WPS Health Insurance To Expand Medicare Supplement Insurance In 45 States

April 11, 2022

WPS Health Insurance and its wholly owned subsidiary, The EPIC Life Insurance Company ®, are planning to expand Medicare supplement insurance, already being sold in 16 states, to 29 more states over the next 36 months. The insurance plans from WPS Health Insurance and The EPIC Life Insurance Company offer customers no-worry, no-hassle service backed by…

Sidecar Health Launches Group Health Product For Employers Of 51 Or More

April 11, 2022

Sidecar Health anticipates quickly expanding the offering to additional states. Sidecar Health is about providing our members with complete transparency and the ability to shop for the best care possible independently,” said Patrick Quigley, Founder and CEO of Sidecar Health.“ Expanding our offerings to employers was naturally the next step for Sidecar…

Maryland Lawmakers Override Hogan’s Veto On Family And Medical Leave

April 9, 2022

Maryland is slated to launch a paid family and medical leave insurance program for nearly every worker statewide after the Democrat-controlled General Assembly overrode Gov. The decision by lawmakers to launch the paid leave program over the Republican governor’ s objections came amid a series of weekend votes to overturn Hogan’ s Friday vetoes of a number…

Colorado Regulators Fine Bright Health $1M For ‘Operational Problems’

April 8, 2022

The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has announced that as a result…

April 8, 2022
California will begin offering medical care to unauthorized immigrants this week.

HIV/AIDS Insurance Plan: Broward Health Seeking ‘Appalling’ Rate Hikes

A Medicare Advantage health insurance plan that connects Floridians living with HIV/AIDS with medical services is severing its contract with Broward Health amid complaints that the hospital system is seeking“ unacceptable” cost increases for in-network services.

Chicago-Area Advocates Look To Lawmakers To Protect Undocumented Elderly

April 7, 2022

Editors’ note: The Chicago Tribune and Injustice Watch teamed up to report on the challenges facing Illinois’ aging undocumented population. Ortega, 51, immigrated to the Chicago area from Mexico more than two decades ago with her husband, Alfonso Vazquez, and their children, Janeth and Omar. Despite paying taxes that help fund programs such as Medicare and…

Workplace Life, DI And Supplemental Sales Increase In 2021, LIMRA Reports

April 6, 2022

WINDSOR, Conn. April 5, 2022—New annualized premium for workplace life insurance, disability insurance and supplemental health products rose in 2021,…

April 6, 2022
A Texas doctor was convicted of misdiagnosing patients.

Authorities Say Texas Doctor Owes $148M For Ongoing Healthcare Fraud

Zamora Quezada, who owned the Center for Arthritis& Osteoporosis in Texas, was convicted on one count of conspiracy to commit healthcare fraud, seven counts of healthcare fraud and one count of conspiracy to obstruct justice.

Insulin Price Cap Approved By U.S. House As Warnock Pushes For Senate Passage

April 5, 2022

WASHINGTON— The U.S. House on Thursday passed a bill on a bipartisan 232-193 vote that would limit the price of insulin, as congressional Democrats met throughout the day with health care advocates to make their case for the proposal. Raphael Warnock of Georgia and Patty Murray of Washington state held a virtual round table with residents from their states to…

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