Iowa Makes Final Plea To Bolster Sagging ACA Market

GAINESVILLE, FLORIDA– Ona M. Colasante, 60, a physician who formerly practiced in Gainesville, was sentenced Friday afternoon to 12 months in prison and ordered to pay a $1,134,000 fine and more than $1 million in restitution after being convicted on May 2, 2016, of 162 counts of health care fraud. The sentence was announced by Christopher P. Canova, United States…

And in Indiana, the buffet line could soon get longer if more doctors and patients are attracted to a membership plan picking up steam under a new law. For a flat monthly fee, usually $50 to $100, patients can go to their primary care doctors for an unlimited number of exams, basic lab tests, generic drugs and vaccinations, without dealing with any insurance claims or…

Frustrated that people are continuing to show up at the emergency room with problems that aren’t life-threatening, Anthem Inc., Indiana’s largest health insurer, is pushing a new message: Save the ER for emergencies, or you’ll be responsible for the cost, which could easily run to thousands of dollars. Joseph Fox, medical director for Anthem’ s Indiana operations.

Now, according to the Division of Medicaid, officials say approximately 70 percent of the around 709,000 enrolled in the Medicaid are in a managed care program. Erin Barham, a spokeswoman for the Division of Medicaid, said, “The goals are to improve access to care, the quality of care, and health-care outcomes and therefore, reduce the overall cost of the program…

Aug. 17– Medica– the only insurer selling statewide plans on the state’s individual market– filed rates Wednesday with the Iowa Insurance Division, asking for an increase of 56.7 percent. “We remain hopeful the federal government will fund the cost-sharing reductions, but we are working with the Iowa Insurance Division to help consumers understand the…

Aug. 17– Stephen Hemsley, the chief executive who oversaw extraordinary growth in more than a decade running UnitedHealth Group, is leaving the job next month and will be succeeded by Dave Wichmann, the company’s president. Minnetonka- based UnitedHealth Group announced the Sept. 1 move on Wednesday, with Hemsley saying in a statement that it’s “the right time for…

Aug. 16– WASHINGTON– People and small businesses that buy health insurance on New York’s marketplace face the possibility of double-digit premium increases in 2018, due to the state’s approval Tuesday of a new set of rates for the coming year. The state’s decision will not affect the vast majority of New York residents, who get their health insurance through a…

The Pro-Choice Coalition of Oregon said it is the first legislation in the United States to comprehensively address systemic barriers to accessing reproductive health care. Oregon’s legislation was introduced largely in response to Republican congressional attempts to repeal former President Barack Obama’s health care law, which includes minimum…

Covered California is proposing that insurers who lose money in 2018 on the exchange would be allowed to make larger profits each of the following three years to recover their losses. “It’s always a difficult process even in a more stable policy environment where we can predict more readily what federal and state health care policies are going to be,” says…

CHEYENNE- Uncertainty surrounding federal healthcare policy is likely to drive up the cost of health insurance for Wyoming consumers with policies through the federal health exchange in 2018.. On Sept. 15, Blue Cross Blue Shield of Wyoming, the state’s only insurer on the federal marketplace, is expected to announce its final rates for 2018.

During the next several years, the Attorney General’s Office gathered Medicaid claims data for Lovelace, sought additional information from the company and Rodriguez, and interviewed witnesses and government officials. At the same time, the Attorney General’s Office repeatedly sought and was granted court orders to keep Rodriguez’s complaint sealed…

Medicaid, a 1960s Great Society pillar long reviled by conservatives, seems to have emerged even stronger after the Republican failure to pass health overhaul legislation.

“We know it resulted in job loss when it was in effect and we also know it resulted in decreased investment and development,” said Patrick Hope, executive director of the Medical Imaging& Technology Alliance, one of several trade groups fighting reinstatement of the tax. Various failed versions of Republican bills to repeal and replace the Obama health care law…

Researchers at Duke University Medical Center found that among a study of 300 cancer patients, more than one-third felt distress in the face of out-of-pocket medical expenses related to their treatment. The study was published as a research letter in the Journal of the American Medical Association Oncology. “A lot of people that get forgotten are those who are…

Aug. 10– Owatonna- based Federated Insurance said it won’t return to the group health insurance market in 2018, a move that means employers in Minnesota and 22 other states will lose an option next year for group coverage. Even so, Federated said Wednesday that the company sells group coverage to more than 600 employers in Minnesota that collectively cover more…

GRIFTON- The list of charges against a former Grifton insurance agent continues to grow longer. David Pickett, 59, of 205 Queen St., Grifton, was arrested July 11 in Wayne County. In total, Pickett is now facing 63 charges stemming from Pitt, Carteret, Craven, Duplin, Harnett, Jones, Lenoir and Wayne counties.

Aug. 09– The Texas House gave final approval Wednesday to a bill that would prohibit abortion coverage in private insurance plans as well as coverage offered to state employees and plans under the Affordable Care Act. House Bill 214 next goes to the Senate, which passed an identical version two weeks ago. Jonathan Stickland of Bedford– began pressing for action on…

Aug. 09– When Ron Drummond had a routine hernia surgery last year, he didn’t bill any insurance company. Instead, he got 25 to 30 personal checks from people he barely knows, many accompanied by a note saying the sender was praying for him. Dave Weldon, a physician and former Republican congressman from Florida, is president of the Alliance of Health Care Sharing…

Medica, based in Minnetonka, Minnesota, is the only company planning to offer the health plans in Nebraska and Iowa in 2018.. Geoff Bartsh, who heads Medica’s individual and family health plans, said that because the financial impact would not be significant, the fate of out-of-pocket subsidies would not be a factor in deciding whether to sell insurance under the…

Among all the reasons for rising health insurance premiums, this one might be the most obscure: A long-term care insurer in Pennsylvania just went belly-up.

The analysis, released Tuesday, is based on a new national Blue Cross “health index” tool that estimates the prevalence and cost of diseases in states and counties based on the private insurance claims of 40 million Americans. Diabetes, for example, costs each member of a private Blue Cross health plan nearly $140 per year in higher premiums, the new analysis showed.

The federal government announced earlier this year that open enrollment for states using HealthCare.gov would start Nov. 1 and stretch to Dec. 15, a shorter period than the three-month open enrollment originally planned for 2018 coverage. Minnesota and other states that run their own health insurance exchanges were given flexibility by the federal…

HARTFORD, Conn. & SANTA MONICA, CA – August 7, 2017 – Aetna (NYSE: AET) today announced significant enhancements to the…

Our Cyril Tuohy ponders whether tiny Switzerland, with its private decentralized health care system for 8 million people, could be a model for U.S. health care reform going forward.

According to the Bureau of Labor Statistics, private industry employer costs for insurance benefits averaged $2.59 per hour worked or 8 percent of total compensation. Officials estimate aggregate health care spending in the United States will grow at an average annual rate of 5.8 percent from 2015 to 2025, or 1.3 percentage points higher than the expected…

_ Cigna Corp. on Friday reported second-quarter profit of $813 million. The average estimate of 11 analysts surveyed by Zacks Investment Research was for earnings of $2.48 per share. Seven analysts surveyed by Zacks expected $9.98 billion.

Aug. 04– An Allegheny County doctor whose cooperation led to the arrest of his business partners at a Rostraver pain clinic where illegal prescriptions were handed out to patients was sentenced Thursday to serve two years on probation. Edward Sweeney, 69, of Shaler told a Westmoreland County judge that he hoped the help he gave investigators will restore his…

Aug. 04– HARTFORD– Aetna Chief Executive Officer Mark Bertolini said Thursday it was time for Congress to find a bipartisan fix for the troubled Affordable Care Act. “They don’t have the votes in the Senate.” Aetna’ s net income for the April-June period was $1.2 billion, or $3.60 per share, an increase of 52 percent over last year’s second quarter, soundly beating Wall…

Aug. 03– Florida health insurers are seeking double-digit rate hikes for 2018 Affordable Care Act coverage, but this week state regulators asked insurers to submit backup plans to raise premiums even higher next year because of uncertainty surrounding the future funding of subsidies that help low-income Americans pay their out-of-pocket costs.

_ Aetna Inc. on Thursday reported second-quarter net income of $1.2 billion. The average estimate of 10 analysts surveyed by Zacks Investment Research was for earnings of $2.34 per share. Six analysts surveyed by Zacks expected $15.3 billion.

Aug. 02– Evergreen Health Inc. has been formally ordered into the state’s receivership program after its investors backed out last month, leaving the young health insurance company financially unstable. On Wednesday, Baltimore Circuit Judge Yolanda Tanner ordered Risk& Regulatory Consulting LLC, a professional services firm in Connecticut, to take control…

BlueCross BlueShield, which offers the only individual plan sold on the S.C. marketplace, has proposed the increase to the federal Health and Human Services Department. The S.C. Department of Insurance is reviewing BlueCross BlueShield’s proposal. “Our responsibility… is to make sure that the rate that is approved is the correct rate for both the consumer and…

BIRMINGHAM, Ala.–(BUSINESS WIRE)–DirectPath, the industry leader in employee engagement, health care transparency and compliance, today unveiled new research, Strategies and Service…

A U.S. appeals court allowed the attorneys general from 17 Democratic states to defend subsidy payments to health insurers under the Affordable Care Act.

Blue Cross and Blue Shield of North Carolina– the only insurer offering ACA policies in 95 out of North Carolina’s 100 counties this year– said it would seek less despite ongoing uncertainty about how Congress and President Donald Trump would alter or scrap President Barack Obama’s health insurance overhaul law. Blue Cross said in May that if Washington would…

Minneapolis- based Medica unveiled its proposed 2018 rates as it sought approval from Nebraska state regulators. Medica spokesman Greg Bury said the company covers about 36,000 Nebraska residents right now, but that number is projected to surge to 90,000 next year. Medica is the only insurer offering individual policies in Nebraska that comply with the…

_ Humana Inc. on Wednesday reported second-quarter profit of $650 million. The average estimate of 10 analysts surveyed by Zacks Investment Research was for earnings of $3.08 per share. Seven analysts surveyed by Zacks expected $13.61 billion.

The employee who emailed Anthem records to his personal email worked for LaunchPoint Ventures, which is based in Indiana and performs insurance coordination for Anthem, which is headquartered in Indianapolis. “LaunchPoint is providing those impacted with information on how to better protect against potential identity theft and fraud, as well as access to…

Aug. 02– Most Americans will have from Nov. 1 to Dec. 15 this year to get 2018 health insurance on the individual market. The new Jan. 14 deadline was announced Tuesday by MNsure, Minnesota’s state-run health insurance exchange. Open enrollment will still begin on Nov. 1 for Minnesotans on the individual market, where about 4 percent of the state buys coverage.

Aug. 02– PROVIDENCE, R.I.– Rhode Island has enacted a new law that requires private insurers to cover “fertility preservation” for people who undergo medical treatments that may leave them sterile. Nationally, more than 100,000 people under age 45 are diagnosed with cancer in the U.S. each year, according to the National Cancer Institute. In Rhode Island, roughly 375…

Aug. 02– With the Republican effort to repeal and replace the Affordable Care Act stalled in the Senate, across-the-aisle efforts are unfolding in both chambers of Congress aimed at shoring up the nation’s health insurance markets. And in the Senate, lawmakers who lead the chamber’s health committee plan hearings next month on how to stabilize the law.

If approved, this would be the first time the average rate has decreased under the current federal health care law in Alaska, a remote state where high health care and premium costs have been an ongoing concern. The company in a statement called the rate decrease encouraging, but it cautioned against drawing any conclusions about a small Alaska market that it…

WASHINGTON The collapse of the latest Republican attempts to bury the Affordable Care Act has turned attention to whether President Donald Trump’s administration will shore up the nation’s health care system he wants to get rid of. In Pennsylvania, for instance, Insurance Commissioner Teresa Miller said she fears insurers will raise rates by 25 percent or…

Covered California’s rate release comes just after multiple attempts to repeal the Affordable Care Act failed in Washington, and the president calling to “let Obamacare fail.” Under that federal framework and financing, California has shown that we can make progress and take additional steps toward that goal. ” But California’s Insurance Commissioner, Dave…

Aug. 01– BOISE– The Idaho Department of Insurance is seeking public comments on proposed 2018 health insurance premium rates– with increases anywhere from 6 to 81 percent. The department reviews insurance carriers’ proposals to determine if rates are “unreasonable,” according to a statement Monday. “I am deeply disappointed and frustrated to share these rates,”…

The decision announced Monday by Eagan- based Blue Cross and Blue Shield of Minnesota is another blow to MNsure’s small business program, which never really got off the ground after being launched for 2014.. Blue Cross became the only carrier selling small business coverage through MNsure in 2016 after Minnetonka- based Medica dropped out of what’s called…

But they have iffy prospects at best, and there were no signs Monday that GOP leaders have chosen a fresh pathway after last week’s collapse of their struggle to repeal and rewrite the statute. He was among three GOP senators who joined Democrats in opposing a bare-bones bill rolling back a few pieces of President Barack Obama’s statute, dealing it a stunning…

Health and Human Services Secretary Tom Price said Sunday that waiving Obamacare’s individual mandate is on the table as President Trump and congressional Republicans look for a path forward on health care. “All things are on the table to try to help patients,” Mr. Price said on ABC’s “This Week.” In January, Mr. Trump signed an executive order that includes wording…

A federal judge has sided with congressional Republicans in saying the payments under the previous administration should have been authorized by Congress but is allowing them to flow pending any appeals court rulings. “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!

The state Commerce Department on Monday is scheduled to release preliminary rate requests from health insurers for the roughly 170,000 people who buy individual policies. The sneak peek at premiums promises to shift attention back to Minnesota after many in the state’s insurance market followed Republican attempts last week to repeal the Affordable…

In the seven years since the Affordable Care Act was passed, CEOs of U.S. health care companies have made a lot of money. Based on corporate financial filings with the Securities and Exchange Commission, Herman did research on 113 heads of 70 of the largest U.S. health care companies in the last seven years. The top earner was John Martin, the former CEO of the…

By a News Reporter-Staff News Editor at Agriculture Week– According to a new U.S. Department of Agriculture-funded study, lack of access to affordable health insurance is one of the most significant concerns facing American farmers, an overlooked risk factor that affects their ability to run a successful enterprise. “The rising cost of healthcare and the…

July 27– The Maryland Insurance Administration plans to ask a judge to appoint a receiver to take over Evergreen Health and gradually close down the health insurer unless another investor or buyer emerges. “It’s a sad day for the citizens of Maryland anytime in an industry you lose a competitor,” Redmer said. The unraveling of Evergreen will leave just two…

Even if the ACA is dismantled by Republicans in Washington, D.C., all proposed GOP plans include the reinsurance program, which allows states to seek federal waivers. If Oklahoma’s waiver request is approved, it could take effect as soon as Jan. 1. Wayne Pemberton, R- Muskogee, also did not specifically remember the waiver authorization, but said Oklahoma needs more…