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The Food and Drug Administration is pushing to approve Pfizer-BioNTech's two-dose COVID-19 vaccine on Monday, further expediting an earlier timeline for licensing the shot, according to people familiar with the agency's planning. Regulators were working to finish the process by Friday but were still working through a substantial amount of paperwork and…

Blue Cross and Blue Shield of N.C. said Friday it has received approval of an average 2.8% rate increase for individual federal health insurance plans. Blue Cross projects that its plans will cover more than 475,000 North Carolinians in 2022.. For example, for the 2021 plan year, Blue Cross said there would be an overall 1% rate decline statewide, but an average…
A South Carolina shooting is tied to $10 million in life insurance proceeds.

WSU’s lawsuit against Factory Mutual, originally filed in July, has been moved to federal court in Spokane. Factory Mutual, operating under the trade name FM Global and based in Rhode Island, requested that the lawsuit be heard in federal court.

–With confirmed cases of COVID-19 on the rise in the United States, Cigna has established new requirements to help protect its workforce. Employees who work remotely must be fully vaccinated before entering any U.S. worksite, beginning September 7. Steve Miller, Chief Clinical Officer of Cigna Corporation.

“Structural racism and discrimination impact health outcome and healthcare systems in the United States,” said Dieleman, an associate professor of health metric sciences at the University of Washington in Seattle. Black and Hispanic people in the United States are believed to be at higher risk for severe infection compared to White people, but have reduced…
Rhode Island regulators will decide how much health insurers can raise rates.

Rhode Island Attorney General Peter Neronha has filed objections to rate increases sought by Blue Cross Blue Shield of Rhode Island, Neighborhood Health Plan and other insurers that offer polices to state residents.

Aug. 16— Thousands of San Luis Obispo County residents will retain access to their current doctors, after Anthem Blue Cross and Dignity Health announced they have reached a new contract agreement Monday. “We are pleased to continue working with Dignity,” John Pickett, Anthem Blue Cross regional vice president of provider solutions, said in a news release.

Debt obligations of publicly traded U.S. health insurers more than quadrupled over the last decade, to $138.3 billion in 2020 from $32.7 billion in a 2011, according to a new AM Best special report. The Best’ s Special Report, titled,“ U.S. Publicly Traded Health Insurers Take on Debt to Support M&A Strategy,” states that the aggregate increase in debt obligations was…
Insurance brokers are prepared to offer more benefits' options.

The COVID-19 pandemic forced agencies and companies alike to reassess employee benefits. As employers continue to face a hiring shortage, attracting talent will almost certainly be contingent upon being able to offer employee benefits that cover a full spectrum of needs.
Former NFL ran a health insurance fraud scheme, authorities say.

Two women allegedly conspired to enter the names of licensed medical practitioners into billing information for Medicare claims without the practitioners’ knowledge, the U.S. Attorney’s office said.

Aug. 15— A COVID-19 patient who suffered a 141- day stay at a local Asante hospital generated a $3 million bill. She said the patient's insurance covered $500,000 of the bill, and Asante absorbed the rest. For now, patients in the Rogue Valley aren't being charged by Asante or Providence hospitals for the cost of their medical care.

Aug. 14— WASHINGTON, D.C.— Officials from Ohio offered differing opinions on the decision by the Centers for Medicare and Medicaid Services, a part of the President Joe Biden's administration for ending a policy approved by the Donald Trump's administration that placed work requirements on Medicaid recipients. Sherrod Brown, D- Ohio, praised the decision, which…
Gov. Mike DeWine called the decision by the Biden administration "disappointing."

Two years ago, the U.S. Centers for Medicare and Medicaid Services under the Trump administration approved Ohio’s request to make the changes, which hadn’t been implemented due to the ongoing pandemic.

Nearly two years after seeking bankruptcy protection, the company is scheduled to appear before a U.S. Bankruptcy Court judge to ask for approval of its plan to reorganize into a new entity no longer controlled by members of the wealthy Sackler family, and with profits dedicated to abating the opioid crisis. Ed Neiger, a lawyer representing individual victims…

A group of residents from western North Carolina filed a lawsuit Tuesday, Aug. 10, against HCA Healthcare and Mission Health alleging the anti-competitive business practices have driven medical prices up and the quality of health care down in that part of the state. The group bought the non-profit Mission Health in 2019 for $1.5 billion, a deal approved by N.C.

Missouri cannot deny or restrict those newly eligible for Medicaid benefits, a trial court judge ruled Tuesday, requiring the state to expand its low-income health care program to include roughly 275,000 additional Missourians. Cole County Circuit Judge Jon Beetem sided with three women suing the state and their attorneys, following the orders of a state…

“We're investing California's historic surplus to accomplish transformative changes we've long dreamed of– including this historic Medi-Cal expansion to ensure thousands of older undocumented Californians, many of whom have been serving on the front lines of the pandemic, can access critical health care services,” Newsom said. He added that it would “bring…

Heyward Donigan became Rite Aid’ s CEO months before the coronavirus pandemic brought some big changes to how drugstores operate. Like its rivals, Rite Aid started offering same-day prescription deliveries. The company also partnered with Instacart and DoorDash to deliver other products.

“Dignity Health has offered Anthem a proposal with rates that do not even cover hospital inflation costs and are below increases in prior agreements.” Anthem sent a letter to policyholders last week stating the current contract expired July 15. Anthem on its website is directing policyholders to find alternative in-network facilities.

Newsom made the announcement while signing Assembly Bill 133 during a visit to the Clinica Sierra Vista Elm Community Health Center in south Fresno, which serves a large number of undocumented workers. The expansion comes after the state expanded Medi-Cal, the state's version of Medicaid, to undocumented children in 2016 and young adults up to the age of 26 in…

Moving with uncharacteristic speed, the high court overruled Cole County Circuit Judge Jon Beetem's decision that upended the long-running push to add as many as 275,000 low-income Missourians to the government-run health insurance program. “The Supreme Court has now spoken and decided that our clients are eligible for coverage,” said attorney Chuck…

A Mississippi pharmacist pleaded guilty today for his role in a multimillion-dollar scheme to defraud TRICARE and private insurance companies by paying kickbacks to distributors for the referral of medically unnecessary compounded prescription medications that were ultimately dispensed by his pharmacies. A federal district court judge will…

On June 17 the Affordable Care Act survived a third attempt to eliminate it via the Supreme Court. If that mood holds, what's next for healthcare in the United States, and what values should guide what comes next? According to the Department of Health and Human Services, as of June 2021, “31 million Americans now have coverage through the Affordable Care Act.”

Jul. 20— The state program that provides insurance for health insurers was renewed for one year by Minnesota legislators, and some lawmakers worry that's not enough to keep premiums down in coming years. Tama Theis in a July 1 newsletter, just after the budget became law. Dan Wolgamott in a text message to the St. Cloud Times. “

It seemed like such a good idea at the time. U.S. pharmacies collecting millions of Medicare dollars would be offered incentives to do more than simply push pills. If they don't meet the new standards, such as making sure their patients receive their medications and get flu and pneumonia shots, they'll have to give up some of that Medicare funding.

As the pandemic wanes, many companies are asking their employees to return to the office. However, a majority of remote U.S. workers who went virtual during the pandemic have no desire to return to the office and may move to a new job if work from home policies are revoked. Additionally, many would consider permanently relocating to a new city or community if they…

Jul. 9— JEFFERSON CITY— Leaders of the Republican-controlled Missouri House have joined the court battle over their refusal to expand Medicaid to 275,000 low-income people. In a brief filed this week, the House called on the Missouri Supreme Court to uphold a decision last month by a Cole County judge striking down a citizen-led effort to expand the…

Jul. 7— JEFFERSON CITY— A dozen health clinics have joined the push to convince Missouri's highest court to force the Legislature and Gov. In a brief filed Friday, the 12 federally qualified health centers, including CareSTL Health in St. Louis, sided with a coalition of business groups and health care organizations in urging the Missouri Supreme Court to sign off…

Jul. 5— A provision in Ohio's new two year budget will allow health care workers, hospitals and health insurance providers to deny services that violate their moral or religious beliefs. While talking Thursday about the budget he signed Wednesday night, Ohio Gov. Todd Kepler, southwest medical director of Equitas Health, a nonprofit health care system serving…

JEFFERSON CITY, Missouri, July 1– The American Cancer Society Cancer Action Network issued the following news release on June 30, 2021:. Health and patient advocacy groups submitted an amicus curiae brief today, supported by Missouri- based health economists and law professors, in the Missouri Supreme Court, noting the vital role that the implementation of…

–Today, The Guardian Life Insurance Company of America released its 10th Annual Workplace Benefits Study, which uncovered how COVID-19 has reshaped employee benefits and workplace culture. The data shows how the pandemic prompted rapid change in areas that had already been gathering momentum pre-pandemic, including flexible work arrangements, employee…

Embracing flexibility is the key to a more productive workforce in the post-pandemic world. That was the word from Stephanie Berger, Centered Insurance Solutions, who shared the lessons her benefits brokerage firm learned after more than a year of remote working. Berger spoke at Monday’s National Association of Health Underwriter virtual annual convention.

When this happens in two consecutive years, the president and Congress are required- by law- to act. And Congress must then consider the legislation on an expedited basis. Yet neither the White House nor Congress has moved to slow the cost increase and decrease Medicare's growing dependence on general revenue financing.
Exclusive

Employers are reopening their offices and transitioning their workers back to either an in-person or a hybrid workplace. So what does this mean for human resource teams? David Pearson, senior vice president with ExtensisHR, gave some advice to health insurance and benefits brokers during the National Association of Health Underwriters virtual annual convention.

Compared to people who have low-deductible health care insurance plans, those enrolled in high-deductible insurance plans were less likely to seek care in the emergency room for chest pain. Low-income patients were less likely to visit the ER for chest pain and were nearly one-third more likely to have a heart attack during a subsequent hospitalization 30…

Debbie Dingell, D- Dearborn, wants Congress to provide states more funding in the future to expand home and community-based care to Medicaid recipients and to make sure the people providing those services are better paid. Home and community-based programs in Michigan and other states allow people who otherwise might need to be moved into nursing facilities…

Medicaid expansion has been a top priority for Kansas Democrats, notably Gov. A bill introduced in Congress last week to let cities and counties opt in to expand Medicaid is gaining attention from advocates in Kansas, who have long pushed for increase eligibility in the program statewide, a plan which has been thwarted by legislative Republicans.
Hospitals are not complying with new price transparency rules, a study finds.

A new University of Minnesota study finds that U.S. hospitals have been slow to fully comply with a new federal rule that was designed to bring more price transparency to health care.

Expansion supporters had hoped he would order the state to implement the program beginning July 1, even though the Republican-controlled General Assembly refused to fund it. “If the Court allows them to spend other state revenues by initiative, such action would deprive the General Assembly of its constitutional right to appropriate revenues in all other…

Supporters of the Affordable Care Act breathed a sigh of relief heard coast to coast last week, when the Supreme Court turned away what looks like the last federal challenge seeking to overturn the law on constitutional grounds. “The Supreme Court decision really does mark the end to the broadside challenge into the Affordable Care Act,” says Nicholas Bagley of…

AMY G OLDSTEIN The Washington Post. From February 2020 through January, Medicaid enrollment climbed nationwide by 9.7 million, according to a report based on the most recent available data and expected to be released Monday by the Centers for Medicare and Medicaid Services. But according to federal health officials and other Medicaid experts, much of the…

Missouri faces a budget shortfall of $1.4 billion over the next two years without the tax, the Republican governor said in an afternoon news conference, where he outlined a raft of draconian reductions he said would begin July 1 unless lawmakers act quickly. Parson's ultimatum came as Republicans remain divided over renewing a tax on hospitals that provides…

Jun. 21— More than 114,000 New Hampshire residents have enrolled in Obamacare for 2021, program advocates said Monday. Jayme Simoes, New Hampshire director of Protect Our Care, noted that national enrollment numbers for Obamacare are at record highs. “These New Hampshire enrollment numbers are further proof that the ACA works, is resilient, and that Americans…

In 2030, when the youngest of the baby boom generation will have reached the age of eligibility, the total number of Medicare enrollees is expected to reach 81.5 million, up 27% from 2020' s 64.3 million. Dave Rich, CEO of Ensurem, a Florida- based insurance technology and product distribution firm, says, “This wave of baby boomers, whose needs and expectations are…

Pennsylvania is trying for the third time since 2015 to replace its Medicaid contracts— worth a total of $65 billion over the last five years— with companies that manage physical health benefits for 2.6 million Pennsylvanians. “The plans see this as really big business,” said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, the…

Thus ended the third attempt by Republicans to use the Supreme Court to sabotage the ACA, all unsuccessful. Of course, in 2016, Republicans won control of the House, Senate and presidency on a platform that included the promise to repeal and replace “Obamacare” with “something terrific,” in the words of former President Trump. The Republicans failed and should stop…

The Maine House voted to advance a measure Thursday sponsored by Rep. Heidi Brooks, D- Lewiston, that would allow Maine to adopt a single-payer health care model contingent on federal law. “This legislation sends a signal to our federal delegation that Maine is ready to adopt a healthcare system that is accessible, affordable and equitable.

—President Joe Biden turned to his old boss, former President Barack Obama, on Saturday to help him encourage Americans to sign up for “Obamacare” health care coverage during an expanded special enrollment period in the pandemic.