Humana rolls out value-based model with 8 specialty groups, Excellus to pay $1M fine for denying contraceptive coverage & more — 11 payer highlights

The following payers made headlines this week, beginning with the most recent. 

1. Anthem signals ACA exchange presence in Kentucky, Virginia Indianapolis-based Anthem filed preliminary plans to sell insurance on 2018 ACA exchanges in Kentucky and Virginia.

2. Judge dismisses BCBS of North Carolina's suit to recoup $130M in risk corridors payments 
A U.S. Court of Federal Claims judge dismissed a lawsuit filed by Blue Cross and Blue Shield of North Carolina seeking $130 million in payments under the ACA's risk corridors program.

3. UnitedHealthcare names CEO; Optum appoints CEOs across 3 divisions
Minnetonka, Minn.-based UnitedHealth Group made changes to the executive teams of its UnitedHealthcare and Optum operations.

4. Passport Health Plan to create health and wellness campus, move HQ
Louisville, Ky.-based Passport Health Plan, a Medicaid managed care organization, will develop a 20-acre health and wellness campus to offer community health services and house its headquarters. 

5. Humana launches orthopedic value-based care model with 8 specialty groups in Kentucky, Indiana
Louisville, Ky.-based Humana and eight orthopedic specialty groups in Kentucky and Indiana are instating a value-based care model for Humana's Medicare Advantage members receiving total hip or knee joint replacements.

6. Excellus Health Plan to pay $1M fine for denying contraceptive coverage
The New York State Department of Financial Services fined Excellus Health Plan $1 million for wrongfully denying coverage for contraceptive services. 

7. Indian River Medical Center, Aetna at impasse over contract
Vero Beach, Fla.-based Indian River Medical Center and Hartford, Conn.-based Aetna may end their contract if negotiations between the parties fail.

8. Defunct SC co-op sues feds over $36.9M in reinsurance payments
Charleston, S.C.-based Consumers' Choice Health Plan, a failed health insurance co-op, filed a lawsuit against the federal government claiming the government's inability to pay reinsurance payments led to its 2015 collapse.

9. Partners' insurance arm offers money-back guarantee to attract new members
Neighborhood Health Plan, a subsidiary of Boston-based Partners HealthCare, is offering a money-back guarantee to employers with at least 100 workers who join the plan as new customers.

10. BCBS of Minnesota names former Aetna exec COO
Eagan-based Blue Cross and Blue Shield of Minnesota selected Cain Hayes as executive vice president, COO and president of health business.

11. WellCare appoints president for Hawaii-based health plan 
Tampa, Fla.-based WellCare Health Plans named Scott Sivik state president of its Kapolei, Hawaii-based 'Ohana Health Plan. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Top 40 articles from the past 6 months