Payer Issues

Independence Blue Cross notifies some members to PHI leak

Independence Blue Cross in Pennsylvania is notifying an undisclosed number of plan members about a potential compromise of their protected health information after an employee uploaded a file containing personal data to a website that was publicly accessible for three months. By Julie Spitzer - 9/18/18

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Can patients with HSAs deduct the new Apple Watch as a medical device? Not yet

The FDA-cleared Apple Watch Series 4 will allow wearers to take electrocardiograms on their wrists and receive alerts if their heartbeat becomes irregular, leaving some to question whether the device will count as a medical device for tax purposes, according to MarketWatch. By Julie Spitzer - 9/18/18
5 takeaways on using step therapy to lower Part B drug prices: Health Affairs

CMS said Aug. 7 it will give private Medicare Advantage plans more negotiating power over prices for Part B drugs, which are administered in physician offices and hospitals, in an effort to reduce spending. By Morgan Haefner - 9/17/18

61% of hospital leaders say single-payer would help lower healthcare costs

A new report from the New England Journal of Medicine-Catalysts about trends in payer-provider integration suggests that the industry is warming up to single-payer — with 61 percent of hospital leaders saying single-payer would boost the industry’s efforts to lower costs and provide better care. By Alia Paavola - 9/17/18
8 recent lawsuits involving payers

Becker's Hospital Review reported these eight lawsuits involving payers since Aug. 1, beginning with the most recent. By Morgan Haefner - 9/17/18
8 recent payer-provider disputes, agreements

Becker's Hospital Review reported these eight contract resolutions and dissolutions between payers and providers since Aug. 13, beginning with the most recent. By Morgan Haefner - 9/17/18
Humana adds 10 Iora primary care practices to value-based network

Humana and Iora Health, a Boston-based network of primary care clinics, expanded their valued-based contract a fifth year, the companies said Sept. 12. By Morgan Haefner - 9/14/18

Patient advocates, healthcare groups sue Trump administration to block short-term health plans

The Trump administration is being sued by patient advocates and other healthcare groups over its decision to expand availability of short-term health plans that do not ensure a full set of health benefits, according to the Los Angeles Times. By Morgan Haefner - 9/14/18
Payers investing in housing to cut healthcare costs, AHIP says

Health insurance providers are increasingly designing programs to offer safe and affordable housing options to improve the health and reduce care costs for members at risk of homelessness, according to a report from America's Health Insurance Plans. By Morgan Haefner - 9/14/18
BCBS of Rhode Island blames vendor for breach of customer data

Blue Cross Blue Shield of Rhode Island notified 1,567 members that an unnamed vendor responsible for sending members' benefits explanations breached their personal healthcare information, according to a media statement shared with Becker's Hospital Review. By Julie Spitzer - 9/14/18
Mayo Clinic to launch health plans with Minnesota insurer

Rochester, Minn.-based Mayo Clinic is creating health insurance products to network with providers nationwide, the health system said Sept. 13. By Morgan Haefner - 9/14/18

Average individual deductible hits nearly $1.5K: 6 survey findings

In 2018, workers with employer-sponsored insurance will pay an average deductible of $1,491 for individual coverage and $2,788 for family coverage, according to a new survey from the International Foundation of Employee Benefit Plans, cited by Benefit News. By Alia Paavola - 9/13/18
America's uninsured rate remained relatively unchanged from 2016 to 2017

The number of uninsured people and the uninsured rate were not statistically different in 2017 compared to 2016, according to a report from the Census Bureau. By Kelly Gooch - 9/13/18
BCBS, Humana rank highest among consumers

Americans ranked Blue Cross Blue Shield as the most relevant health plan provider, according to Prophet's latest brand relevance index. By Morgan Haefner - 9/13/18
Cigna to fund digital health startups through $250M venture

Cigna launched a venture to fund startups offering analytics, digital health and care management services, the company said Sept. 12. By Morgan Haefner - 9/13/18
Humana CEO unloads $6M in stock

Humana CEO Bruce Broussard sold nearly $6 million worth of stock Sept. 10, according to a recent Securities and Exchange Commission filing. By Morgan Haefner - 9/13/18
UnitedHealthcare CEO sells $7M in stock

UnitedHealthcare CEO and Executive Vice President Steven Nelson sold 26,033 shares of UnitedHealth Group stock Sept. 7, according to a Securities and Exchange Commission filing. By Morgan Haefner - 9/12/18
Montana health insurer wins lawsuit over cost-sharing reduction payments

A federal judge ruled Sept. 4 that health insurers are entitled to unpaid cost-sharing reduction payments, which help insurers subsidize the cost of coverage for low-income Americans, according to a Health Affairs blog post. By Morgan Haefner - 9/10/18
4,600 Arkansas residents lose Medicaid coverage under work requirements

The Arkansas State Department of Human Services said 4,574 Medicaid beneficiaries lost their health insurance Sept. 1 after failing to comply with the program's work requirements for three months, according to the Arkansas Democrat Gazette. By Morgan Haefner - 9/10/18
Montefiore Health, Aetna sign multiyear agreement

Bronx, N.Y.-based Montefiore Health System agreed to a multiyear agreement with Aetna, an Aetna spokesperson confirmed with Becker's Hospital Review. By Morgan Haefner - 9/10/18

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