News

Humana receives interest from potential buyers, may sell

Humana received acquisition interest Friday--a move that, if finalized, would create a potential domino effect of consolidation throughout a health insurance industry that faces increasing pressure to rein in costs. 

Failure to expand dental coverage stymies healthcare reform efforts

Roughly 4 million Georgia residents lack dental coverage, and many haven't seen a dentist in decades. The issue: The Affordable Care Act didn't include dental care among its "essential health benefits." 

Repeal of health insurance tax edges closer to reality

The controversial health insurance tax, which amounted to $8 billion last year and increased by 41 percent this year, may be on its way out.

3 key reasons CMS overhauled MCO rule

Although insurers have already begun pushing back against proposed Medicaid managed care organization regulations, the Centers for Medicare & Medicaid Services released the rule so that it could catch existing regulation up with reality.

Insurers seek delay to midsize group ACA changes

Insurers want to delay an Affordable Care Act provision that requiries them to change their benefit and pricing policies for small business plans, alleging those changes would drastically increase costs.

ACA news roundup: Old lawsuits, new controversies

All eyes are on the Affordable Care Act as the healthcare reform law's fate continues to spark debates and lawsuits. FierceHealthPayer rounded up the top ACA stories from this week to discuss the legal issues, the controversies and the what-ifs.

House lawsuit challenging ACA implementation gets day in court

lawsuit filed by House Republicans challenging two key facets of Affordable Care Act implementation is getting its day in U.S. District Court, the Associated Press reported.

GOP Senators introduce new healthcare plan in Florida

Republican Senate leaders in Florida offered a healthcare compromise Tuesday to the ongoing budget battle that's threatening to shut down state government.

Proposed MCO rule would subject Medicaid managed care plans to quality ratings

The Centers for Medicare & Medicaid Services wants to bring quality ratings to Medicaid managed care organizations.

Blue Cross and Blue Shield faces antitrust allegations

Blue Cross and Blue Shield insurance companies as well as the Blue Cross Blue Shield Association face antitrust lawsuits alleging that the 37 independently owned insurers act as an illegal cartel.

Shifting Medicaid enrollees into exchanges could improve access to care

As several states have implemented their own version of Medicaid expansion, shifting Medicaid enrollees into health insurance exchange plans can boost consumers' access to healthcare and stimulate the marketplaces.

Supreme Court to decide on all-payer claims database challenge

King v. Burwell isn't the only healthcare reform case the Supreme Court will rule on next month. At issue: Whether state laws requiring insurers to submit information to all-payer claims databases supercede federal laws.

MCO rule under fire for introducing medical loss ratio

The Centers for Medicare & Medicaid Services released its proposed rule to update Medicaid managed care organization regulations yesterday, and the rule is already under fire for proposing a medical loss ratio of 85 percent for managed care plans.

How healthcare CEO salaries hurt consumers

The healthcare industry had the highest level of median pay for CEOs last year--$13.6 million--beating out other top industries such as basic materials, consumer goods and financial. 

ACA to add $274B in admin costs to healthcare system through 2022

The Affordable Care Act will add hundreds of billions of dollars in administrative costs to the nation's healthcare system through 2022. Private insurers will bear the brunt of this overhead.

CMS updates Medicaid managed care organization rules

The Centers for Medicare & Medicaid Services has released its long-awaited proposed rule that updates its Medicaid managed care organization regulations.

Talk of possible Aetna, Anthem acquisitions reaches fever pitch

It's time to play "Let's Make a Deal." Or, perhaps, "The Price Is Right." Also, "Who Wants to Be a Millionaire?" In case you missed the news--and, judging from...

CareFirst hack compromises info for 1.1 million consumers

CareFirst BlueCross BlueShield on Wednesday announced that it was the target of a cyberattack that compromised information of about 1.1 million current and former consumers, as well as individuals who conducted business with the company online. 

'Underinsured' Americans latest healthcare reform controversy

A new healthcare reform debate may be on the horizon. Democrats refer to the issue at hand as the nation's "underinsured" population.

Consumers buy high-deductible health plans begrudgingly

Non-group insurance enrollment hit an all-time high in 2015, but many of those consumers that bought high-deductible plans do not think are a good value.