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April 18, 2017

Hot Topic

Contracting disputes between health insurers and providers frequently move to the courtroom. Here’s a look at recent trends:

Aetna Wages ‘Scorched-Earth’ Litigation Against Outlier Out-of-Network Providers
Health Plan Week

Aetna Wins $37M Judgment Against Calif. Provider, Opens New Salvo in Network Wars
Health Plan Week

DOJ Lawsuit Against Carolinas HealthCare May Impact Contracting in Other Markets
Health Plan Week

Today's AIS Health Datapoint

80.16% ... is Blue Cross and Blue Shield of Montana’s Medicare Advantage (MA) market share in Montana, the highest state-level market share of any Blues MA plan in the country. The plan's enrollment grew 87.99% from 2016 to 2017.

From THE AIS GUIDE TO BLUE CROSS AND BLUE SHIELD PLANS. (Not affiliated with the Blue Cross and Blue Shield Association or its member companies.)

            The AIS Guide to Blue Cross and Blue Shield Plans is now online!

Quote of the Day

“Treatment cure rates are now above 90 percent, duration of therapy has been reduced to as little as eight weeks for the majority of patients, and real treatment costs are one-third lower than just a few years ago. In almost any other commercial setting, this would result in a significant expansion of market access, but with Hepatitis C, we’re seeing fewer patients receive care even though the number of patients seeking treatment continues to grow.”

— According to Nezam Afdhal, M.D., a professor at Harvard University and chairman of Trio Health’s Scientific Steering Committee

Click here to read the SPECIALTY PHARMACY NEWS article in which this quote appeared — "Study Shows Increase in Non-Starts Of Hepatitis C Drugs Since 2014" (Free for SPN subscribers; $17 for non-subscribers.)


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