Spotlight on Health Insurers
A weekly scan of actions taken by individual health plans
Spotlight on Health Insurers is a weekly review of news from the nation's leading health insurers, including coverage of exchanges, value-based health care arrangements, provider contracting and personnel changes. Subscribe now to get an issue delivered to your inbox every Thursday!

August 25, 2016

This week's topics: Health Insurance ExchangesHealth Plan BusinessLegal/Regulatory IssuesPeople on the MoveProvider Contracting

Health Insurance Exchanges

State accepts new hike in Blue Cross exchange premiums
Gwinnett Daily Post, Aug. 24, 2016
The Georgia insurance department approved a 21.4% average premium rate increase for Blue Cross and Blue Shield of Georgia for the 2017 health insurance exchange products.

Another blow to health care as Humana exits Utah individual marketplace
Deseret News, Aug. 24, 2016
Humana, Inc’s exit from the individual marketplace in Utah leaves the state with three carriers on the exchange for next year including, Molina, SelectHealth and University of Utah Health Plans.

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Health Plan Business

SelectAccount Receives Distinction as a Strategic Alliance Partner of the Blue Cross and Blue Shield Association National Labor Office
Press release, Aug. 25, 2016

Under the strategic partnership, SelectAccount will provide medical spending accounts solutions to organized labor.

Blue Cross Extends Network, Offers Special Considerations
The Advocate, Aug. 24, 2016
Blue Cross and Blue Shield of Louisiana is broadening its Preferred Care PPO network to offer coverage to HMO Louisiana and Community Blue members residing in areas affected by the flood.

Blue Shield of California expands ACO network in Southern California
State of Reform, Aug. 24, 2016
Blue Shield of California is collaborating with PrimeCare Medical Network, Inc., to offer enhanced care coordination to local residents.

Cigna Revises Policy, Will Cover 3D Mammography for Breast Cancer Screening
Press Release, Aug. 23, 2016
Cigna Corp.’s coverage policy for breast cancer screening has been tweaked to now cover 3D mammography for routine breast cancer screening.

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AIS’s Medicare and Medicaid Market Data: 2016

Legal/Regulatory Issues

Humana and Aetna to the DOJ: Get real
Louisville Business First, Aug. 23, 2016
The two insurers continue to fight back, arguing that suit to block the acquisitiondoes not “comport with reality."

Millions owed to Iowa Medicaid providers, according to state reports
KCRG, Aug. 23, 2016
Amerigroup reported $124,447,023 in unpaid claims, and AmeriHealth reported $120,040,333, say state reports.

Federal Officials Warn Medicaid Enrollees To Drop Subsidized Marketplace Coverage
Kaiser Health News, Aug. 22, 2016
The federal government is zeroing in on people who are enrolled in Medicaid and at the same time receiving federal subsidies to purchase private insurance coverage.

Blue Cross’s ACA fiasco still under review, says N.C. Department of Insurance
The Charlotte Observer, Aug. 22, 2016
The N.C. Department of Insurance said the investigation still calls for “further examination.”

Medicare Probes Whether Health Care Providers Steered Patients To Private Plans
Kaiser Health News, Aug. 19, 2016
The federal government has initiated a probe into whether health-care providers are pushing patients eligible for Medicare and Medicaid benefits into insurance plans offered on the health law’s exchange.

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AIS's Value-Based Care News

People on the Move

Former Anthem Blue Cross President, Mark Morgan Joins Limelight Health's Board of Directors
Press release, Aug. 24, 2016
In his former role, Morgan was tasked with overseeing business and strategy in California.

WellCare Appoints Rhonda Mims Chief Public Affairs Officer
Press release, Aug. 23, 2016
WellCare Health Plans, Inc named Rhonda Mims senior vice president and chief public affairs officer, who previously was the managing director of corporate social responsibility at Paul Hastings, LLP.

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Specialty Pharmacy Trends and Strategies: 2016-2017 Edition

Provider Contracting

Blue Cross Blue Shield, Billings Clinic announce employer insurance network
Billings Gazette, Aug. 19, 2016
Blue Cross Blue Shield of Montana and Billings Clinic have entered into a partnership to form an insurance network for large employer-sponsored plans.

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