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April 20, 2015

Recent Stories of Interest

From Health Plan Week - The waiting, indeed, was the hardest part for Medicare Advantage (MA) plans. But any sense of dread over the CMS final 2016 MA payment rates was erased when on April 6 the agency said it would increase payments by 1.25% next year versus the Feb. 20 draft proposal calling for a 0.95% reduction (HPW 3/2/15, p. 1). CMS said revised medical spending estimates and not any policy reason prompted the shift from negative to positive. And even though other parts of the final notice and Part D Call Letter did not inspire optimism among health insurers — like the scuttling of plans to soften some star-rating measures that were intended to benefit dual-eligibles insurers but raised doubts even among them — the predominant view is MA plans and their advocates now possess leverage over CMS in pushing for more profitable payment rates. Read more

UnitedHealth Group’s $12.8 billion play for the fourth-largest PBM Catamaran has raised… Read more

Humana Inc.’s sale of its wholly owned urgent care/occupational medicine subsidiary Concentra… Read more

Moves by PBMs, in collaboration with health plans, to stomp out what… Read more

From the Editor

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April 16, 2015
EEOC Issues Wellness Program Guidelines

The EEOC issued wellness program guidelines to prevent discrimination against those with disabilities. http://tinyurl.com/mo7jplo

April 15, 2015
SGR Repeal Easily Clears Senate

The doc-fix bill repealing the sustainable growth rate passed the Senate April 14 with little problem. http://tinyurl.com/najjz4h

April 13, 2015
BCBSM, IBC Spin Off Medicaid Plan

Blue Cross Blue Shield of Michigan is spinning off its Medicaid plan in a for-profit venture with Independence Blue Cross. http://tinyurl.com/qa8odwt

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