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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.

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.

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.

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