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From Health Plan Week - When touting future prospects and trying to inform large audiences about what sets them apart from rivals, many companies take the investor day route. Two major health insurers held such events recently, capitalizing on significant publicity of late to keep attention on their brands high. • On June 21, Cigna Corp., soon after the demise of Anthem Inc.’s bid to acquire it (HPW 6/5/17, p. 9), held its first investor day since 2012. Read more

From Health Plan Week - Call it a civilized clash of the titans. In a two-person panel at America’s Health Insurance Plans’ (AHIP) annual conference in Austin, Texas, on June 8, representatives of the health insurance and pharmaceutical industries went at it. Eric Schultz, president and CEO of Harvard Pilgrim Health Care, Inc., was cordial but not happy. He told David Ricks, chairman, president and CEO of Eli Lilly and Co., that pharmaceutical companies should reveal… Read more

From Health Plan Week - CMS said May 15 it intends to propose rules, taking effect Jan. 1, 2018, that would allow small employers in states with federally facilitated Small Business Health Options Program exchanges under the Affordable Care Act (ACA) to enroll directly with insurers offering SHOP plans or through agents and brokers. Employers would no longer enroll through HealthCare.gov’s portal. (Separately, CMS said May 17 it is “streamlining” the federal portal’s enrollment process for… Read more

From Medicare Advantage News - As part of an ongoing effort to regionalize Medicaid purchasing and provide Apple Health Medicaid beneficiaries with the full continuum of physical and behavioral health services through managed care by 2020, the Washington state Health Care Authority (HCA) has notified subsidiaries of Anthem, Inc., Centene Corp. and Molina Healthcare, Inc. of its intent to award Fully Integrated Managed Care (FIMC) contracts in the North Central Region. The new FIMC program… Read more

From Drug Benefit News - Without a year-round audit readiness approach, SCAN Health Plan would not have been able to successfully negotiate the complexity and challenge of a CMS pilot medication therapy management (MTM) enforcement audit, according to Crystal Chang, manager of clinical pharmacy services at SCAN. Because SCAN, the Long Beach, Calif.-based managed care plan, was the first plan to be audited in the 2016 pilot, “it was a learning experience” for both CMS and… Read more

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