News Briefs

News Briefs

March 23, 2020

✦ America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) sent a letter to House and Senate leaders on March 19 outlining various legislative proposals to “protect Americans’ health care and coverage.” The trade groups want: a nationwide special enrollment period for the individual market; a 90% subsidy for COBRA or other insurance coverage for those who lose jobs; some mechanism to help companies continue to provide health insurance to their employees (such as direct subsidies or payroll tax relief); and a “backstop contingency program” that would be triggered if insurers’ costs are significantly higher than expected, in order to prevent a spike in premiums. Regarding the backstop program, AHIP and BCBSA say it should “cover a portion of related costs for 2020 and 2021 and apply to the individual, employer, Medicare and Medicaid markets.”

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News Briefs

March 19, 2020

✦ The Medicare Payment Advisory Commission in its latest report to Congress observed “positive trends” in Medicare Advantage benchmarks, bids and payments relative to fee for service, MedPAC Executive Director James Mathews, Ph.D., told members of the press during a March 13 call about the commission’s March report. Specifically, MedPAC estimated that Medicare payments to MA plans this year will average about 100% of fee-for-service Medicare payments, while plan bids are 88% of FFS and benchmarks are currently 107% of FFS. The commission in its annual March report also discussed the growth of Medicare reinsurance — now the largest component of Part D spending — and the use of high-cost drugs pushing enrollees into the catastrophic phase of the Part D benefit. Mathews said MedPAC is “working toward a recommendation” in its forthcoming June report that would build on its 2016 recommendation for restructuring the Part D benefit. At the same time, the commission is “staking out a direction for a revised quality measurement program” in MA that it will likely discuss in the June report. View the March report at www.medpac.gov.

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News Briefs

March 16, 2020

✦ On March 9, global insurance brokerage firm Aon PLC agreed to buy fellow broker Willis Towers Watson in a deal that values the new firm at roughly $80 billion, according to a joint press release. The release emphasized the technology-driven nature of the deal and claimed the transaction will generate $10 billion in shareholder value. Companies like Aon and Willis Towers Watson help employers choose health plans and PBMs for their workers. Both firms’ stocks, which have trended downward since February, rallied the day after the announcement, but declined severely in subsequent days as markets crashed in response to an onslaught of bad COVID-19 news.

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News Briefs

March 12, 2020

✦ CMS on March 11 rolled out a voluntary model that would set out-of-pocket costs for insulin at a maximum $35 copayment per 30-day supply throughout the benefit year for beneficiaries in participating enhanced Part D plans. The goal is to ensure that beneficiaries in participating plans “will have predictable copays for a broad set of formulary insulins, including rapid-acting, short-acting, intermediate-acting, and long-acting insulins, marketed by participating manufacturers from the beginning of the plan year and through the coverage gap phase,” according to a press release. Visit https://go.cms.gov/39Kn1zx.

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News Briefs

March 9, 2020

✦ Cigna Corp. said in a March 5 press release that it will waive all copays or cost sharing for members whom health practitioners recommend receive coronavirus (COVID-19) testing. America’s Health Insurance Plans’ board of directors, meanwhile, pledged that it will “work with public and private-sector partners to implement solutions so that out-of-pocket costs are not a barrier to people seeking testing for, and treatment of, COVID-19.”

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News Briefs

March 5, 2020

✦ CMS’s 2019 Medicare Parts C and D program audits resulted in civil monetary penalties amounting to nearly $1.2 million imposed on six organizations, according to CMP notices posted at www.cms.gov. The agency in a memo dated Feb. 28 released the audit scores of the 13 organizations that underwent 2019 program audits, with scores ranging from 0 to 1.74 (the lower the score, the better the performance). Outside of the program audit process, CMS barred Medicare Advantage and Prescription Drug Plan operator Delaware Life Insurance Co. from marketing and enrollment activities and imposed a CMP on Miami-based Solis Health Plans, Inc. for failing to ensure that its agents and brokers followed Medicare marketing rules during the 2019 Annual Election Period. View all the notices at https://go.cms.gov/2x1Q7vP.

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