Health Plan Business

From Health Plan Week - Two senators are pushing America’s Health Insurance Plans (AHIP) and the Blue Cross and Blue Shield Association (BCBSA) to intervene in claims issues following the Oct. 1 Las Vegas shooting, which left 59 dead and more than 500 injured. But the request is difficult to comply with and somewhat out of the norm when it comes to claims practices following a disaster, says one insider. Chantel Sheaks, a director at PwC who specializes in benefits, tells AIS Health that she has not encountered health plans doing what the senators have requested. Read more

From Health Plan Week - Several states have submitted new or amended 1115 Demonstration Waiver requests that would allow them to implement alternative models of Medicaid delivery to improve member outcomes (and therefore cut costs) by integrating primary care, behavioral health services and long-term care. Other states are seeking conservative reforms such as limited eligibility, benefit designs that mirror employer-sponsored coverage and work requirements. Read more

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