Member: Health Plan Weekly

Guidelines Offer Little Clarity on Future of Vertical Deals

July 9, 2020

On June 30, the Trump administration released the first major update to regulators’ guidance on vertical mergers and acquisitions since 1984. The document from the Federal Trade Commission and Dept. of Justice (DOJ) has already drawn controversy, as two FTC officials issued dissenting statements arguing the guidelines aren’t critical enough of deals that consolidate multiple parts of a supply chain.

However, health care and legal experts aren’t convinced that the new guidelines will provide much more assistance to firms hoping to execute vertical transactions akin to insurer Cigna Corp. buying PBM Express Scripts, pharmacy giant CVS Health Corp. buying insurer Aetna, or UnitedHealth Group — which already owns an insurer and a PBM — purchasing a bevy of other care-delivery assets.

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Payers Are Poised to See Changes From Hospital Transparency

July 6, 2020

In another blow to an industry already beleaguered by the COVID-19 pandemic, a federal judge recently upheld a federal rule that requires hospitals to engage in unprecedented price transparency measures. Health systems are likely preparing to comply with the new requirements even as they await the outcome of an appeal — but health insurers, too, are poised to feel an impact if the regulations go into effect.

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House Committee Paints Damning Picture of Short-Term Plans

July 6, 2020

More than a year after they began probing health insurers and brokers for information to fuel an investigation of short-term, limited-duration insurance (STLDI) plans, Democratic leaders of the House Energy & Commerce Committee released a report concluding that this market’s growth has come at the expense of consumers who are often duped into purchasing bare-bones coverage.

Policy experts, however, disagree about what conclusions can actually be drawn from the latest salvo in an ongoing debate over alternatives to Affordable Care Act (ACA) exchange plans.

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Cigna Taps Priority Health, Oscar to Bolster Offerings

July 6, 2020

Cigna Corp. has now partnered with two smaller insurers, Priority Health in Grand Rapids, Mich., and New York-based Oscar, in an effort to increase its share of commercial group business, particularly small groups.

The alliances, which take effect next year and later this year, respectively, widen available offerings for both Cigna and its partners: Cigna gets access to stronger provider networks and more advanced online tools than it has in-house, while Priority Health and Oscar get access to Cigna’s national platform.

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