Tagged with Humana

IL – Blue Cross Blue Shield Awaits State Review

For the first time since 1990, the Illinois Department of Insurance will conduct a broad market examination of Blue Cross and Blue Shield of Illinois to see how the insurer treats its customers in compliance with consumer protection regulations.

Humana and Tenet Agree on New Contract

Humana and Tenet have renewed a multiyear agreement to keep all of Tenet’s U.S. hospitals and outpatient centers in Humana’s coverage network.

Anthem Ends Cigna Merger Agreement

Anthem recently announced that it will stop pursuing Cigna. The insurer claims Cigna sabotaged the deal and states it will not pay the agreed-upon breakup fee of $1.8 billion.

Aetna to Exit all ACA Insurance Marketplaces in 2018

Aetna has announced plans completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.

Uninsured Rate Swells to 11.3% in Q1

Gallup-Healthways Well-Being Index poll shows uninsured rate increased to 11.3% in the first quarter of 2017 from a record low of 10.9% in the last half of 2016.

Humana to Exit ACA Exchanges by 2018

Humana has announced its plans to cease sales of individual health insurance plans through the ACA’s exchanges by 2018, potentially leaving more than 150,000 customers without a carrier.

Judge Denies Aetna-Humana Merger

A federal judge ruled against Aetna’s proposed acquisition of Humana, maintaining the Justice Department’s decision that the multi-billion deal would be anticompetitive and raise prices for consumers.

FL – Major Insurers Join New Value-Based Prescription Drug Model

Humana, UnitedHealthcare, WellCare, Blue Cross and Blue Shield of Florida and CVS Health are among those participating in a Medicare Part D model that gives insurers financial incentives to offer innovative programs that encourage patients to take their medications.

Humana Updating Surgery Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Surgery procedures, including: sigmoidoscopy, colonoscopy, other medical and surgical service during the postoperative period, FL Medicaid services included in delivery, birth center non-covered services, Florida Medicaid, and extracorporeal photopheresis.

Humana Updating Internal Medicine Claim Processing Edits

Effective September 19, Humana will update claim processing edits for Internal Medicine procedures, including: Sequential IV push, Telephone assessment and management, Home visit, Polysomnography, and Immune globulin.