Legislation and Policy
Texas Supreme Court Ruling May Affect Insurer, Hospital Rates.
The Dallas Morning News Share to FacebookShare to Twitter (5/2, Rice) reports on a decision by the Texas Supreme Court siding with an uninsured woman who challenged her $11,000 emergency room bill, ruling that the hospital must show the discounted rates it has with insurance companies in order to prove that the bill was “reasonable.” Some view the decision as “unprecedented” and could “have broader implications on how hospitals and health insurers negotiate their rates,” worrying “it could deal a big blow to free market competition in health care.” The court explained, “The reimbursement rates sought, taken together, reflect the amounts the hospital is willing to accept from the vast majority of its patients as payment in full for such services.”
Sen. McCaskill Opens Inquiry Into Air Ambulance, Insurer Billing.
Modern Healthcare Share to FacebookShare to Twitter (5/2, Luthi, Subscription Publication) reports Sen. Claire McCaskill (D-MO) launched an inquiry into nine air ambulance companies and insurers following news that “people are facing tens of thousands of dollars in out-of-pocket costs after emergency air transport to hospitals.” The senator sent letters to Aetna, Air Evac Lifeteam, Air Methods, Anthem, Blue Cross and Blue Shield of Kansas City, Cigna, Humana, LifeFlight Eagle and UnitedHealth Group, seeking information on their company policies and reimbursement rates. In the letters, “McCaskill blames the failure of some insurers and air ambulance companies to agree on reimbursement terms for the financial burden on patients.”
New Jersey Health Officials Raise Concerns About Short-Term And Skimpy Health Plans Proposed By Trump Administration.
NJBIZ (NJ) Share to FacebookShare to Twitter (5/2, Calio) reports New Jersey’s Department of Banking and Insurance has informed CMS that “offering short-term, limited duration health insurance plans is prohibited in New Jersey and made a plea to the federal government to have them discontinued on a nationwide basis.” The article says New Jersey health officials also wrote to CMS “about federal regulations that would permit the sale of ‘skimpy health plans’ that do not comply with the strong protections provided by the Affordable Care Act.”
Public Health and Private Healthcare Systems
Michigan House Committee Mulling Bill That Seeks To Impose Medicaid Work Requirements.
MLive (MI) Share to FacebookShare to Twitter (5/2, Lawler) reports that on Wednesday, Michigan’s “House Appropriations Committee…held its first hearing on a bill to require recipients to work 29 hours per week in order to remain on Medicaid.” The sponsors of the measure “said the original intent of Medicaid was to cover the very low-income, disabled, elderly and children. That expanded when Michigan expanded Medicaid, or Healthy Michigan, under the Affordable Care Act in 2013.” One of them explained that the bill is not supposed to be “punitive,” but one critic argued that regardless of the sponsors’ “intentions, passing this bill would result in some losing coverage.”
Humana Says Increase In Medicare Advantage Enrollment Resulted In Higher Revenue, Profit For Q1.
Contributor Bruce Japsen writes in a Forbes Share to FacebookShare to Twitter (5/2) piece that on Wednesday, Humana said enrollment in its “increasingly popular Medicare Advantage plans surged to more than 3 million in the first quarter, boosting total revenue and profits.” He says the insurer has focused on its Medicare business for years, and it exited ACA exchanges last year. Data show Humana’s total revenue rose by 3.8 percent to $14.3 billion, while profit totaled “$491 million, or $3.53, compared to $1.1 billion in the first quarter of last year.”
The Washington Examiner Share to FacebookShare to Twitter (5/2, Williams) reports that enrollment “in Humana’s Medicare Advantage plans climbed 6 percent to 3 million for the quarter that ended on March 31.” Earlier this year, CMS announced “rates for Medicare Advantage would increase by 0.45 percent next year.” According to Humana, this move will “result in a 3 percent rate increase for its own plans.”
Consumer Directed Healthcare News
Medicare Costs Could Increase By About 200% For Retirees With The Highest Incomes, Analysis Shows.
On its website, CNBC Share to FacebookShare to Twitter (5/2, Mercado) reports “high-income retirees can expect to shell out even more money to cover their Medicare premiums” this year. This is due to the fact that “there is a shift in the income brackets that are used to determine how much older Americans will pay for their Medicare Part B and Part D coverage, according to a recent analysis by HealthView Services.” Data show those who earn the most “may end up paying 200 percent more for Parts B and D compared to someone in the first bracket.”