Yolanda Jimenez-Colón, who leads Latino Relations for Gateway Health’s Community Engagement & Growth Department, has been selected as one of 50 of the Most Influential Latinos in the Delaware Valley. Ms. Jimenez-Colón will be recognized for her commitment and contributions to the Delaware Valley’s Latino community at a ceremony to be held from 5:30 p.m. to 11:00 p.m., Friday, November 17 at the National Museum of Jewish History, 101 S. Independence Mall East, Philadelphia. The awards ceremony begins at 7:00 p.m. [Read more…]

The Pharmaceutical Care Management Association (PCMA) released the following statement on the Centers for Medicare & Medicaid Services’ (CMS) Medicare Parts C and D proposed rule: [Read more…]

Tufts Health Plan today announced it is rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA) on its annual rating of private health insurance plans.* It is the only health plan in the nation to receive the 5 out of 5 rating for both its HMO and PPO products.* Only three other plans in the country, from a pool of nearly 500 -earned a rating of “5.” Its Massachusetts PPO is the only PPO plan in the country to receive a 5 out of 5 rating. [Read more…]

Using real care and cost data over an extended period of time that mimics real world experiences and shows optimization across health care markets. What if workers and dependents could right-fit their own benefits using the power of such analytics? It would revolutionize shopping for health coverage – especially for large companies with up to several thousand workers. [Read more…]

Pat Geraghty, CEO of Florida Blue, the leading health insurer in Florida, today announced that the company will donate $1 million to support relief and recovery efforts across the state in the wake of Hurricane Irma. [Read more…]

Tampa-based WellCare Health Plans, Inc. (NYSE: WCG), a leading provider of Medicaid, Medicare Advantage and Medicare Prescription Drug Plans throughout the country, today announced that, after activating its emergency business continuity plan ahead of Hurricane Irma’s arrival in Florida, its Tampa-area facilities remain operational and the company is facing minimal interruption in business in serving its 4.4 million members. [Read more…]

A Trump administration agency proposal to cut Medicare drug payments to hospitals serving poor and rural Americans is counterproductive and would actually reduce access to care, a group of over 1,300 hospitals says in comments submitted today to the U.S. Department of Health and Human Services (HHS). [Read more…]

Hurricane Irma is expected to cause catastrophic destruction across Puerto Rico, Florida, and possibly other states, even as the Gulf Coast is working to recover from Hurricane Harvey. Many healthcare facilities and pharmacies are already unavailable for extended periods, and others soon will be. As the waters subside, patients in affected areas may be displaced, many care locations will be temporarily closed, and prescribing patterns could be disrupted due to evacuations, power outages, and massive flooding across the region. [Read more…]

For nearly two decades, New Life Agency has been committed to providing the best value and service in the Assisted Reproduction Insurance industry. Today, New Life Agency announces a powerful three-way partnership designed to deliver substantial savings on today’s expensive fertility medications. [Read more…]

While Middle American men and women share similar feelings of financial security, women are more likely to worry about their personal finances and with good reason: they are three times more likely to say they cannot afford to save for retirement, according to a new study from Massachusetts Mutual Life Insurance Co. (MassMutual). [Read more…]

While a narrow majority of 1,033 physicians surveyed by Merritt Hawkins strongly (42%) or somewhat (14%) support a “single payer healthcare system” in the U.S., more than 90% of 1,208 persons responding to an internet survey by the Association of American Physicians and Surgeons said they were opposed. [Read more…]

Hurricane Harvey has struck a significant blow to the Houston, Texas metro area, home to the sixth largest import terminal in the world, as well as all of the shipping lanes in the Gulf Coast area. Given the strong economic linkages between the gulf coast and the country as a whole, Harvey is a disaster that will impact the U.S. economy far beyond that of the gulf coast. [Read more…]

As Hurricane Irma heads toward Florida, residents are preparing for its impact. Anxiety is running high for many in the path of this very strong storm. [Read more…]

Unaffordable medical expenses are often the first consequence when a critical illness such as cancer or heart disease strikes, so FTLife has responded by launching the MediSave Medical Account. This helps customers prepare for the possibility that serious illness could strike a breadwinner, or other family member, at any time. [Read more…]

The Corporate Whistleblower Center says, “We are urging a medical doctor, a nurse or a manager at a nursing home, skilled nursing facility, a rehab center, a dialysis center or a company providing hospice services to call us anytime at 866-714-6466 if they can prove their employer is involved in significant Medicare overbilling. One of our top targets are healthcare companies that are gouging Medicare with unnecessary medical procedures, or medical treatments that never took place. Recently a small group of whistleblowers with this exact type of information received a $3.6-million-dollar reward.”

http://CorporateWhistleblower.Com

According to the Corporate Whistleblower Center, “We are convinced there probably a more than a few people in every state that could be millionaires based on their inside information about Medicare fraud and healthcare companies ripping off the federal government. If you possess this type of information please call us at 866-714-6466. Why sit on a winning lotto ticket without ever knowing what it could be worth?”

Rise People, a new digital HR and group health insurance platform, has announced that Brigitte Parent, formerly SVP of Group Benefits at Sun Life Financial Canada, has joined its advisory board.<--more-->

Parent, named one of Canada’s Top 100 Most Powerful Women by the Women’s Executive Network, brings extensive strategic group and individual insurance experience to Rise.

Having joined Sun Life in 1995, Parent has extensive experience as a senior leader for both its Canadian and global businesses. Most recently, she served as Senior Vice-President of Group Benefits. Parent was also Senior Vice-President of Individual Insurance and Wealth for Canada where she was responsible for the manufacturing and distribution of insurance and wealth management products and solutions.

In 2015, Parent was recognized as one of Canada’s Top 100 Most Powerful Women by The Women’s Executive Network, where she received the RBC Champions Award to recognize the difference she has made in helping advance women in the Canadian workplace.

KEPRO announced today that the Division of TennCare, the state of Tennessee’s Medicaid program, has awarded the contract for the management of its toll-free call center to support TennCare members to KEPRO.

KEPRO will manage the toll-free call center that allows TennCare’s members to file medical issues or appeals by phone. The call center currently receives an average of 2,500 calls per week.

The registered nurses of Berkshire Medical Center, represented by the Massachusetts Nurses Association, have filed an unfair labor practice charge with the National Labor Relations Board against BMC citing management’s months long refusal to provide information necessary to negotiate over health insurance, which is a mandatory subject of bargaining under federal labor law. [Read more…]

Today, ISMIE Mutual Insurance Company and ISMIE Indemnity announced entry into Pennsylvania. The companies will offer occurrence and claims made medical liability coverage for individual health professionals, groups and health care facilities. [Read more…]

The American Council of the Blind commends U.S. Representatives Gus Bilirakis (R-FL) and Anna Eshoo (D-CA) on the introduction of H.R. 3457, which calls for the Controller General of the United States to investigate the government’s systemic failure to provide materials in accessible formats for recipients of Medicare and Medicaid. [Read more…]

Avella just announced that it has launched a new e-commerce platform designed to streamline ordering compounded preparations. This easy-to-use, secure and intuitive web-based portal gives ophthalmology providers the ability to save payment information and easily order or re-order with customized shipping method. It also provides access to ordering history and invoices at a glance. [Read more…]

Wellthy Therapeutics, a Digital Therapeutics company based out of Mumbai, is one of the five companies selected, and the only Healthcare company to enrol into Swiss Re InsurTech Accelerator programme this year. Wellthy’s artificial intelligence powered mobile intervention focuses on reversing and controlling diabetes through integrated care. Wellthy facilitates behavioural change and enables on demand care to improve health through a clinically proven policyholder centric tool, while reducing risk for health and life insurers. [Read more…]

Springbuk, the leading employer-facing health intelligence platform, continues to show strong growth of its business-to-business software. With the introduction of more than 300 new employer customers in the second quarter, Springbuk now has over 900 employers on the analytics platform. [Read more…]

Sempre Health, the leading solution for behavior-based healthcare pricing, officially launched health plan partnerships today to empower consumers to lower their own medication costs. Sempre works with health plans and pharma manufacturers to dynamically adjust a patient’s co-payment based on individual adherence and behavior, seamlessly at the point of fill. [Read more…]

Missouri Care, Inc., a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), announced today that it has signed an agreement with SSM Health that provides in-network coverage to Missouri Care’s MO HealthNet Managed Care (Medicaid) members. This agreement includes access to academic medical centers, community hospitals, physicians, urgent care centers, ambulatory care centers and other services and facilities owned by or affiliated with SSM Health. [Read more…]

A young Ohio father and his baby boy who battled brain cancer at the same time are among the 22 million Americans at risk of losing health insurance if a bill being considered by the United States Senate becomes law. The family is featured in a new video released today urging lawmakers to vote no. [Read more…]

A comprehensive program announced today by pharmacy benefit manager Prime Therapeutics LLC (Prime), which serves 14 Blue Cross and Blue Shield plans nationally, identifies members who are at risk of controlled substance misuse and gets them into programs that can help reduce their risk. Prime’s “Controlled Substance Management Program” combines existing and new offerings into a multi-layered program to help address the national epidemic. [Read more…]

Last year the U.S. Department of Health & Human Services issued a report about Americans’ concerns and actions related to long-term care (LTC), also referred to as long-term services and supports (LTSS). [Read more…]

Johnson & Johnson (NYSE: JNJ) today announced sales of $18.8 billion for the second quarter of 2017, an increase of 1.9% as compared to the second quarter of 2016. Operational sales results increased 2.9% and the negative impact of currency was 1.0%. Domestic sales increased 1.6%. International sales increased 2.3%, reflecting operational growth of 4.4% and a negative currency impact of 2.1%. Excluding the net impact of acquisitions and divestitures, on an operational basis, worldwide sales increased 0.5%, domestic sales decreased 1.0% and international sales increased 2.0%.* [Read more…]

The American College of Emergency Physicians (ACEP) has issued a statement deeply critical of the draft health care legislation introduced yesterday in the Senate, known as the Better Care Reconciliation Act, or BCRA. ACEP’s president, Dr. Rebecca Parker, said: [Read more…]

The American Diabetes Association has grave concerns about the impact the draft Senate health care bill will have on people with diabetes. Individuals with diabetes need access to continuous health care to effectively manage their disease and to prevent dangerous and costly complications. The proposed legislation could significantly limit access to care and yield increased costs for people with diabetes, and particularly for older Americans, who are at greater risk for diabetes. The bill also does not guarantee comprehensive coverage. [Read more…]

MENOMONEE FALLS, Wisc., June 2, 2017 /PRNewswire/ — The accolades continue to accrue for SKYGEN USA. The company, which is dedicated to transforming the delivery of health benefits through innovative, technology-enabled solutions that drive down the cost of care while ensuring healthier outcomes for all Americans, announced today that it has been ranked number 86 on the prestigious 2017 Healthcare Informatics (HCI) 100 list. [Read more…]

SACRAMENTO, Calif., June 2, 2017 /PRNewswire/ — CAHU is dismayed that the California State Senate saw fit to pass the $400 billion per year tax plan to pay for universal single payer legislation, SB 562 (Lara/Atkins). [Read more…]

American Well announced today that its clinical partner, Online Care Group, is open and available for telehealth visits in Texas, following the historic signing of Bill SB107 into law by Governor Abbott on May 27. This bill embraces telehealth, holding medical professionals using telehealth to the same standard of care as those in a traditional medical practice and paving the way for more expansive use of high-quality telehealth services. [Read more…]

TORONTO, May 16, 2017 /CNW/ – Alternate Health Corp. (CSE:AHG, OTC:AHGIF), a diverse healthcare company revolutionizing patient care and research through compliance and technology in the emerging medical cannabis industry, announced today the completion of its initial study to demonstrate the effectiveness of cannabinoid in treating chronic post-Zika virus symptoms. [Read more…]

Milliman, Inc., a premier global consulting and actuarial firm, has released the 2017 Milliman Medical Index (MMI), which measures the cost of healthcare for a typical American family of four receiving coverage from an employer-sponsored preferred provider plan (PPO). In 2017, costs for this family will increase by 4.3%—which marks the lowest rate of increase in the history of this study—though the total dollar increase of $1,118 is consistent with the last decade of healthcare cost increases. [Read more…]

More Americans now have health insurance than ever before, but that doesn’t mean there are fewer gaps in the screening, monitoring, and management of healthcare and chronic disease. Most health plan members believe their plan’s communications are impersonal and centered around bills rather than healthcare guidance. The majority of members are either disconnected from or rarely visit their health plans on social media and member portals. Additionally, many members feel they are missing valuable support from their plans around digital health data and price transparency. The findings are based on a survey of 750 insured consumers who have sponsored health insurance. The results are now available in the 2017 HealthMine Health Intelligence Report: Communication and Digital Healthcare Tools. [Read more…]

EPIC Insurance Brokers & Consultants, a retail property, casualty insurance brokerage and employee benefits consultant, announced today that Reba Mathew Pharm.D., R.Ph has joined the firm’s Employee Benefits Consulting Practice as Pharmacy Practice Director. [Read more…]

The growing global market presence of SCIO Health Analytics™ is featured in healthcare technology consulting firm Signify Research’s most recent market report, “Population Health Management IT – North America – 2017.” [Read more…]

Aflac will partner with Tough Mudder Inc., the leading active lifestyle brand and media company, as the “Official Supplemental Insurance Provider” for Tough Mudder’s 2017 events season. The partnership includes the introduction of the Aflac Small Business Challenge designed for teams participating in Tough Mudder events on behalf of small businesses. [Read more…]

xG Health Solutions, powered by Geisinger®, and Casenet, through a strategic alliance, will deliver evidence-based assessment and care plan content to the health plan market. Through this partnership, xG’s Intelligent Care Management™ evidence-based content will be available in Casenet’s TruCare GuidedCare product. The clinical content is based on nationally-recognized practice guidelines and standards of care, including assessments and care plans for 45 conditions that are most commonly addressed in care management programs. [Read more…]

DaVita Inc. (NYSE: DVA), a leading independent medical group and a leading global provider of kidney care services has been certified as a “Freedom-Centered Workplace” by WorldBlu. This is the tenth consecutive year the company has been recognized on the list, formerly known as “most democratic” workplaces.

Organizations become eligible for a spot on the WorldBlu List of Most Freedom-Centered Workplaces™ after teammates complete The WorldBlu Freedom at Work™ Assessment, a survey evaluating their practice of the WorldBlu 10 Principles of Organizational Democracy™. The assessment was developed based on a decade of research into what makes a successful freedom-centered company. Organizations from the for-profit and non-profit sectors that have been in operation for at least one full year and have five or more employees can apply for the certification.

WellCare of New York, Inc., a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), has signed an agreement with Catholic Health and Catholic Medical Partners, an independent practice association (IPA) that provides in-network coverage to WellCare’s Medicare Advantage, Medicaid and Child Health Plus members. [Read more…]

ProgenyHealth, the only national company focused exclusively on neonatal intensive care unit (NICU) case management, has entered into an agreement with Family Health Network to manage the unique healthcare needs of their premature and medically complex newborn population. ProgenyHealth will provide comprehensive NICU care management services to their Medicaid members for the first year of life. [Read more…]

Minnesota health insurers reported $687 million in operating losses for 2016, according to information released today by the Minnesota Council of Health Plans. Medical reserves were tapped to pay for doctor visits, nursing, hospital stays, medications and other care.

Overall, revenue from premiums increased 4 percent over the prior year to nearly $25.9 billion, while expenses increased 6 percent to $26.6 billion. State public programs accounted for more than half of the overall red ink, followed by continued losses in the individual market. Insurance employers provide remained steady. On average, health insurers paid $763 per second for care. To pay those bills, insurers withdrew nearly $560 million from state-mandated medical reserves.

Sirius International Insurance Group, Ltd. has acquired ArmadaCorp Capital, LLC., a market leading provider of supplemental healthcare insurance products and administration services in the United States. [Read more…]

The Texas Association of Freestanding Emergency Centers (TAFEC) supports legislation introduced in the Texas Legislature aimed at increasing oversight of health insurance companies and protecting consumers from surprise medical costs. [Read more…]

More than half of commercially-insured patients’ out-of-pocket spending for brand medicines is based on the full list price, according to a new analysis from Amundsen Consulting, a division of QuintilesIMS. The data also show cost -sharing for nearly one in five brand prescriptions is based on the list price. [Read more…]

The Pharmaceutical Care Management Association (PCMA) today released the following points regarding a new PhRMA report on patient out-of-pocket spending:

— According to the Centers for Medicare and Medicaid Services (CMS), the average amount spent out-of-pocket for drugs continues to decline, projected to be 13% of drug spending in 2016, down from 23% in 2006.

— Rising drug costs is a pricing problem, not a coverage problem. Health plans don’t have unlimited funds to pay first dollar coverage on every drug, regardless of its price.

— The simplest, most obvious way for drugmakers to reduce costs and improve access is to cut their prices.

— The report ignores the most obvious and important point: rising out-of-pocket costs are a by-product of rising drug prices and the wave of new high-priced specialty brands coming to market.

— While not all health plans apply manufacturer rebates to reduce cost-sharing on each drug, it’s usually because the savings are being used to reduce premiums.

— Higher cost-sharing on certain brand drugs is often used to promote less expensive but equally effective generics, which comprise almost 90% of prescriptions.

— The employers and unions that offer coverage know better than the drug industry what’s best for their patient populations. Whether health plans decide to reduce costs by reducing premiums for all or cost-sharing on certain drugs should be up to them – not drugmakers.

PCMA is the national association representing America’s pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.

SOURCE Pharmaceutical Care Management Association

WellCare Health Plans, Inc. (NYSE: WCG) today announced that it will release its financial results for the first quarter of 2017 on Wednesday, May 3, 2017, at approximately 6:00 a.m. EDT. The company will also host a conference call at 8:00 a.m. EDT that morning to discuss its financial results. [Read more…]

DW Healthcare Partners, a private equity firm focused exclusively on the healthcare industry, announced today the closing of its fourth fund totaling USD $295 million in total capital commitments. This brings DW Healthcare Partners’ total capital under management to USD $800 million. [Read more…]

Symbility Solutions Inc. (“Symbility”) (TSX.V: SY), a global software company focused on modernizing the insurance industry, confirmed that it will release its fourth quarter and full year 2016 financial results before market open Tuesday, April 11, 2017. The press release, with accompanying financial information, will be posted on the Symbility’s website at www.symbilitysolutions.com and on www.sedar.com [Read more…]

ASPiRA Labs, a Vermillion company (NASDAQ: VRML), today announced it has signed an in-network, contracted agreement with TriCare South for ASPiRA’s U.S. FDA cleared, Centers for Medicare and Medicaid Services (CMS) covered, American College of Obstetricians and Gynecologists (ACOG) Level B recommended ovarian cancer risk assessment test, OVA1® (Multivariate Index Assay or MIA). TriCare South serves about 2.5 million beneficiaries in the states of Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee, Texas (excluding El Paso) and Fort Campbell, Kentucky. [Read more…]

Combined Insurance, a leading provider of individual supplemental accident, disability, health, and life insurance products, and a Chubb company, demonstrates its continued commitment to giving back to U.S. servicemen and women with a $30,000 donation to Luke’s Wings—recipient of the company’s philanthropic sales program for the third consecutive year. [Read more…]

It is that time of year when offers of university places start to drop into electronic mailboxes around the world. Higher education is big business now, places at UK universities are some of the most sought after in the world. These institutions will often charge overseas student annual fees of well over £25,000, so for the parents, ensuring the success of the academic investment is as significant as it is for a company sending key employees abroad. [Read more…]

Recondo Technology, the market leader in cloud-based single-platform revenue cycle management (RCM) solutions, has released a suite of application programming interfaces (APIs) to significantly streamline payment, improve patient satisfaction, and simplify technology innovation. [Read more…]

Centene Corporation (NYSE: CNC) has appointed former Missouri Attorney General Chris Koster to Senior Vice President, Corporate Services effective today. Mr. Koster will report directly to Chairman, President and CEO Michael F. Neidorff, and will assist in business-related issues, outside of Government Relations, for Centene’s locally-based health plans across the country. [Read more…]

Talix, Inc., a premier provider of risk analytics solutions for value-based care, today announced that Shahyan Currimbhoy, senior vice president of product management and engineering at Talix, and Karena Weikel, ASA, FAHM, CSFS, vice president of risk and revenue management at Geisinger Health Plan (GHP), will be presenting at the 2017 RISE Nashville Summit. The summit takes place March 6-8, 2017 at the Omni Nashville Hotel in Nashville, Tenn. [Read more…]

Don’t repeal the Affordable Care Act (ACA) without specifying what will replace it. This is among the policy recommendations issued by the National Alliance of Healthcare Purchaser Coalitions (National Alliance), a nonprofit, membership association of employer led coalitions across the country serving 12,000 purchasers and 41 million Americans.

Additional recommendations include:

— Preserve employer-sponsored coverage by refraining from capping the individual tax exclusion for premiums and continue to allow businesses to fully deduct the costs.

— Avoid increasing the number of uninsured individuals, as the cost of their inevitable medical care will get shifted to those who do pay the bills.

— Continue to move away from fee-for-service (or “volume-based reimbursement”) toward alternative payment models that reward providers for good outcomes and high quality, not medical errors, unnecessary procedures and other low value care. Preserve the ability of the federal government to partner in these efforts (Center for Medicare & Medicaid Innovation and other value-promoting elements of the ACA, and the Medicare Access and CHIP Reauthorization Act of 2015).

— Expand assistance to states, regions, and local communities promoting transparency by pushing hospitals and medical groups to report on the quality of care they provide.

— Support comparative effectiveness research. Employer-purchasers need to know which new or higher cost therapies result in outcomes that are significantly better, somewhat better, about the same, or worse than current or less costly options.

— Allow employer-purchasers maximum flexibility in experimenting with benefit designs.

A Purchaser Viewpoint on Health Policy in Transit is the result of a collaboration of the National Alliance’s Government Affairs Affinity Group led by members including the Louisiana Business Group on Health, Midwest Business Group on Health, Minnesota Health Action Group, Pacific Business Group on Health, and Wyoming Business Coalition on Health.

In three new issue briefs, the American Academy of Actuaries examines a number of key public policy considerations that policymakers should weigh when evaluating specific proposals for reforming or replacing the Affordable Care Act. Developed by the Academy’s Individual and Small Group Markets Committee, the papers address high-risk pools, selling health insurance across state lines, and association health plans. [Read more…]

America’s leading nursing organizations and the over 3.5 million nurses they represent, today called on the Trump Administration and Congress to prioritize patient health and the patient-provider relationship in any health reform proposals. [Read more…]

Consumers are just beginning to discover that Anthem eliminated coverage for out-of-network doctors now that the Affordable Care Act “Open Enrollment Period” to secure health coverage for 2017 ended on January 31. [Read more…]

Aflac, the leader in voluntary insurance sales at the worksite in the United States, is making it even easier for customers to access much-needed financial support while they are in the hospital. [Read more…]

Employer-sponsored health insurance is greatly affected by geographic region, industry, and employer size. While some cost trends have been fairly consistent since the Patient Protection and Affordable Care Act (ACA) was put in place, United Benefit Advisors (UBA) finds several surprises in their 2016 Health Plan Survey. [Read more…]

Secretary of Health Dr. Karen Murphy is urging the commonwealth’s U.S. Congressional delegation to consider the effect that repealing the Affordable Care Act (ACA) could have on all Pennsylvanians, especially children and seniors in need. [Read more…]

Discern Health has announced their affiliation with Mai Pham, MD, MPH as a Senior Advisor. Mai most recently served as Chief Innovation Officer at the Centers for Medicare & Medicaid Innovation (CMMI). Among other achievements at CMMI, Mai spearheaded development and implementation of the alternative payment model (APM) portion of MACRA, which will fundamentally change the way that Medicare pays for physician services. [Read more…]

International Medical Group® (IMG®), a leader in global benefits and assistance services, has named Craig Peters as chief revenue officer (CRO). [Read more…]

Hospitals and health systems in New Jersey have already absorbed nearly $1.5 billion in funding cuts since the Affordable Care Act was enacted in 2010, with the promise of expanded healthcare coverage to mitigate these losses. As the 115th Congress advances legislation to repeal major provisions of the ACA, healthcare providers are concerned the cuts will remain despite the coverage of 796,291 state residents being jeopardized. [Read more…]

The President and CEO of the Senior Care Pharmacy Coalition (SCPC) today predicted the increasingly apparent role of Pharmacy Benefit Managers (PBMs) as unaccountable middlemen in the national drug pricing chain will result in a higher level of scrutiny from Congress, regulators and the media in 2017. [Read more…]

The Permanente Medical Groups serving Kaiser Permanente members and patients across California received 5-star ratings for overall performance — the highest recognition possible by the California Office of the Patient Advocate — in the second annual Medical Group Report Card for Medicare Advantage Members. [Read more…]

Insurance Commissioner Teresa Miller today reminded Pennsylvania consumers that the open enrollment period for 2017 health insurance coverage available through the federal marketplace at www.Healthcare.gov closes at 11:59 p.m. on January 31. More than 413,000 Pennsylvanians are currently enrolled in plans for 2017. [Read more…]

To help people affected by breast cancer understand and prepare for changes to healthcare insurance policies that might affect them, Living Beyond Breast Cancer (LBBC) has created a Healthcare Newsroom on LBBC.ORG. [Read more…]

Milliman, Inc., the premier global consulting and actuarial firm, has published six questions for consideration by healthcare stakeholders about the Trump Administration’s recent executive order, which gives a sweeping command to the leaders of the new administration to unwind certain aspects of the Patient Protection and Affordable Care Act (ACA)—especially those components deemed “burdensome.” It remains unclear how the Trump Administration will implement this authority, especially due to the interconnected nature of the ACA, but given Milliman’s comprehension of the law, several key questions arise. [Read more…]

MailMyPrescriptions.com has entered into an agreement with Alliance HealthCard of Florida, Inc. Alliance HealthCard of Florida, Inc., a division of Aon Benefit Solutions, Inc., an Aon subsidiary (NYSE: AON), will make mailmyprescriptions.com available to America’s Health Care Plan/RX Plan Agency, Inc. (AHCP) owned by National General Insurance Company (NASDAQ: NGHC). [Read more…]

Alere Inc. (NYSE: ALR), a global leader in rapid diagnostic tests, has provided an update on the decision by the Centers for Medicare & Medicaid Services (CMS) to revoke Arriva Medical’s Medicare billing privileges. [Read more…]

ReWalk Robotics Ltd. (Nasdaq: RWLK) (“ReWalk”), the leading global exoskeleton developer and manufacturer, announced today the donation of a ReWalk Personal 6.0 System to Daniel Timms, who sustained a spinal cord injury (SCI) in 2012 in a parachuting accident. Thanks to a number of generous donors, Walkabout Foundation, a London-based not-for-profit organization that donates wheelchairs to disadvantaged individuals worldwide and supports critical research in paralysis, was able to provide the device for Mr. Timms. [Read more…]

WellCare Health Plans, Inc. (NYSE: WCG) has signed a definitive agreement to acquire certain assets, including Medicaid membership and certain provider contracts, from Phoenix Health Plan (PHP), a wholly owned managed care subsidiary of Tenet Healthcare. PHP provides health benefits primarily to more than 50,000 Medicaid beneficiaries as of Dec. 1, 2016 in Maricopa County, Arizona, the state’s largest geographic service area. [Read more…]

Harmony Health Plan, Inc., a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), gave $10,000 to Kidz Korna to help make the holidays special for thousands of children living in Chicago’s low-income communities, such as Englewood, Bronzeville, Roseland and the Westside. [Read more…]

Chubb today announced that Graham Lambourne, currently Global Clients Claims Manager, Europe has been promoted to the role of Head of Multinational Claims for Overseas General Insurance. [Read more…]

Finding a replacement for Obamacare that their colleagues will support may prove to be an impossible task for Republicans on Capitol Hill, says a health economist familiar with the obstacles involved. [Read more…]

Apollo Medical Holdings, Inc. (“ApolloMed” or “the Company”) (OTC: AMEH), an integrated population health management company, and Network Medical Management, Inc. (“NMM”), one of the largest healthcare Management Services Organizations (MSOs) in the United States, have announced that they have signed a definitive merger agreement pursuant to which the companies will combine in a stock-for-stock merger transaction. [Read more…]

Holiday stress can be a pain in the neck…and the teeth, warns Delta Dental. If too much family time or the mad dash for last minute gifts causes you to grind or clench your teeth, be aware that it can cause your teeth to ache, wear down, become loose or even crack. Headaches, pain or soreness of your neck and jaw muscles, and clicking, popping and pain in your jaw joints are also possible side effects. [Read more…]

Medicare’s star ratings of hospitals fail to provide the public with an easy comparison of the quality of inpatient care provided. An analysis by J. Graham Atkinson, D.Phil., Jayne Koskinas Ted Giovanis Foundation for Health and Policy (JKTG) executive vice president for research and policy reveals the biases inherent in the rating system along with conceptual problems in the design of the method used to combine individual quality scores. [Read more…]

NextHealth Technologies Inc., a prescriptive analytics and consumer engagement platform that measurably reduces medical costs for health plans, announced that David H. Klein has joined its board. As a CEO with over 30 years of experience managing health plans and delivery systems, Mr. Klein brings extensive experience in strategy, operations and policy. [Read more…]

WellCare Health Plans, Inc. (NYSE: WCG) announced that its employees are giving back to the Tampa Bay community this holiday season by volunteering with Tampa-based, social-service agency Metropolitan Ministries, which provides life-changing support to those who are homeless and at risk of becoming homeless by assisting them with food, clothing, shelter and other vital services. [Read more…]

Emerge, an online platform that reimagines how consumers purchase emergency insurance, has announced that its site is live and ready to educate individuals and help them avoid the risk of medical debt. [Read more…]

Veterans Deserve Care, a grassroots coalition committed to reducing wait times in VA facilities, applauded a decision by the U.S. Department of Veterans Affairs (VA) to finalize a rule allowing veterans to receive high-quality care by providing direct access to nurse practitioners. [Read more…]

The City of Fort Worth (the “City”) is pleased to announce the expansion of its member healthcare coverage offering starting January 2017 through Employer Direct Healthcare’s SurgeryPlus®, a supplemental benefit for non-emergent surgeries that provides higher quality care, a better experience and lower costs. [Read more…]

The Pennsylvania Medical Cannabis Industry Group (“PAMCIG”) has partnered with Next Wave Insurance Services, LLC (“Next Wave”), which is backed by top rated insurance and reinsurance carrier partners providing comprehensive insurance coverage nationwide. The partnership between the largest marijuana trade association in the state and the leading provider of property and casualty insurance will bring a valuable solution to the potential applicants for Pennsylvania’s medical marijuana industry. [Read more…]

GetInsured, a market leader in individual health insurance ecommerce, announced recently that it has acquired Array Health, a leading provider of group health insurance ecommerce technology. Together, the companies will make it possible for insurers, employers, state governments and benefits brokers to deliver a superior consumer experience through a single, scalable ecommerce solution that supports group, individual and Medicare health enrollment. [Read more…]

The U.S. business group of Sun Life Financial has released a study titled “Voluntary Benefits: An Unknown but Needed Option,” illustrating that due to health care costs continuing to rise, American workers need to adequately understand what voluntary benefits are. [Read more…]

AMSUS, The Society of Federal Health Professionals, announced the creation of a new board, the Executive Advisory Board (EAB), during its Annual Meeting in Maryland recently. [Read more…]

The Partnership for Quality Home Healthcare — a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation’s seniors – recently urged Congress to pass the Pre-Claim Undermines Seniors’ Health (PUSH) Act of 2016 to provide more time for implementing a Medicare home health pre-claim review policy to ensure Medicare and home health agencies are prepared to manage the process and maintain continuity of care for home health beneficiaries. [Read more…]

Research shows old age is seen as a problem, worries about healthcare and social services and people not prioritising or doing enough to prepare for their own retirement. Research conducted by Chase de Vere, the national firm of independent financial advisers, paints a depressing picture of increasing longevity in the UK. [Read more…]

FAIR Health’s consumer website marked another year as the preeminent site for consumers to access accurate, actionable healthcare cost estimates and health insurance information. In a time of flux in healthcare policy at the federal and state levels, the site continues to serve as a lighthouse to consumers at sea among high-deductible health plans, narrow networks and other potentially confusing aspects of the healthcare marketplace. To that end, FAIR Health offers five tips for consumers below. [Read more…]

International Medical Group® (IMG®), a leader in global benefits and assistance services, recently announced the company’s new corporate branding and logo. [Read more…]

The annual enrollment period for Medicare ends next week for most Medicare beneficiaries. For the first time, Magnolia Health, is offering a Medicare Advantage HMO, available to anyone eligible for Medicare and living in the following counties in Mississippi: George, Harrison, Hinds, Jackson, Madison, Rankin and Stone. [Read more…]

Former Walmart associate Jacqueline Cote and her lawyers filed a motion today asking the U.S. District Court for the District of Massachusetts to grant preliminary approval of a class action settlement in Cote’s action that challenged Walmart’s lack of health insurance benefits for same-sex spouses of Walmart associates prior to 2014. [Read more…]

Sovereign Health, a leading national provider of behavioral health treatment services, has announced the seventh installment of the “Beyond NIMBY” series, a second series that addresses the strong community opposition to recovery-oriented housing and addiction treatment services for persons with substance use disorders in residential neighborhoods — often referred to as “not in my backyard.” [Read more…]

UPMC Health Plan Service and Sales Associates are now available to answer individual’s health insurance questions and meet your health care coverage needs at a new Monroeville Mall store. The grand opening celebration was today, Saturday, Nov. 5, 2016 from 10 a.m. to 3 p.m. [Read more…]