Rose Meltzer

CMS’ newest explanation is the latest chapter in a months-long saga that started with a federal court ruling vacating the methodology in February.

The elderly and disabled and those who also qualify for Medicare cost more to cover, but Medicaid may not be covering them in the most cost-effective way.

In a significant move meant to foster competition, allowing Medicare Advantage plans to negotiate Part B drug prices will generate cost savings that they then can pass on to consumers, the agency says.

The insurance association hopes the move will “help consumers create and maintain healthy habits,” despite studies that suggest owning a fitness device will not improve one’s health.

Among rating areas in states with federally facilitated marketplaces, the number of insurers was a more accurate predictor of premiums than enrollee health or provider characteristics.

At conferences, over dinner, via text, and more, the companies colluded to increase the price of drugs for common conditions as much as 8,000%, the insurer’s complaint says.

A year and a half after it was supposed to implement a preauthorization process for chiropractic claims, an industry with a 41.7% improper payment rate, CMS still hasn’t established that process.

Partnering with multiple telemedicine providers gives consumers additional choice, which ties directly into the company’s model, said President and CEO David Cordani.

Three weeks ahead of the vote on their planned merger, the two companies expressed far different levels of enthusiasm for rewarding value over volume.

Enrollment in commercial plans fell below 4 million, but enrollment in Medicare products is on the rise, the company reported Thursday.