Category: Health Insurance

Rite Aid comes out of Chapter 11 bankruptcy

The Rite Aid Corporation said it has successfully completed its financial restructuring and emerged from Chapter 11 bankruptcy, cutting about $2 billion worth of total debt and adding $2.5 billion in exit financing.
The company said it would now have a…

Finance execs are focused on cutting costs through technology

Healthcare finance leaders are increasingly focused on cutting costs, with 38% identifying it as their top priority, according to U.S. Bank’s latest CFO Insights Healthcare Report.
Artificial intelligence has emerged as a critical area of investment, w…

Longtime Head of L.A. Care To Retire After Navigating Major Medi-Cal Changes

John Baackes, who steered Medi-Cal’s largest health plan following the Affordable Care Act expansion, and later prepared it for a state overhaul of Medi-Cal, will retire after this year. Baackes believes low payments to doctors and other providers, along with an acute labor shortage, hamper Medi-Cal’s success.

Large PBMs control 70% of the market, report finds

Newly published data suggests low competition among middling players in the pharmaceutical supply chain, with numbers showing that the four largest pharmacy benefit managers in the country control roughly 70% of the national market.

US Uninsured Rate Was Stable in 2023, Even as States’ Medicaid Purge Began

About 8% of Americans lacked health insurance in 2023, the Census Bureau announced. But its report doesn’t capture the effect of states winnowing their Medicaid rolls by millions of people since the pandemic emergency ended.

Evernorth making Stelara biosimilar available for $0 out-of-pocket

Evernorth Health Services, a subsidiary of Cigna, plans to have a Stelara biosimilar available for $0 out-of-pocket cost for eligible patients of its specialty pharmacy, Accredo, beginning in early 2025.

ACA Enrollment Platforms Suspended Over Alleged Foreign Access to Consumer Data

Federal regulators provided more specifics about why they suspended two private sector Affordable Care Act enrollment sites, including concerns about potential overseas accessing of consumer data and suspicions of involvement in Obamacare enrollment and switching schemes. The companies reject the assertions.

Feds’ final rules address equitable access to mental health benefits

In a push to shore up access to mental health and substance use disorder care, the departments of Labor, Health and Human Services and the Treasury have issued final rules meant to clarify protections and expand equitable access to those benefits.

PBM executives face penalties if their testimony goes uncorrected 

The heads of three large pharmacy benefit managers have until tomorrow to respond to a House Committee or face perjury charges that could result in fines or even prison time, according to the letters sent by House Committee on Oversight and Accountabil…

Elevance subsidiary Wellpoint adding ACA plans in three states

Floridians looking for individual or family health plans will have new options from Elevance Health subsidiary Wellpoint during open enrollment for coverage beginning January 2025.
The company will be debuting new individual marketplace plans in three …