Some private Medicare Advantage plans are offering large physician-management companies more money upfront and control of their patients’ care, but the doctors are responsible for staying within the budget.
Health insurers and pharmacy benefit managers are exploring how two legal provisions — which have been on the books for decades — could bring down the price tags of certain prescription medications.
The state’s third-largest insurer faces anger from customers in the individual market who unexpectedly lost their insurance despite paying premiums faithfully. In its recently filed lawsuit, the company blamed a contractor for “egregious” billing problems.
Many insurers added surcharges to policies they sold to individuals last year to make up for a cut in federal funding. Now, federal officials suggest that states encourage insurers to sell policies without those surcharges outside of the marketplace to help people who don’t get a premium subsidy.