Here are eight Aetna updates Becker’s has reported since Oct. 5.
- Starting in 2025, Aetna will take over a three-year health benefits contract for more than 740,000 North Carolina state employees, public educators, retirees and their dependents, upending a 45-year relationship between the state and Blue Cross and Blue Shield of North Carolina. Becker’s sat down with Jim Bostian, president of Aetna’s Midsouth and Capitol markets, to discuss how his team won out among competitors to administer North Carolina’s state health plan.
- Aetna is expanding its ACA plans to five new states — Indiana, Kansas, Mayland, Ohio and Utah — in 2024.
- CVS Health is planning to lay off an additional 70 employees at Aetna in Connecticut, in addition to a previously announced round of layoffs.
- About 30,000 Aetna beneficiaries are at a risk of losing coverage at Portland-based Oregon Health & Science University if the sides are unable to agree on a new contract by Dec. 31. OHSU has been negotiating with Aetna since January 2022.
- CVS Health delivered on its claims that its Medicare Advantage star ratings would improve for 2024. According to documents filed with the Securities and Exchange Commission, 87% of Aetna’s Medicare Advantage membership will be enrolled in contracts rated at four stars or higher by CMS in 2024, up from 21% in 2023. Aetna’s National PPO plan, which has more than 2 million members, was rated at four stars by CMS for 2024, up from 3.5 stars in 2023.
- An Alaska grand jury indicted a physician and three clinic managers on felony charges over alleged billing fraud against the state’s Medicaid program, Aetna and Premera BCBS of Alaska.
- Phoenix Children’s and Aetna reached a new contract agreement. The agreement is retroactive to Aug. 7, the day after the previous contract expired.
- Aetna received $632,070 in overpayments for Medicare Advantage claims from 2015 to 2016, an audit from HHS’ Office of Inspector General found. The OIG used the audit sample to estimate the insurer received at least $25.5 million in overpayments during the time period.
