Payer

Medicare fraud fugitive hides in Cuba, returns to Miami voluntarily

After he stole $2.8 million in taxpayer funded Medicare payments, Sandy De La Fe fled to Matanzas, Cuba, where he hid for two years. But last week, the former pharmacy owner voluntarily returned to U.S. shores and turned himself in,…

HCA Holdings: ACA open enrollment is encouraging thus far

Although numerous insurers have said they're losing money on the exchanges, the CEO of Nashville, Tenn.-based HCA Holdings — the largest U.S. for-profit hospital chain — said he is happy with this year's ACA open enrollment season, according to Reuters.

Independence Blue Cross first payer to cover whole genome sequencing

Independent Blue Cross and Culver City, Calif.-based NantHealth have agreed to provide insurance coverage for a comprehensive whole genome and proteome diagnostic platform to diagnose molecular differences in an individual's cancer and identify personalized therapies.

15 state attorneys general join DOJ's probe of health insurer mergers

Attorneys general from approximately 15 states are working with the Department of Justice in its review of Aetna's $54.2 billion bid for Humana and Anthem's $37 billion plan to buy Cigna, according to Reuters.

BCBS, Ohio Independent Collaborative ink patient-centered care agreement to lower costs

Anthem Blue Cross and Blue Shield of Ohio and the Ohio Independent Collaborative will launch a patient-centered care plan for Anthem Medicare Advantage members, designed to lower the cost of healthcare while improving overall quality.

BCBS of NC: fixes, refunds to come to 25k customers this week

Thousands of Blue Cross Blue Shield customers in North Carolina can expect refunds this week as it scrambles to fix what company officials are calling the most serious system failure in recent decades, according to the Charlotte Observer.

Humana hits financial trouble with ACA enrollment

As open enrollment draws to a close at the end of this month, Louisville, Ky.-based Humana said it likely won't collect enough money to cover the cost of individual plans, according to Crain's Detroit Business.

Cigna, Aetna hired total of 8 external lobbying groups despite Aetna's departure from AHIP

Together, health insurers Aetna and Cigna spent over $1.3 million on outside lobbyists last year, according to The CT Mirror.

Special enrollment sessions drive up premiums, insurers say

The Obama administration has offered millions of people the chance to sign up for health plans after the enrollment deadlines over the last two years, a move that insurance companies say has destabilized the markets and raised premiums, according to…

ThedaCare, Network Health part ways

Network Health Plan members will pay out-of-pocket costs at ThedaCare hospitals after the organizations failed to reach a contract extension, according to WBAY.