The U.S. Office of Inspector General found Wisconsin's Medicaid program erroneously paid capitation payments totaling $589,478 for patients who had already died, according to the Milwaukee Journal Sentinel.
Payer
CMS was ordered to pay Montana Health Co-op more than $1.2 million after a federal court ruled the agency must make cost-sharing payments to the insurer despite Congress providing no funding, according to an Oct. 5 final order.
Financial data for the first half of 2018 show that health insurers selling policies on the ACA exchanges are returning to profitability, according to an Oct. 5 brief published by the Kaiser Family Foundation.
A state-brokered consent decree between Pittsburgh rivals Highmark Health and UPMC expires June 30, 2019. After that date, Highmark Medicare Advantage members will be unable to access several UPMC providers and hospitals at in-network rates.
Immigrants paid 12.6 percent of premiums to private health insurers in 2014 but represented only 9.1 percent of the health insurers' expenses, according to a study published in the October issue of Health Affairs.
Advertisement
HHS' final rule on short-term health plans went into effect Oct. 2.
About 11,000 patients could lose access to OhioHealth due to a contractual issue between the Columbus-based health system and Anthem Blue Cross and Blue Shield's Medicare Advantage plan, according to The Columbus Dispatch.
Hartford (Conn.) HealthCare has reached a three-year network agreement with Cigna for the system's six hospitals, effective Nov. 1, according to the Hartford Courant.
Savannah, Ga.-based Memorial Health University Medical Center has renewed its network agreement with Anthem Blue Cross and Blue Shield of Georgia, according to the Savannah Morning News.
Aetna will remain in Hartford, Conn., for at least a decade after it is acquired by CVS Health, the pharmacy benefits manager told Connecticut insurance regulators Oct. 3, according to the Hartford Courant.