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Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.
Evidence
All the proof that payors are putting wealth over health.
Insurers in Massachusetts sued for hawking misleading plans
We recently covered how UnitedHealthcare’s short-term health plan Golden Rule was able to shirk responsibility for covering a man’s cancer treatment. Now, Massachusetts Attorney General Maura Healey is suing three health insurance… Read More
Unanimous Supreme Court decision is a blow to PBMs and the insurers that own them
In 2015, Arkansas passed a law prohibiting pharmacy benefits managers (PBMs) from reimbursing pharmacies less than what it cost to acquire a drug. The law was challenged by the PBM lobbying group… Read More
Six health insurance executives to keep an eye on in 2021
The COVID-19 pandemic has forced many industries to pivot. The entertainment industry has taken to Zoom and other virtual formats to continue providing “live” shows. The restaurant industry has shifted to takeout,… Read More
Survey indicates COVID-19 pandemic adding to insurance cost burdens
A new survey from The Commonwealth Fund (reported on in Healthcare Dive) brings more bad news from the ongoing COVID-19 pandemic. The survey confirms what we already knew—that insurance premiums and deductibles… Read More
CVS and Aetna tighten their grip on market choice with this new plan
As we eagerly stumble into 2021, let’s take a quick look back to 2019 for a moment: CVS closed on a mega-merger deal with Aetna designed to give Aetna members access to… Read More
The five most important things to know about hospital financial losses amid the COVID-19 pandemic
Earlier this month, we covered a Becker’s Hospital Review article about the more than 30 hospitals forced to file for bankruptcy this year and described the factors that could put hospitals in… Read More
This is how much revenue United projects for 2021. Spoiler: it’s a lot
It’s been well documented that insurers have profited from a drop in care utilization during the pandemic, while providers experienced a sharp drop in revenue with many elective procedures being postponed or… Read More
Public opposition to new lab coding policy pushes UnitedHealthcare to hit pause
Back in November, we covered a Health Leaders story about a new lab coding requirement UnitedHealthcare planned to implement in early 2021, smack in the middle of cold and flu season and… Read More
Here’s what members and employers need to get more from the health insurance industry
Health insurance has always been a highly valued employee benefit, and now in the midst of the COVID-19 pandemic, it is even more true. Access to healthcare, including access to health insurance… Read More
UnitedHealthcare squeezes Gaston County’s only hospital during worst pandemic months
Residents of Gaston County with UnitedHealthcare insurance are expected to face higher costs at Gaston County’s only hospital, CaroMont Regional Medical Center. This is due to UnitedHealthcare terminating their CaroMont Health contract.… Read More
Non-profit to for-profit? NJ’s largest insurer seeks corporate restructure
New Jersey’s largest health insurance company, Horizon, says that a corporate restructuring will allow it to better invest in technology, build partnerships, and cut costs of care. Patient advocates say it’s an… Read More
Over 30 hospitals have been forced to file for bankruptcy this year
2020: the year COVID-19 flipped the world upside down. COVID-19 continues to have a disproportionately detrimental impact on the healthcare industry, as pre-COVID-19 many hospitals were already struggling. Even before the global… Read More
New research shows just how hard it is for consumers to understand their insurance options
It’s open enrollment season again, which means that employees across the country are assessing the insurance options offered by their employers and trying to understand which plan will offer the most value… Read More
Employers give C+ to health plans overall, and even lower grades to United
In summer 2020, nonprofit watchdog The Leapfrog Group surveyed more than 170 employers on their satisfaction with health plans’ responsiveness, transparency, payment reform, and value. When asked to grade their health plan… Read More
The five most important things to know about Cigna’s newly branded health services unit, Evernorth
Recently, we covered an article by HealthcareDive that discussed Optum’s advantage in vertical integration in the health insurance industry. While there is no question that Optum continues to lead the pack, we… Read More
Cigna sued for refusing to cover COVID-19 testing
Life as we knew it completely changed in March, when the country began navigating the new normal of living in a pandemic. The novel coronavirus completely dominated the spring news cycle, and… Read More
UnitedHealthcare ordered to reprocess 67,000 behavioral health claims
Back in October, we shared a Bloomberg article about insurers violating the spirit of the The Mental Health Parity and Addiction Equity Act. At the center of this story was a lawsuit… Read More
Six health insurance CEOs made more than $15 million each in 2019
It’s not uncommon for health insurance executives’ massive annual compensation packages to make the news, and 2019 was no exception. Last year, six health insurance CEOs received an excess of $15 million… Read More
Cigna accused of fraudulently overbilling Medicare Advantage plans
In August, the complaint in a federal whistleblower lawsuit against Cigna was unsealed. In it, Cigna is accused of collecting billions of dollars in overpayments from its HealthSpring Medicare Advantage plans. How… Read More
What if a COVID-19 diagnosis could be used against health plan members?
If the ACA is struck down by the Supreme Court, the protection it provided for people with pre-existing conditions will no longer exist. Insurers will go back to being able to charge… Read More
Colorado’s attorney general takes the unusual step of intervening in a proposed United merger
The 2017 acquisition of DaVita Medical Group by UnitedHealthGroup had impacts across the country, but the strongest opposition to the deal came from the Colorado State Attorney General Phil Weiser, who took… Read More
As virtual doctor’s visits rise in popularity, major health insurers change the rules
Up until COVID-19 hit, utilization of virtual care was extremely low. Most people had never tried telehealth; some weren’t even aware that they could connect with doctors and nurses from their phones… Read More
Humana rides senior population to record quarterly profits
Many articles that call attention to insurers’ huge profits during the pandemic have singled out UnitedHealthcare, but United is not the only payor to see profits rise as a result of delayed… Read More
United piles on more coding to already exhausted and overwhelmed providers
In September, UnitedHealthcare released a plan that will require all in-network freestanding and outpatient lab claims to include a unique code for testing services. This code is in addition to existing standard… Read More