Affordable Care Act

Parents, high school grads have summer homework: finding health insurance

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水曜日, 5月 29, 2024

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While grads are busy contemplating dorm room decor and mini-fridges, they might not realize the importance of a more crucial item: health insurance.

Key Points:

While grads are busy contemplating dorm room decor and mini-fridges, they might not realize the importance of a more crucial item: health insurance.
Most colleges and universities in the United States require their students to have health insurance.
Young adults are allowed to stay covered by a parent’s health insurance plan until the age of 26.
Healthinsurance.org, owned by HealthInsurance.org, LLC, has been providing consumer information about health insurance and health reform for over 25 years.

Manatt Continues to Build National Advisor Team with Addition of Behavioral Health Care Leader

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水曜日, 5月 15, 2024

Manatt, Phelps & Phillips, LLP, a multidisciplinary, integrated professional services firm, today announced the arrival of National Advisor John O’Brien to the Firm’s Health Care industry group.

Key Points:

Manatt, Phelps & Phillips, LLP, a multidisciplinary, integrated professional services firm, today announced the arrival of National Advisor John O’Brien to the Firm’s Health Care industry group.
“Our National Advisors include highly accomplished leaders across health care, government and other industries who all bring significant experience navigating the top business, policy and operational matters confronting our clients,” said Manatt CEO and Managing Partner Donna L. Wilson .
“I have long admired Manatt’s commitment to its clients in improving our health care system, with a focus on equity and access to care,” said O’Brien.
“I couldn’t be more excited to join Manatt as I continue supporting states, health systems and other health care organizations advance high-quality care throughout communities nationwide.”

Liberty HealthShare Enhances Liberty Assist Sharing Program

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木曜日, 5月 9, 2024

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CANTON, Ohio, May 9, 2024 /PRNewswire/ -- Liberty HealthShare®, one of the country's leading Christian healthsharing ministries, today announced that it has enhanced its Liberty Assist sharing program.

Key Points:

CANTON, Ohio, May 9, 2024 /PRNewswire/ -- Liberty HealthShare®, one of the country's leading Christian healthsharing ministries, today announced that it has enhanced its Liberty Assist sharing program.
Liberty HealthShare's Liberty Assist sharing program is now an even greater value for seniors on Medicare.
"With monthly sharing contributions starting at just $87, Liberty Assist is affordable for retirees looking to control their healthcare expenses and enjoy the benefits of being a healthshare member," said Dorsey Morrow, Liberty HealthShare chief executive officer.
The three core Liberty HealthShare sharing programs, Liberty Unite , Liberty Connect , and Liberty Essential , are excellent for singles, couples, and families.

Oscar Health Announces Results for First Quarter 2024

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火曜日, 5月 7, 2024

A member covered under more than one of our health plans counts as a single member for the purposes of this metric.

Key Points:

A member covered under more than one of our health plans counts as a single member for the purposes of this metric.
Oscar will host a conference call to discuss the financial results today, May 7, 2024, at 8:00 a.m. (ET).
A live audio webcast will be available via the Investor Relations page of Oscar’s website at ir.hioscar.com.
New factors emerge from time to time, and it is not possible for us to predict which will arise.

Landmark Ruling in RICO Lawsuit Against Centene Corporation, Alleging the Company Defrauds Consumers through Sale of Its Ambetter Health Insurance Plans

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月曜日, 5月 6, 2024

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CHICAGO, May 6, 2024 /PRNewswire-PRWeb/ -- U.S. District Court Judge Nancy L. Maldonado ruled that Plaintiffs in Havrilla v. Centene Corp. (N.D. Ill.) could proceed on the majority of their claims against Centene Corporation and two of its subsidiaries, Centene Management Company, LLC, and Celtic Insurance Company.

Key Points:

In a landmark ruling, U.S. District Court Judge Nancy L. Maldonado allowed the majority of claims in the RICO lawsuit against Centene Corporation to proceed, asserting that the plaintiffs provided sufficient evidence of a multi-billion-dollar scheme to defraud consumers through Ambetter health insurance plans.
This means that those (primarily low income) consumers who purchase Ambetter health insurance "run into difficulty finding healthcare providers who actually accept the insurance—including providers that are listed on the Ambetter plans' websites and provider directories."
Defendants had moved to dismiss the complaint on grounds of lack of subject-matter jurisdiction and failure to state a claim.
"No company should be allowed to abuse the healthcare system and take advantage of consumers in the way that we believe Centene has.

National Women’s Law Center and Law Firm Emery Celli Brinckerhoff Abady Ward & Maazel, LLP Announce Settlement of Class Action Lawsuit Against Aetna Over LGBTQ+ Fertility Coverage

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金曜日, 5月 3, 2024

v. Aetna , filed in September 2021, the plaintiffs challenged Aetna’s definition of infertility, alleging it led to unequal insurance coverage treatment for LGBTQ+ couples.

Key Points:

v. Aetna , filed in September 2021, the plaintiffs challenged Aetna’s definition of infertility, alleging it led to unequal insurance coverage treatment for LGBTQ+ couples.
Aetna will re-process eligible insurance claims to reimburse class members for their out-of-pocket artificial insemination cycles, up to the plan limits.
Aetna will also separately pay all the costs of the administrator and special master who will allocate the common fund.
If you believe you are in the class of individuals covered by this settlement, please visit this page or contact: 1-800-205-6861.

Petauri™ Announces 2 Key Hires at Petauri Advisors

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月曜日, 4月 29, 2024

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NASHVILLE, Tenn., April 29, 2024 /PRNewswire/ -- Petauri Advisors, a strategic life sciences consulting business unit of Petauri, a leading purpose-built pharmaceutical services platform, announced today that it has added to its executive ranks 2 experienced leaders who bring extensive market access experience and expertise comprising implementation of Medicare Part D, the Affordable Care Act, and brand marketing.

Key Points:

Petauri Advisors has added Gina Valerio and Joe Honcz to its ranks as VP and SVP, respectively.
Given her deep expertise in market access and brand marketing strategy, along with her profound understanding of the evolving healthcare landscape, Gina will be a highly valued partner to Petauri Advisors clients navigating today's market access challenges.
Before joining Petauri, Gina provided strategic market access consultative services to various pharmaceutical and life sciences companies in the San Diego area.
"With their proven track record across the continuum of managed care, Gina and Joe bring valuable and diverse experience to Petauri Advisors," said Steve O'Malley, President, Petauri Advisors.

Whitman-Walker Institute Applauds the Biden-Harris Administration for Finalizing Robust Affordable Care Act Nondiscrimination Protections for LGBTQI+ Communities

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金曜日, 4月 26, 2024

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WASHINGTON, April 26, 2024 /PRNewswire/ -- Today, the Biden-Harris Administration released a final rule under Section 1557, the core nondiscrimination provision of the Affordable Care Act.

Key Points:

WASHINGTON, April 26, 2024 /PRNewswire/ -- Today, the Biden-Harris Administration released a final rule under Section 1557, the core nondiscrimination provision of the Affordable Care Act.
This groundbreaking rule marks a critical step in protecting access to health care and coverage for LGBTQI+ people nationwide.
The new rule restores and expands important protections to ensure everyone can receive the health insurance coverage and health care they need, free from discrimination.
Comment from Whitman-Walker Institute on the finalization of the Section 1557 rule:
"Whitman-Walker Institute applauds the Biden-Harris administration for finalizing the rulemaking under Section 1557 of the Affordable Care Act, which restores critical nondiscrimination protections for LGBTQI+ people.

Federal Court Rules CVS Acted With "Deliberate Indifference" When It Adopted Rx Program That Discriminates Against People Living With HIV, Says Consumer Watchdog

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金曜日, 4月 19, 2024

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The lawsuit alleges that the program cuts off access to knowledgeable pharmacists and other critical benefits and services essential for people living with HIV.

Key Points:

The lawsuit alleges that the program cuts off access to knowledgeable pharmacists and other critical benefits and services essential for people living with HIV.
The four HIV-positive "John Doe" Plaintiffs in the case are represented by lawyers for the non-profit Consumer Watchdog and Whatley Kallas, LLP.
"… Plaintiffs sufficiently allege that Defendants implemented The Program by "utiliz[ing] its discretion" under its contracts with employers and 'offer[ing] financial inducements to plan sponsors.
Furthermore...CVS Caremark has an ongoing ability to alter plan terms and the prescription drug benefits provided thereunder to Class Members.

IHA’s Symphony Chosen As Provider Directory Data Source for Covered California

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木曜日, 3月 14, 2024

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“Provider directory accuracy is critically important as new members come to Covered California and move between plans,” says Jeff Rideout, MD, MA, FACP, President and CEO of IHA.

Key Points:

“Provider directory accuracy is critically important as new members come to Covered California and move between plans,” says Jeff Rideout, MD, MA, FACP, President and CEO of IHA.
All of the 12 Covered California Qualified Health Plans and provider networks are already actively engaged with Symphony.
Symphony currently identifies more than 80,000 corrections to provider directories every 30 days, ensuring health plans can maintain accurate provider directories.
Availity Provider Data Management (PDM), a web-based multi-player platform designed for provider information, supports Symphony’s data sharing, reconciliation, and validation for participating health plans, provider organizations, and small provider entities.