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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

AMA: 73% Of Insurer Markets Were Highly Concentrated Last Year

Most insurer markets are highly concentrated, including many regions where a single payer dominates at least half of the market share, according to a new analysis from the American Medical Association. The AMA released an updated look at concentration in payer markets and found that across product lines, 73% of metropolitan statistical areas were highly concentrated in ...

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U.S. Healthcare Spending Rises To $4.5 Trillion In 2022

Healthcare spending in the United States rose 4.1% in 2022 to $4.5 trillion, federal data showed on Wednesday, a rate that officials said indicated a return to pre-pandemic patterns after two years of volatility. The growth was driven by spending on Medicaid and private health insurance, with the insured share of the population surging to ...

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Biden Wants States to Ensure Obamacare Plans Cover Enough Doctors and Hospitals

The Biden administration plans to push states to boost oversight of the number of doctors, hospitals, and other health providers insurers cover in Obamacare plans, under rules proposed in November. The annual regulatory proposal, known as the payment parameters rule, also seeks to expand access to adult dental coverage in Affordable Care Act marketplaces and ...

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SmileDirectClub’s Sudden Collapse Leaves Teeth Alignment Patients Stranded

The sudden collapse of SmileDirectClub has stranded users of its clear-plastic, removable teeth aligners — in some cases just weeks after they were given a discount for paying up front. Why it matters: Customers experiencing problems with their treatment will not be able to get new aligners, treatment, or other support from the company. Catch up fast: SDC filed for ...

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Biden’s Pharma Fix: New ‘March-In’ Rule Allows HHS To Seize Patents Of Pricey Drugs

Pres. Biden’s administration on Thursday unveiled a new framework allowing authorities the right to seize certain drug patents and license them to other manufacturers in order to lower drug prices.

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Targeting Costly Meds, Biden Admin Asserts Authority To Seize Certain Drug Patents

The Biden administration has determined that it has the authority to seize the patents of certain high-priced medicines, a move that could open the door to a more aggressive federal campaign to slash drug prices. The determination, which was described by three people familiar with the matter, represents the culmination of a nearly nine-month review of ...

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CVS’ Drug Price Revamp May Not Help Consumers Much

CVS Pharmacy is promising to make its drug pricing system simpler and more transparent. But that may not translate into lower costs or more clarity for consumers. The company announced Tuesday that its new CVS CostVantage model will revamp how its pharmacies are paid for prescription medications. It will use a formula that includes “the cost of ...

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Health Insurers Push Back On Biden’s ‘Burdensome’ New Mental Health Parity Rules

Since Pres. Biden proposed rules to reinforce the Mental Health Parity law in July, there’s been mixed reaction to the rules, however, employer groups and insurers point out one glaring issue – a shortage of mental health providers.

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Cigna Calls Off Humana Pursuit, Plans Big Stock Buyback

Cigna Group abandoned its pursuit of a tie-up with Humana after shareholders balked at a deal that would have created a roughly $140 billion giant in the health-insurance industry. The companies couldn’t come to agreement on price and other financial terms, according to people familiar with the matter. In the near term, Cigna is turning its ...

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House Passes Site-Neutral Policy, Transparency, PBM Reform Package

The House passed a relatively major health care package late Monday, an end-of-year victory after the same policies had to be yanked from consideration in September because they lacked bipartisan support.

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