A federal appeals court in California has shielded a health insurer against a state-law breach-of-contract claims and other state-law claims. A three judge panel at the 9th U.S. Circuit Court of Appeals recently found that the state-law claims had a “connection with” a benefit plan governed by the Employee Retirement Income Security Act. Congress passed ERISA in ...
Risant Health, the nonprofit entity created by Kaiser Permanente, has signed a definitive agreement to acquire North Carolina’s Cone Health, the nonprofit systems said Friday. Cone would be the second system to join Risant, subject to regulatory approval, following Geisinger Health earlier this year. Financial details of the deal were not disclosed. It is expected to close in ...
Cigna and Oscar Health have announced they will exit the Small Group market in California and other states as of December 15, 2024. Cigna + Oscar exited the Covered California Affordable Care Act marketplace in 2023. Current groups with Cigna + Oscar coverage will be allowed to renew early (for coverage effective 12/1/2024) if they ...
Sutter Health was absolved this week from a California whistleblower lawsuit alleging the nonprofit system owed $519 million for double-billing patients. After a seven-week trial, Alameda County Superior Court Judge Stephen Kaus ruled Monday retired surgeon Dr. Gregory Duncan and patient Gary Hulbert failed to show that Sutter’s billing practices for surgical patients were fraudulent. Duncan and ...
The U.S. Supreme Court on Monday declined to hear a challenge to a $2.7 billion nationwide class action settlement with Blue Cross Blue Shield over allegations that the insurance giant overcharged commercial and individual subscribers for years. The justices without comment denied a petition from home improvement retailer Home Depot objecting to the landmark antitrust ...
(Editor’s Note: the KFF Health story identified California as having in excess of $500 million in Deloitte Medicaid contracts) Deloitte, a global consultancy that reported revenue last year of $65 billion, pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid. The company promotes itself as the industry ...