Group Health Plan Compliance Requirement Due 10/15

Employers (of any size) providing prescription drug coverage benefits must distribute an annual notice to all Medicare-eligible individuals by October 15th – including both employees and dependents.

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Many Preventive Medical Services Cost Patients Nothing. Will a Texas Court Decision Change That?

A federal judge’s ruling in Texas has thrown into question whether millions of insured Americans will continue to receive some preventive medical services, such as cancer screenings and drugs that protect people from HIV infection, without making a copayment.

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Molina Scores Huge Win with State Medi-Cal Contracts

Last month, a strategic decision paid off in spades. Molina Healthcare scored its largest Medicaid win ever as the California Department of Health Care Services on August 25 announced it intends to award the company new or additional contracts in Los Angeles, Sacramento and San Diego counties.

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It’s Medical Loss Ratio (MLR) Rebate Check Time Again

The Affordable Care Act (ACA) requires group health plans to spend a minimum percentage of premium dollars on members’ health care expenses and services. Likewise, it sets a threshold on the maximum amount of premium dollars that can be spent on other administrative costs, such as marketing, profits, salaries, agent commissions, etc.

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Consumers Say They Are Willing To Pay More For Healthcare Services Based On These Factors, Survey Finds

Quality of care, care team choice, location and speed all play a role in how much consumers are willing to spend on their healthcare, according to new survey responses from more than 2,000 American adults. Fifty-seven percent of those polled in mid-March said they would be willing to pay more based on the quality of ...

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Hospitals Divert Primary Care Patients to Health Center ‘Look-Alikes’ to Boost Finances

A growing number of hospitals are outsourcing often-unprofitable outpatient services for their poorest patients by setting up independent, nonprofit organizations to provide primary care. Medicare and Medicaid pay these clinics, known as federally qualified health center look-alikes, significantly more than they would if the sites were owned by hospitals. Like the nearly 1,400 federally qualified health ...

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