Health Insurer Issues Refunds
Rebates for some Massachusetts health insurance customers and higher profits for CVS Health are two impacts of the pandemic; people used fewer health services.
State House News Service:
Blue Cross Delivering $101 Million In Refunds, Rebates
Blue Cross Blue Shield of Massachusetts customers and members will receive $101 million in premium refunds and rebates due to lower than anticipated health care costs during the COVID-19 emergency, the big insurer announced Wednesday. "Since many elective procedures and routine visits have been deferred during the pandemic, our medical costs during the second quarter were lower than we originally anticipated," said Andrew Dreyfus, president and CEO of Blue Cross. "We're giving money back to our customers and members to help provide financial relief during what we know is an incredibly challenging and uncertain time." (Norton, 8/5)
Modern Healthcare:
Lower Healthcare Utilization Bolsters CVS Health Q2 Profit
A dramatic drop in healthcare utilization among Aetna members during the COVID-19 crisis bolstered CVS Health's bottom line in the second quarter of 2020. The company said the deferral of non-urgent healthcare services during the pandemic contributed an estimated $1.8 billion to $2.1 billion to its healthcare benefits segment's operating income. That unit comprises the Aetna business that CVS bought in late 2018. That business reported adjusted operating income of $3.1 billion for the three months ended June 30, an increase of nearly 188.7%. (Livingston, 8/5)
San Francisco Chronicle:
‘We Get Inundated’: Bay Area Health Care Workers Demand More Staffing, Gear In National Coronavirus Rally
Robin Watkins had spent a 12-hour overnight shift caring for coronavirus patients at Kaiser Permanente Oakland Medical Center on Wednesday, but the nurse didn’t go straight home after work. Instead, he rallied in the morning mist to demand more staffing and protective gear. At least 40 nurses decked in red California Nurses Association shirts and masks marched in front of the hospital, hoisting signs that said “Save Lives” and chanting, “Mighty, mighty nurses, fighting for our patients.” The same cries echoed at two dozen Bay Area hospitals, part of a national movement of unionized workers protesting at 200 U.S. locations Wednesday. (Moench, 8/5)
Modern Healthcare:
Government Funds, Expense Cuts Behind For-Profit Hospitals' Q2 Profit Growth
Despite more than a month-long suspension in high-margin surgeries due to the pandemic, the country's four largest investor-owned hospital chains managed to increase their cumulative profit 69% during the second quarter to $1.5 billion, surprising analysts and others who follow the industry. The higher profits were largely due to the combined $2 billion in federal stimulus grants the four companies, HCA Healthcare, Community Health Systems, Tenet Healthcare Corp. and Universal Health Services, recorded during the quarter that ended June 30, money they don't have to repay. If not for those grants, some of the companies may have lost money in the quarter without more significant operating changes. (Bannow, 8/5)
Modern Healthcare:
Anthem Sues Former Executive Who Leads Fla.-Based Ultimate Health Plans
Anthem has sued a former senior executive for allegedly poaching more than a dozen Anthem employees and using confidential information to benefit a competing health plan. Indianapolis-based Anthem accused former executive Nancy Gareau, who is now the CEO of small, Spring Hill, Fla.-based Medicare Advantage insurer Ultimate Health Plans, of leading a "full-on raid" on Anthem's workforce. (Livingston, 8/5)
In news from the Justice Department —
Modern Healthcare:
DOJ Accuses Cigna Of Medicare Advantage Fraud
The U.S. Justice Department joined a lawsuit alleging Cigna Corp. exaggerated the illnesses of its Medicare members in order to obtain higher payments from the federal government. The Justice Department claimed that Cigna and its Medicare Advantage business HealthSpring violated the False Claims Act by submitting improper diagnostic codes for payment that were based on health conditions that did not exist or were not found in any medical records. As a result, CMS overpaid Cigna by more than $1.4 billion, DOJ alleged. (Livingston, 8/5)
Modern Healthcare:
Feds Move To Block Geisinger Hospital Acquisition
The Justice Department on Wednesday sued Geisinger Health to prevent it from acquiring part of a competing hospital in central Pennsylvania. While Danville, Pa.-based Geisinger and Evangelical Community Hospital, an independent hospital in Lewisburg, Pa., have categorized their deal as an "agreement" rather than an acquisition, the Justice Department said the providers won't have the same incentive to compete with each other, and that could raise healthcare prices in the area. (Teichert, 8/5)
