Texas’ Planned Medicaid Changes Could Upend Coverage For 1.8 Million
Under the proposal, three top nonprofit children's health plans would be bounced as the state looks to shift coverage to more for-profit companies.
The Texas Tribune:
Proposed Medicaid Changes Could Shake Up Coverage For 1.8 Million Texans
Texas health officials are poised to drop the state’s three largest nonprofit children’s health plans from multibillion-dollar Medicaid and children’s health insurance contracts — threatening the future of plans run by legacy children’s hospitals in Fort Worth and South Texas and shaking up health care coverage for low-income families throughout the state. (Harper, 4/18)
News Service of Florida:
Trial Date Set In The Challenge To Florida's Medicaid 'Redetermination' Process
A federal judge has scheduled a trial May 13 in a lawsuit over people being dropped from Florida’s Medicaid program after the end of a federal public health emergency that was declared in 2020 because of the COVID-19 pandemic. Jacksonville-based U.S. District Judge Marcia Morales Howard issued an order last week scheduling the trial, according to a court docket. (4/18)
The CT Mirror:
CT Canceled Only One Audit Of Self-Reported Medicaid Overpayments
When Helen Zervas was notified in January 2020 that her optometry practice was going to be audited by Connecticut officials, the Bristol eye doctor responded by hiring an attorney and voluntarily repaying nearly $600,000 to the state. In doing so, Zervas, the owner of Family Eye Care, joined a list of more than 45 doctors, pharmacies and other medical providers that willingly returned money to Connecticut in recent years after notifying the state that they had overcharged the Medicaid insurance program. (Brown and Altimari, 4/18)
Forbes:
Elevance Health Reports $2.2 Billion Profit Despite Drop In Medicaid Enrollment
Elevance Health reported a first quarter profit of $2.2 billion as strong growth in sales of commercial health insurance and healthcare services offset a big decrease in Medicaid enrollment. Elevance, which sells government and commercial health insurance including Blue Cross and Blue Shield plans in 14 states, Wednesday reported first quarter net income jumped 12.2% to $2.2 billion compared to $2 billion in the year-ago quarter. (Japsen, 4/18)
On Medicare —
Modern Healthcare:
Aetna Lawsuit Could Upend Medicare Advantage Benefits
A legal fight between four Pennsylvania health systems and Aetna could upend how Medicare Advantage insurers manage costs for supplemental benefits. Bridges Health Partners, a clinically integrated network in western Pennsylvania, filed a lawsuit in state court Wednesday alleging CVS Health subsidiary Aetna broke contract terms by categorizing extra benefits such as gym memberships and CVS gift cards as medical expenses. (Tepper, 4/18)
KFF Health News:
Medicare’s Push To Improve Chronic Care Attracts Businesses, But Not Many Doctors
Carrie Lester looks forward to the phone call every Thursday from her doctors’ medical assistant, who asks how she’s doing and if she needs prescription refills. The assistant counsels her on dealing with anxiety and her other health issues. Lester credits the chats for keeping her out of the hospital and reducing the need for clinic visits to manage chronic conditions including depression, fibromyalgia, and hypertension. (Galewitz and Hacker, 4/18)
