Aetna Is Leaving ACA Marketplace
A million Affordable Care Act enrollees across 17 states will have to find alternate coverage in 2026. Separately, the Centers for Medicare & Medicaid Services now has a center to fight waste, fraud, and abuse. Also, the Milken Institute is creating a Women’s Health Network to study women's issues.
Stat:
Aetna To Abandon Affordable Care Act Insurance Marketplaces, Again
CVS Health will not sell its Aetna health plans in the Affordable Care Act’s individual marketplaces in 2026, marking the second time in the past decade that Aetna has given up on ACA coverage. (Herman, 5/1)
In other news about the Affordable Care Act —
Fierce Healthcare:
CMS Sets Up Fraud Center While Contractor Rolls Out New Tool
The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week. Listed on a new webpage are a list of “recent success stories.” They include taking action against improper enrollment in Affordable Care Act (ACA) plans, cracking down on false billing of wound care services and scrutinizing “problematic activities” regarding hospice claims. (Tong, 5/1)
KFF Health News:
Covered California Pushes For Better Health Care As Federal Spending Cuts Loom
Faced with potential federal spending cuts that threaten health coverage and falling childhood vaccination rates, Monica Soni, the chief medical officer of Covered California, has a lot on her plate — and on her mind. California’s Affordable Care Act health insurance exchange covers nearly 2 million residents and 89% of them receive federal subsidies that reduce their premiums. Many middle-income households got subsidies for the first time after Congress expanded them in 2021, which helped generate a boom in enrollment in ACA exchanges nationwide. (Wolfson, 5/2)
And more updates from the health care industry —
Fierce Healthcare:
Jill Biden, Milken Institute Team Up For Women's Health Network
The Milken Institute is launching a Women’s Health Network chaired by former first lady Jill Biden. The network will engage research institutions, startups and entrepreneurs, corporations and businesses, investors, payers, policymakers, patient and community organizations, health systems and philanthropists to advance women's health. They aim to make headway on understanding and treating conditions that disproportionately impact women such as Alzheimer’s disease, menopause, endometriosis and heart disease. (Beavins, 5/1)
CBS News:
As Crozer Health System Prepares To Shut Down, Patients And Employees Are Devastated
The end is near for Delaware County's largest health system. Thursday was the last full day that Crozer-Chester Medical Center in Upland was open. Hallways, patient rooms and operating rooms, are now empty as the hospital prepares to shut down permanently at 8 a.m. on Friday. Patients are trying to figure out where to go now to get care. "It's somber," Melanie McKendry, the lead medical assistant at the gynecologic-oncology unit at Crozer Chester Medical Center, said. "It feels like we're at our own funeral, basically." (Wright and Holden, 5/1)
Modern Healthcare:
Banner Health Acquires VillageMD Clinics
Walgreens-backed VillageMD is exiting Colorado. Banner Health said Thursday it acquired seven Village Medical primary care clinics and two walk-in sites in the state. Forty-six providers and more than 150 support staff will join Banner, according to a news release. The clinics will be rebranded and integrated into the health system in the coming months, the release said. (Hudson, 5/1)
KFF Health News:
Montana Lawmakers Approve $124M To Revamp Behavioral Health System
Montana’s frayed behavioral health care system, still recovering from the effects of past budget cuts, will get a shot in the arm after state lawmakers approved sweeping changes to upgrade and expand facilities, increase community services, and revise commitment procedures. Lawmakers backed the bulk of Republican Gov. Greg Gianforte’s multimillion-dollar vision to bolster and expand the system, which has experienced waitlists for care and has been working in recent years to reverse the loss of community-based mental health services and regain federal certification of the state psychiatric hospital, lost in 2022 after a spate of patient deaths. (O'Connell, 5/2)
CBS News:
Boston Medical Center Health System Renames Good Samaritan And St. Elizabeth's Hospitals
You will soon see the name Boston Medical Center on two more hospitals in Massachusetts. Good Samaritan Medical Center in Brockton is being renamed Boston Medical Center - South (BMC South) and St. Elizabeth's Medical Center in Brighton will become Boston Medical Center - Brighton (BMC Brighton). Boston Medical Center Health System made the announcement Thursday. It assumed operations of both hospitals last October after St. Elizabeth's was seized by the state of Massachusetts using eminent domain. (D, 5/1)
WUFT:
UF Health And United Healthcare Reconcile Differences, Agree On Multiyear Contract
UF Health hospitals and physicians are once again part of the United Healthcare. After months of negotiations, the two sides finalized a new multiyear contract that will restore insurance network access to about 100,000 UF Health patients in Gainesville, Jacksonville and St. Augustine. (Zarran, 5/1)
WUSF:
BayCare Breaks Ground On 154-Bed Hospital In North Manatee County
BayCare Health System broke ground Wednesday on a hospital in north Manatee County, part of a $563 million health care campus that will anchor a 288-acre residential-commercial development. (Mayer, 5/1)
On the slaying of UnitedHealthcare CEO Brian Thompson —
ABC News:
Luigi Mangione Attorneys Seek Dismissal Of State Murder Case
Defense attorneys for alleged CEO killer Luigi Mangione said Thursday in a new court filing that the murder indictment a state grand jury returned against him should be dismissed due to double jeopardy and other alleged violations. The indictment should be dismissed "because concurrent state and federal prosecutions violate the Double Jeopardy Clause, the Fourteenth Amendment's Due Process Clause and Mr. Mangione's constitutional rights against self-incrimination, to meaningfully defend himself, to a fair and impartial jury and to the effective assistance of counsel," defense attorneys wrote. (Katersky, 5/1)