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Covered California Limiting Consumer Choices

Insurers UnitedHealth Group and Oscar likely will start selling health plans through Covered California next year, the Los Angeles Times reports (Terhune, Los Angeles Times, 7/24).

HEALTH CARE NETWORK – Updates in Health Care Reform 7/24/15

–         Drug Costs,  ACA Penalty,
Medicare Fraud, Waste, Abuse & Overpayments

Small-Business Owners Swarm DC to Oppose HRA Fines

July 28 – Small-business owners are descending on Washington this week to lobby Congress to roll back an ObamaCare rule that could hit companies with thousands of dollars’ worth of penalties.

Report Warns Good News, Bad News for Medicare Recipients

As Medicare approaches its 50th anniversary next week, the federal program got some welcome financial news Wednesday: Its giant hospital trust fund will be solvent until 2030, and its long-term outlook has improved, according to a report from the program’s trustees.

A Review of Essential Health Benefits

Under the Affordable Care Act (ACA or health care reform law), individual and small group health plans must include a certain set of benefits.

Unions/Large Employers critical of Cadillac Tax – Home Care Bill

“Cadillac Tax” Draws Criticism from Large Employers and Unions.  Extended In-Home Care bill passed for Chronically Ill Medicare Beneficiaries.

Assembly To Consider Bill Capping Out-of-Pocket Rx Drug Costs

This bill (AB 339) aims to cap out-of-pocket costs for prescription medications, Modern Healthcare reports (Dickson, Modern Healthcare, 7/4). Prices for specialty drugs for the treatment of serious or chronic conditions have soared in recent years.

Get Ready for Two New Sets of Reporting Requirements

(Audio Presentation)

 

Dependent to Age 26? Not so fast…

Plans that offer coverage to children on their parents’ plan are required to make coverage available until the adult child reaches the age of 26 – Aetna’sPolicy

Community Rating And How It Affects You

As of January 1, 2016 this means employers with 1 to 100 employees. With the ACA law, new small group health care plans have to be priced using community rating.

Health Net Being Acquired in $6.8 Billion Deal

Los Angeles‑based managed care provider Health Net is being acquired by Centene Corp. in a deal valued at $6.8 billion

Aetna to Buy Humana as Health Insurer Landscape Shifts

Aetna aims to spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal health care overhaul.

 

Financing MediCal Program May Not Be Sustainable

Financing the Medi-Cal program may not be sustainable, Brown said, given its expansion over the past two years and the looming loss of the managed care organization tax, which could cost the state about $1.1 billion.

 

Governor Brown Calls for Special Legislative Session to Address Health Spending

 

SB-125 Passes House

June 17, 2015,  *annual enrollment periods extend from November 1, of the preceding calendar year, to January 31 of the benefit year *  bill would revise the definition of small employer, for plan years commencing on or after January 1, 2016  * bill would request the University of California to include essential health benefits   …

 

Covered California to Collect Data On Patients