beneficiaries
ALSO NOTED: CMS "secret shoppers" attend Medicare health plan pitches; CA health plans adding interpreters; and much more...
> CMS "secret shoppers" have begun attending insurance agents' sales pitches for Medicare managed care plans to see how they work. Read more...
Kaiser profits more than double
Kaiser Permanente has reported that its Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and subsidiaries saw dramatic increases in its net income, operating income and investment income... Read more...
CA regulators plan limits to health policy cancellations
Two powerful state regulators have come together in California to propose rules limiting health plans' ability to retroactively cancel policies. The state's Department of Managed Health Care (DMHC)... Read more...
Medicare marketing, claims handling problems abound
Misbehavior and administrative problems are surprisingly common within Medicare contractors, according to a new review of federal audits by The New York Times. In particular, plans are having... Read more...
Minnesota HMOs have a slow year
Minnesota's HMOs had a rough 2006, with enrollment and profits dropping despite premium increases that exceeded those in the year before. Enrollment fell 8.2 percent last year, down to 915,000, from... Read more...
Health plan spends $4M to emphasize split with MDs
Sometimes, the perception lingers much longer than the reality. Despite having split up four years ago, it appears that Boston-area consumers still don't know that Harvard Pilgrim Health Care isn't... Read more...
GAO: Medicare HMOs shouldn't have kept money
A new audit by the Government Accountability Office has found that private health plans contracting with Medicare are keeping money which they're supposed to either return to the government or pass... Read more...
SPOTLIGHT: Debate over Medicare HMOs gets hotter
Turning over fee-for-service Medicare dollars to health plans was supposed to save money. But it's beginning to look like this isn't the case. To date, in fact, CMS has paid 12 percent more for... Read more...
Psychiatrists getting largest pharma gifts
It looks like psychiatrists are getting the most love from pharmaceutical companies, a relationship which critics say could be behind the increasing use of costly atypical antipsychotic drugs for children.
As states begin to track pharma gifts to doctors, psychiatrists are increasingly coming up as top beneficiaries for pharma payments. In Vermont, for example, pharma payments to psychiatrists more than doubled last year, hitting $45,692 per individual, up from $20,835 in 2005. …
... Read more...Aetna spends $535M to buy Medicaid firm
Beefing up its Medicaid managed care offerings, Aetna has acquired Phoenix, AZ-based Medicaid management firm Schaller Anderson for $535 million. Schaller Anderson serves more than 1.3 million beneficiaries and manages more than $3 billion in benefits. It has about 1,800 employees in nine states. The company was started by Joseph Anderson and Dr. Don Schaller, who founded the company more than 20 years ago after helping to create Arizona's Medicaid program. The buy follows a previous deal …
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