Payer Roundup—Cleveland Clinic, Molina partner on Medicaid; Former Healthcare.gov executive joins Centene

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Molina Healthcare members will now have access to Cleveland Clinic's full network. (Getty/michaelquirk)

CMS extends Florida Medicaid demonstration

The Centers for Medicare & Medicaid Services announced that it has approved a five-year extension of Florida’s Managed Medical Assistance demonstration, which allows the state operate a capitated managed care program under Medicaid with a low-income pool. The program allows Florida to support safety-net providers that offer charity care to uninsured people. The agency said the extension is part of its ongoing efforts to lessen the reporting burden on states. (CMS announcement)

Former Healthcare.gov CEO takes job with Centene

Kevin Counihan, the former CEO of Healthcare.gov who left that post in January, will join Centene. Though many payers have exited Affordable Care Act marketplaces or are cutting back offerings, Centene has instead expanded its reach further. Counihan will join the insurer as a regional vice president overseeing the company’s plans in midwestern states. (Vox)

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Cleveland Clinic, Molina Healthcare reach Medicaid agreement

The Cleveland Clinic and Molina Healthcare have reached an agreement for Medicaid coverage, they announced, where the clinic will now be included under Molina’s Medicaid plans. As of Aug. 1, all Molina Medicaid enrollees will have access to Cleveland Clinic’s full slate of services. (Announcement)

Pennsylvania shareholder sues Aetna over ACA exchange exit

An institutional shareholder in Pennsylvania has filed suit against Aetna, alleging that the company exited ACA exchanges out of anger over its failed merger with Humana rather than for business reasons. The Allegheny County Employees’ Retirement Fund alleged that the payer breached its fiduciary duties when withdrawing from 11 marketplaces. (Hartford Courant)

BCBSA: Diabetes ranks third in impact on health, costs

Diabetes ranks third in a list of 200 conditions for prevalence, severity, years lost to disability and premature death, according to a survey from the Blue Cross Blue Shield Association. The study dug into the claims of more than 40 million BCBS members and found the impacts of diabetes are continuing to grow, particularly among enrollees aged 18 to 34. To combat the rise of the condition, BCBSA suggests initiatives like rewarding doctors who help patients better manage their diabetes. (Announcement)

Pennsylvania Insurance Department loosens financial restrictions on Highmark

The Pennsylvania Insurance Department has granted Highmark’s request for looser financial oversight as it gears up to invest millions in the Allegheny Health Network, its health system in the western part of the state. The change will allow Highmark to complete more fund transfers to AHS without having to notify the department or get its approval. (LancasterOnline)

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