Payer Roundup—UnitedHealth buys 63K-member Medicare Advantage plan provider

UnitedHealthcare is planning a big move in the MA space, and backlash from the left continues over the DOJ's refusal to defend the ACA. (jetcityimage/Getty)

More Democrats hit back on DOJ's refusal to defend ACA

Democratic Reps. Bobby Scott, Frank Pallone Jr. and Richard Neal say the Department of Justice's decision to not defend the Affordable Care Act in court is a "stunning attack on the rule of law."

The Trump administration announced last week it mostly agrees with a lawsuit filed by 20 Republican state leaders that claims the ACA's individual mandate is unconstitutional, and, as a result, will not defend the 2010 law. Reaction from Democrats has been quick and sharp, and appears to be piling on. 

"If the Trump Administration is successful in arguing against the constitutionality of protecting patients' access to care, it will have immediate and disastrous effects on our healthcare system and the American people," the three congressmen said. (Release)

UnitedHealth buys 63,000-member Medicare Advantage plan provider

UnitedHealthcare has reached a deal to acquire Louisana-based Peoples Health, a Medicare Advantage plan provider.

The purchase is expected to add 63,000 Medicare beneficiaries to UnitedHealth's portfolio, as reported by The New Orleans Times-Picayune last week, which would make UnitedHealth the second-largest MA plan providers in Louisiana, after Humana. 

"Our joining together will lead to an expanded choice of affordable plan options for Louisiana seniors and build on Peoples Health's high-touch, personalized approach to taking care of members," UnitedHealth said in a statement. (The New Orleans Times-Picayune)

Nursing home company to pay $30M in false claims case

Signature HealthCARE, which owns 115 skilled nursing facilities, will pay $30 million to resolve allegations of submitting false Medicare claims. 

The Department of Justice announced the settlement June 8, and the allegations included placing patients in the highest therapy reimbursement.

“Our most vulnerable citizens are put at risk when healthcare providers put their financial interests above their patients’ needs and valuable federal funds are diverted from where they are surely needed,” U.S. Attorney Byung J. “BJay” Pak for the Northern District of Georgia, said. “This settlement demonstrates our commitment to pursuing healthcare providers who provide unnecessary care to advance their bottom line.” (DOJ)