Payer Roundup—New York cardiologist sues Aetna over unpaid claims; Utahans to vote on Medicaid expansion

Utah adds Medicaid expansion to the November ballot 

Add Utah to the list of states that have turned the decision of Medicaid expansion over to voters.  

Lt. Governor Spencer J. Cox tweeted the official results of a statewide signature-gathering process on Tuesday, in which residents secured more than 147,000 valid signatures for the "Utah Decides Healthcare Act of 2018," enough to land the initiative on November's ballot.  

The ballot initiative would expand Medicaid coverage to individuals that make 138% of the federal poverty line or less. (Release

New York cardiologist sues Aetna for $1M in unpaid claims 

A New York cardiologist is suing Aetna to recover nearly $1 million in unpaid medical claims. 

Perry Frankel, M.D., who owns Advanced Cardiovascular Diagnostics (ACD), claims the insurer has failed to pay legitimate medical claims and ordered the practice to stop providing care through its mobile clinic last year. He says the unpaid claims have affected care for dozens of black and Latino union workers.  

"Aetna's reckless behavior has already compromised the health and well-being of thousands," he said in a statement. "This is life-or-death for countless members whose claims have been denied without cause or explanation." (Release

Democrats urge Kasich to rescind Medicaid work requirements 

A group of Congressional Democrats in Ohio are calling on Gov. John Kasich to rescind a waiver for Medicaid work requirements.  

In a letter to Kasich, Reps. Tim Ryan, Marcy Kaptur, Marcia Fudge and Joyce Beatty questioned "the very rationale" of a Medicaid work requirements waiver in Ohio, according to the Associated Press.  

The plan, which state officials say would impact about Medicaid expansion enrollees, could kick beneficiaries out of the program, the lawmakers argued.

Kasich, meanwhile, said the plan only applies to "really healthy" beneficiaries. He submitted the request to CMS at the beginning of the month. (Associated Press

Humana joins Arkansas hypertension program 

Humana joins the Arkansas Department of Health and Jefferson Regional Medical Center to participate in a state-run Community Team-based Care program.  

Through the program, the organizations will collaborate to improve hypertension referral support, medication adherence and controlling blood pressure in an area where hypertension and death rates outpace all other counties in the state. The pilot first began in January with the goal of reducing ER visits and readmissions among patients with hypertension by 15%. (Release