Payer Roundup—Fact-checking Trump’s pre-existing claim; CMS proposal tweaks Medicare appeals process

Trump
Trump says he's not going after pre-existing conditions, contradicting the position of his Justice Department. (Flickr/Gage Skidmore)

Trump says he will ‘always protect’ pre-existing conditions

President Donald Trump told attendees at a West Virginia rally on Saturday that he “will always fight for and always protect patients with pre-existing conditions,” ignoring the position from his own Justice Department, which declined to defend that provision of the law in court.

Trump told rallygoers that “pre-existing conditions are safe, OK? Just remember that.” But as the Associated Press points out, federal prosecutors declined to defend the Affordable Care Act—and its pre-existing protections—in a case filed by 20 attorneys general in Texas seeking to repeal the law. (AP)

Blue Shield of California expands Landmark partnership

Blue Shield of California is expanding a partnership with Landmark Health to provide more members in-home care.

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The insurer first offered the home health services to approximately 600 Medicare members earlier this year. Now, it’s expanding to 10,000 additional members enrolled in individual, employer and Medicaid and Medicare plans in six areas across the state.

“Our goal is patient-centered care, ensuring our members—especially those who are very ill—have access to quality medical and support services that they need to improve their health,” said Jeff Bailet, M.D., executive vice president of Health Care Quality and Affordability at Blue Shield. (Release)

CMS tweaks Medicare and Part D appeals process

A proposed rule released by the Centers for Medicare & Medicaid Services on Friday made some changes to the appeals process for traditional Medicare and Part D members.

The changes—which include eliminating a requirement that appellants sign appeal requests—are aimed at streamlining the appeals process and reducing the burden on patients and providers. That change alone is expected to save approximately $11 million in administrative costs annually. (Rule) (PDF)

Corporate healthcare cost growth remains level

Despite the public outcry about how much employers, healthcare cost growth among private employers has remained fairly slow, Kaiser Family Foundation’s Drew Altman writes in Axios.

Altman points out that healthcare costs as a percentage of overall compensation among the nation’s largest employers have remained between 8% and 9%. And premium growth among all employers has been modest.

But Altman also acknowledges that employers have held down costs through cost-shifting mechanisms, and that approach may be nearing its limit. (Axios)

WellCare expands value-based contract with VillageMD

WellCare is expanding value-based contract with VillageMD, a national primary care provider.

Currently, WellCare members can access VillageMD physicians in Kentucky and Texas, but the insurer is expanding to Georgia and Illinois.

“VillageMD's evidence-based, preemptive approach to care that empowers both physicians and members aims to improve health outcomes particularly for those living with complex medical challenges,” Sue Podbielski, WellCare's vice president, network performance. (Release)

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