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The California Insurance Commissioner has urged the feds to block the merger of Anthem and Cigna. He can not block it in the state so he has urged the feds to do what he can not. He states that the merger would likely mean higher costs for consumers and businesses. The feds could approve the merger, block it completely or demand there is some divestitures before the merger is approved. This is the first state to vote to block the merger. Twelve states have agreed to the merger. The proposed merger would give Athem61% of the California employer market. The new company would then be larger than Kaiser in California.
The day after the above the California managed care regulator said okay to the merger of Aetna and Humana. The Department had reached an agreement with Aetna regarding rate increases. This was followed the following day by the Department of Insurance saying the merger should not be approved.
The California governor has signed a law that allows Medicaid patients to not have their assets seized by the state for repayment until their spouse dies. Since the start of Medicaid under Johnson it was optional that people who received Medicaid benefits needed to repay the government (states) with their assets when they died. This left the spouses without homes in some cases. In 1993, the law was changed to allow the states to recover against all over 50 years of age not just the over 65 group. Homes with "modest value" (a fair market value of 50% or less of the average price of homes in the county where located) are not allowed to be recovered by the state. Top
HHS is again screwing the insurers. They are giving them $7.8 Billion for Obamacare's reinsurance program. This is different from the risk corridor and it covers insurers who have disproportionately sicker enrollees with money from those insurers with the less ill enrollees. This will cover about 55% of claims.
Medicare is going to pay ambulatory medical practices the same no matter the site. Therefore hospitals will not be paid more illegally stating the physician office is a hospital outpatient facility. It is not. It is a physician office. There will be more paid if the services are provided in a dedicated hospital emergency room, within a hospital department within 250 yards of a remote location of the hospital or offices that billed as hospital outpatient departments prior to November 2, 2015. If any of the exceptions changes locations they lose their exception. Medicare will pay about $500 million per year and could save much more if they did away with the facility fees.
Vermont passed and the governor signed a law that forces insurers to pay for vasectomies. Obamacare only applies to women for forcing insurers to pay for contraception. Watch for this to be challenged by the Church.
Canada finally passed their assisted death law. After much haggling they finally ruled that the physician assisted death would apply to people who are terminally ill. They denied those who wanted it also to apply to people with degenerative diseases. Top
New York rejected a bill that would have started medical malpractice statutes of limitation when the mistake was discovered by the patient not when it occurred.
Missouri governor Nixon has vetoed two bills which were opposed by he trial lawyers. The first veto came for a bill which would have allowed collateral source knowledge to jurors. the second one was to change the criteria for expert witness testimony to the more stringent federal standards instead of the weaker state ones. Top
California has removed the license of Dr. Augustus Ohemeng, a Buena Park medical director of Pacific Clinic in Long Beach. He was convicted of healthcare fraud in 2013 for billing for unnecessary tests and procedures. He received a 3 1/2 year prison sentence. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.