The ACR recently had an opportunity to speak with Anthem leadership to follow up on concerns about specialty pharmacy acquisition mandates being implemented by Anthem plans in California and New York. Anthem clarified that they do not expect these mandates to impact community-based providers. Beginning in December 2020, Anthem plans in certain states will require…
Anthem Cancels Planned Modifier 25 Cuts
Anthem, a Blue Cross Blue Shield company that operates in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia and Wisconsin, has decided not to move forward with a policy that would have resulted in decreased reimbursement for evaluation and management (E/M) services when billed with modifier 25. As reported…
Health Insurer Anthem Takes Pharmacy Business in House, Taps CVS to Help
(Reuters)—Health insurer Anthem Inc will start managing its billions of dollars of patient prescriptions itself in 2020, it said on Wednesday, ending a deal with Express Scripts Holding that had deteriorated into lawsuits over terms. Anthem, which sued the pharmacy benefit manager last year over claims of being overcharged by $3 billion annually, said it…
Anthem May Exit More Individual Markets over Obamacare Funding
(Reuters)—Anthem Inc. said it may leave more individual Obamacare markets due to uncertainty about the potential repeal of the healthcare law and subsidies that make the plans affordable for millions of Americans. Republicans on Tuesday began a second day of debate on the U.S. Senate floor of a bill that would end Obamacare, but the…
Anthem Plans to Leave Obamacare Insurance Market in Ohio in 2018
(Reuters)—Anthem Inc., one of the largest sellers of Obamacare individual health insurance, will exit most of the Ohio market next year because of volatility and uncertainty about whether the government will continue to provide subsidies aimed at making the plans affordable, it said on Tuesday. Republicans are trying to cut off the subsidy payments in…
Anthem Still Weighing 2018 Obamacare Individual Participation
NEW YORK (Reuters)—Anthem Inc on Wednesday said its plans for selling 2018 Obamacare individual plans are still up in the air because of political and regulatory uncertainty, making it the latest health insurer to say questions about continued funding of government subsidies will affect consumers next year. Anthem, the biggest provider of individual health plans,…
U.S. Court Blocks Anthem-Cigna Deal
(Reuters)—A federal judge on Wednesday ruled against U.S. health insurer Anthem Inc.’s proposed $54 billion merger with smaller rival Cigna Corp, derailing an unprecedented effort to consolidate the country’s health insurance industry. The U.S. Department of Justice sued in July to stop Anthem’s purchase of Cigna, a deal that would have created the largest U.S….
Anthem May Trim Obamacare Participation in 2018
(Reuters)—U.S. health insurer Anthem Inc on Wednesday raised the prospect of smaller participation in the individual Obamacare exchanges in 2018, saying it would have a market-by-market strategy that hinges on 2017 profitability. The company said that losses due to sicker-than-expected customers in its individual Obamacare plans were a bit less than foreseen in the third…
U.S. Regulators Sue to Block Anthem-Cigna & Aetna-Humana Mergers
NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
U.S. Antitrust Officials Poised to Block Anthem, Aetna Deals
NEW YORK (Reuters)—U.S. antitrust officials are poised to file lawsuits to block Anthem Inc’s acquisition of Cigna Corp., as well as Aetna Inc.’s takeover of Humana Inc., a person familiar with the matter tells Reuters. Antitrust regulators have been scrutinizing the deals and looking at the potential for higher prices if the insurance market consolidates…