Updated payor profiles for 2017 now available The California Medical Association’s (CMA) Center for Economic Services is publishing updated profiles on each of the major payors in California including Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA, Health Net, UnitedHealthcare, Medicare/Noridian and Medi-Cal. Each profile includes key information on health plan market penetration; a description of the plan’s dispute resolution process; and the name and contact numbers for medical directors, provider relations, and other key contacts. Don’t waste your time searching the internet for this information – members can download CMA’s Payor Profiles free of charge ... August 1, 2017 CMA, Managed Care, Medi-Cal, Medicare Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net, Insurance, Medi-Cal, Medicare, Noridian, Payor, Payor Profiles, Running a Practice, UnitedHealthcare 0 0 Comment Read More »
U.S. District Court blocks Anthem-Cigna merger A federal judge has blocked the $48 billion mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). The ruling favored the U.S. Department of Justice (DOJ) and 11 states, including California, who argued that the Anthem-Cigna merger would limit price competition and lower the quality of care that Americans receive. “The California Medical Association (CMA) has opposed the Anthem-Cigna mega-merger since day one because it would hurt patients and increase health care costs,” said CMA President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract ... March 2, 2017 Managed Care Anthem Blue Cross, Cigna 0 0 Comment Read More »
Large insurers drop barriers to prescribing medications for opioid use disorder Three of the nation's largest insurers—Aetna, Cigna, and Anthem Blue Cross—have in recent months announced that they will no longer require physicians to seek prior approval before prescribing medication to treat opioid use disorder. These policy changes come as more than 2.2 million people meet the diagnostic criteria for an opioid use disorder. Treatment of opioid use disorder with opioid maintenance therapies has been shown to be cost-effective, safe and successful when used appropriately. Increasing access to treatment is crucial to addressing opioid misuse and overdose, and the California Medical Association ... March 2, 2017 General Aetna, Anthem Blue Cross, Cigna, Opioids, Preauthorization 0 0 Comment Read More »
Court proceedings begin in Anthem-Cigna mega-merger lawsuit On Monday, the U.S. Justice Department (DOJ) and a bipartisan group of state attorneys started court proceedings to block the $48 billion mega-merger between Anthem and Cigna. The merger, if allowed to proceed, would reduce competition and increase health plan market power, compromising patients’ access to care and negatively impacting the quality and affordability of health care across the country. “The California Medical Association has opposed the Anthem-Cigna mega-merger since day one because it will hurt patients and increase health care costs,” said California Medical Association (CMA) President Ruth E. ... November 28, 2016 General, Managed Care Anthem, Cigna, Mega-mergers 0 0 Comment Read More »
Anthem-Cigna mega-merger compromises health care access, quality and affordability Today, the U.S. Department of Justice (DOJ) and a bipartisan group of state attorneys started court proceedings to block the $48 million mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). “The California Medical Association has opposed the Anthem-Cigna mega-merger since day one because it will hurt patients and increase health care costs,” said California Medical Association (CMA) President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract with fewer physicians, resulting in higher premiums and longer wait times for referrals – not to mention forcing ... November 22, 2016 Managed Care Anthem Blue Cross, Cigna, Insurance, Legal Advocacy 0 0 Comment Read More »
CMA applauds U.S. Justice Department lawsuit against health insurance mega-mergers The California Medical Association (CMA) today applauded the U.S. Department of Justice (DOJ) for filing two lawsuits challenging the proposed merger of Anthem and Cigna and of Aetna and Humana — all of which are among the largest health insurance companies in the country. “We applaud the DOJ for protecting patients against mega-mergers that would drastically reduce competition in the health insurance market, leaving patients at a huge disadvantage in the pursuit of timely and affordable health care,” said CMA President Steven Larson, M.D., MPH. “We also commend California Insurance ... August 5, 2016 Managed Care Aetna, Anthem Blue Cross, Cigna, Department of Justice, DOJ, Advocacy, Humana 0 0 Comment Read More »
DOJ files lawsuit to block two health insurance mega-mergers The U.S. Department of Justice (DOJ) today filed two lawsuits to block health insurance mega-mergers that would compromise patients’ access to care, and negatively impact the quality and affordability of health care across the country. “If allowed to proceed, these mergers would fundamentally reshape the health insurance industry,” U.S. Attorney General Loretta Lynch said at a press conference. “They would leave much of the multi-trillion dollar health insurance industry in the hands of three mammoth insurance companies, restricting competition in key markets.” The California Medical Association (CMA) has long-held concerns over ... August 5, 2016 Managed Care Cigna, Department of Justice, DOJ, Aetna, Anthem Ble Cross, Humana 0 0 Comment Read More »
CMA and AMA urge DOI to oppose Anthem and Cigna merger Last week, the California Medical Association (CMA) testified before the California Department of Insurance (DOI), urging it to oppose the proposed merger of Anthem and Cigna. “We are concerned with the impact of this merger on physicians and patients,” said Francisco Silva, CMA general counsel and senior vice president. “We are concerned that this merger would compromise access to health care, health care quality and patient affordability.” The American Medical Association (AMA) also sent representatives to the hearing to testify against the merger. “We oppose Anthem’s goal of dominating the California ... April 4, 2016 General Department of Insurance, Anthem Blue Cross, Cigna, Regulatory advocacy 0 0 Comment Read More »
California physicians oppose health plan mega-mergers, citing reduced access to affordable high-quality health care SACRAMENTO — Eighty-five percent of California’s physicians are opposed to the merger of health insurance giants Anthem and Cigna, according to a new analysis released by the California Medical Association (CMA) on Monday. The CMA survey, conducted in collaboration with the American Medical Association (AMA), sought to gauge California physicians’ perspective on the proposed Anthem-Cigna and Aetna-Humana mergers, as well as gather insight into the tactics undertaken by insurance companies’ in their negotiations with physicians. “California’s doctors could not be more clear: these mergers are bad for patients and bad for ... March 31, 2016 Managed Care Cigna, Mergers, Anthem 0 0 Comment Read More »
CMA seeking physician feedback on proposed health insurance mergers Proposed mergers of the some of the largest national health insurance companies have been announced, with Aetna reaching a $37 billion deal to purchase Humana, and Anthem agreeing to purchase Cigna for $48.4 billion. State and federal regulators are interested in knowing the prospective effects of these possible mergers on your practice and patient care. The California Medical Association (CMA), in collaboration with the American Medical Association, is asking for your feedback on these proposed mergers. The survey should take about 8-9 minutes to complete. Only de-identified data will be used ... February 9, 2016 Managed Care Anthem Blue Cross, Cigna, Humana, Aetna 0 0 Comment Read More »
