Aetna
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The Kraft Heinz Lawsuit Against Aetna Is the ‘Tip of the Iceberg’
Kraft Heinz recently sued Aetna, claiming that the insurer is not providing all of Kraft Heinz’s medical claims data. More lawsuits of this sort are likely to come, experts warned.
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CVS Health: 60% of Mental Health Physicians See Patients’ Conditions Declining
New CVS Health data found that while 42% of respondents are concerned about their mental health, only 12% are seeing a mental health professional, such as a psychiatrist, psychologist, psychotherapist or wellbeing therapist. Younger respondents are especially struggling: 60% of those aged 18 to 32 years old are concerned about their mental health.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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Oshi Health Scores Its 1st Commercial Contract Through VBC Partnership with Aetna
Oshi Health recently entered a value-based care contract with Aetna. The New York-based startup provides specialized virtual care for patients with digestive disorders, focusing on dietary and behavioral health interventions to reduce the root cause of patients’ symptoms.
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Banner|Aetna launches program to reduce billing confusion among members
Banner|Aetna — the Arizona health plan owned by Banner Health and Aetna — rolled out a new frictionless billing program. It is designed to minimize confusion among members by combining billing information from both the provider and payer.
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CVS Health reports 15.7% reduction in suicide attempts among Aetna members
Among CVS Health’s adult members, there was a 34.1% decrease in suicide attempts in 2022, compared to 2019. However, there was a 32% increase among adolescents, largely due to challenges from Covid-19. In response, CVS Health is expanding its resources with new initiatives that focus on adolescents.
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Insurance company abuses are putting more patients’ care out of reach
Insurers’ abuse of prior authorization is creating health risks for patients and contributing to higher downstream costs for both beneficiaries and the larger health care system.
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Aetna’s prior authorization policy harms California patients
Beginning July 1, Aetna now requires prior authorization for all cataract surgeries, across all its members and plans. Here in California and across the country, ophthalmologists are going to great lengths to secure approval from Aetna for cataract surgery, while the backlog caused by prior authorization and delayed elective care during the Covid-19 pandemic only grows.
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Lawsuit: Aetna fertility coverage policy “an illegal tax” on LGBTQ people
The lawsuit alleges that an Aetna policy discriminates against LGBTQ people by requiring them to pay thousands in out-of-pocket costs for fertility treatments before becoming eligible for coverage. Though Aetna has agreed to pay the costs incurred by the plaintiffs, the suit aims to strike down the policy as a whole.
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Teladoc backs national virtual primary care plan for self-funded companies
The plans, which will be offered by Aetna, are based on Teladoc’s physician care team model, and also includes providers through Aetna’s network and CVS Health services.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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With telehealth, pharmacy offerings, Amazon starts to encroach on PBMs
As Amazon starts to roll out its telehealth and pharmacy offerings, most big health systems and insurers don’t yet view it as a threat. But pharmacy benefit managers and vertically integrated payers will be keeping a watchful eye on the company as it starts to encroach on a slice of their business.
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Aetna accuses Mednax of destroying evidence in overbilling suit: 5 things to know
In a lawsuit filed three years ago, Aetna alleged that Mednax had overbilled for medical procedures and services. Now, the insurer is accusing the medical group of destroying evidence pertaining to the suit and has asked a federal court to sanction Mednax.
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CVS plans to re-enter ACA marketplace in 2022
After completely exiting the ACA exchanges in 2018, CVS plan to re-enter them in 2022. Last year, enrollment through federal exchanges increased, and Aetna CEO Karen Lynch said the markets have stabilized.
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Aetna expands gender-affirming surgery coverage
Aetna will now cover breast augmentation for trans women, signaling hope for increased access to healthcare for the transgender community. The coverage expansion comes after transgender individuals and groups advocated for the change.
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Information of nearly half a million Aetna members exposed in email hack
An email hacking incident exposed the information of close to 500,000 Aetna health plan members, the payer reported to HHS last week. The incident occurred when an unauthorized person gained access to an email account of Aetna’s vision benefit services provider.
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Pharma, Payers, Social Determinants
Unite Us expands social determinants partnerships in Louisiana, West Virginia
The technology company is partnering with major insurers, including Aetna and Humana, as well as providers like Ochsner Health to expand access to its platform that connects patients to community-based social services.
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Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
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Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
