Insurer Aetna Inc said it will buy rival Coventry Health Care Inc for $5.6 billion in cash and stock to boost its share of government business and benefit from U.S. healthcare reforms. The U.S. healthcare reform aims to provide coverage for 16 million more Americans through privately run health insurance exchanges in each state, and will expand Medicaid eligibility for an additional 16 million people by raising limits on household income. The acquisition of Coventry will help Aetna lift its share of revenue from its government business to over 30 percent from 23 percent. It will help Aetna add nearly 4 million medical members and 1.5 million Medicare Part D members.
The Affordable Care Act is proving to be a boon for professional services firms, with Maryland and the District awarding millions of dollars in contracts to health care consulting and actuarial firms to study and advise on ACA-related provisions, including creating state-run health insurance exchanges. About 75 contracts have been awarded nationally in connection with various parts of the federal healthcare law, and between 40 and 45 of those are related to setting up health insurance exchanges, according to Herndon-based Deltek, which analyzes the contracting market. Maryland and D.C. have signed at least 12 contracts with consulting and actuarial firms, as well as a university, for work related to the Affordable Care Act, according to Deltek.
Many Californians are optimistic about one aspect of the new federal healthcare law—the online exchange where residents can shop for coverage, according to a Field Poll released Monday. The survey, taken July 12-29 and funded by the California Wellness Foundation, is Field's sixth annual look at public opinion on healthcare issues. Support for the law (54 percent) continues to be strong in the state. Those who "strongly support" the national law spiked to 38 percent (up seven percentage points from 2011) after a U.S. Supreme Court ruling in June backed key provisions of the law, Field found. More importantly, the poll offered a look ahead at what voters hope the new law will do when fully implemented in the next couple of years.
Prominent pharmacies such as CVS Caremark and Walgreens will promote the healthcare reform law's benefits for seniors, federal health officials announced. The joint effort between the Department of Health and Human Services (HHS) and major pharmacy chains means Medicare beneficiaries will have better access to details about the administration's health law, HHS stated. The information will be available in brochures or, in the case of Wal-Mart and Sam's Club, online. "Our pharmacy partners are helping their customers make informed healthcare decisions," HHS Secretary Kathleen Sebelius said Wednesday at a CVS location in Jacksonville, Fla.
A proposal by the Maryland Hospital Association circulated to policymakers in recent weeks details a plan to shift costs to private payers by raising the rates they pay hospitals by 7 percent over three years while giving sharp discounts to the Medicare program for seniors and the Medicaid program for the poor. Once phased in, the plan would raise charges for commercial insurers and their customers by about $350 million a year and increase their price for a typical hospital admission by $900—in addition to underlying healthcare inflation.
Two doctors who once worked at a Pompano Beach pain clinic are among 11 people facing charges in connection with a three-year pill mill investigation headed by the Drug Enforcement Administration. Dr. Mark Cukierman, 56, was charged with racketeering and delivery of a controlled substance, among other charges. Dr. Michael Fronstin, 75, was arrested on charges of illegally prescribing a controlled substance by a practitioner and delivery of a controlled substance, according to a DEA spokesperson. The two are among seven doctors, three clinic owners and one of their relatives charged with racketeering and other criminal violations in South Florida. They all at one point or another worked at Pompano Beach Medical, formerly known as Pain Management Inc., said DEA spokeswoman Mia Ro.