Exchange Premiums Moderate For 2019 In Face Of Challenges

Open enrollment for 2019 health insurance exchange plans in the individual market begins November 1. This market faces unique challenges in 2019, but entering into the new plan year, plan participation and enrollment is strong and premiums are declining, on average, relative to 2018. Click to read more.

Managed Care Friday

Note: We will reporting live from the Payer’s Behavioral Health Summit in DC Oct 16-17; the first Managed Care Friday Forum series will be held at the end of this month; guests and topics to be announced. 1. 1 in 5: That’s the number of women who suffer from post-partum depression in some states according to CDC research. New studies show that most post-partum depression symptoms actually occur during pregnancy. 1 in 4 men can also experience post-partum. Read more from an interview with a Connecticut delivery nurse by clicking here. 2. MA Drug Step Down: United’s step therapy program for...

The OIG Releases Annual Look At Medicare Lab Payments

As part of the Protecting Access to Medicare Act (PAMA) legislation that directed an overhaul of Medicare’s clinical lab fee schedule, Congress required the HHS Office of Inspector General (OIG) to produce an annual report on Medicare lab payments. In the latest report, the OIG paints a picture of lab payments in 2017, showing lab payments as very stable and highly concentrated among a few tests. Click to read more.