Victory: Judge Blocks Aetna-Humana Merger By Terri Marchiori, Director, Federation Relations, AMA In a landmark win on Jan. 23 for organized medicine and the nation’s patients, federal judge John D. Bates blocked the proposed Aetna-Humana merger, finding that the merger would have substantially lessened competition in Medicare Advantage and commercial health insurance markets. This is an extraordinarily well-documented, comprehensive, fact-based ruling by U.S. District Judge John D. Bates, which acknowledges that meaningful action was needed to preserve competition and protect high-quality medical care from unprecedented market power that Aetna would acquire from the merger deal. ... February 6, 2017 Health Plans Aetna-Humana Merger 0 0 Comment Read More »
June 30 Deadline Looms for Opting out of Anthem Individual / Exchange Network By the California Medical Association June 16, 2014 Physicians who do not want to participate in Anthem Blue Cross's individual / exchange network have until June 30, 2014, to opt out. In March, Anthem Blue Cross notified over 11,000 practices that are currently participating in its individual / exchange network of a contract addendum that will become effective July 1, 2014. The amendment only applies to physicians who are currently participating in the Anthem Blue Cross individual / exchange network. One provision of significant concern is language in section 12 of the addendum ... June 16, 2014 Health Plans Anthem Blue Cross 0 0 Comment Read More »
Urgent Survey Request: Help CMA Outlaw 'All Products' Clauses April 23, 2014 Currently, the California Medical Association (CMA) is in the midst of a legislative struggle to require greater transparency in physician contracts. Representatives of Blue Cross, Blue Shield, and other plans are asserting that plans should be able to require a physician’s participation in all of their products via ambiguously worded clauses, which are often referred to as “all products clauses.” These clauses force physician participation in all networks or products that are currently offered or that may be offered by the health plan and have become a ... April 23, 2014 Health Plans All Products Clauses 0 0 Comment Read More »
Important Information on the Anthem Exchange Addendum As you may have seen in CMA's April 7 Alert, Anthem Blue Cross sent an addendum to over 11,000 practices who are participating in their individual / exchange network. The addendum makes changes to a prior addendum sent out in 2012. CMA has concerns with a few provisions, outlined in the Alert article. While CMA's article identifies issues with three provisions in the addendum, of significant concern is the language in section 12, which removes a participating physician’s ability to opt out of the individual / exchange product without affecting ... April 9, 2014 Health Plans Anthem 0 0 Comment Read More »
What Physicians Need to Know About the Anthem Exchange Addendum By the California Medical Association (CMA): April 8, 2014 Anthem Blue Cross recently notified over 11,000 practices who are currently participating in its individual / exchange network of a contract addendum that will become effective July 1, 2014. The amendment only applies to physicians who are currently participating in the Anthem Blue Cross individual / exchange network. According to the notice, which was mailed on March 31, the addendum contains new regulatory requirements. While many provisions are requirements of Covered California, the California Medical Association (CMA) has concerns with certain provisions ... April 9, 2014 Health Plans Anthem 0 0 Comment Read More »