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Open enrollment for Medicare begins October 15 and this year there are lots of changes that will create more health care options for seniors.

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Legal challenges continue to mount over the state’s Medicaid managed-care program. Lighthouse Health Plan filed a petition in state administrative court last week challenging state decisions that it says will lead to the automatic assignment of Medicaid patients in Northwest Florida to a competitor, Humana. 

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After scoring a big victory in a statewide Medicaid managed-care procurement, Humana and Jon Bussey, who served as its regional director of corporate affairs, have parted ways. 

The Weekly Check Up: Working Some Medicaid Magic

Apr 30, 2018
Humana.com

Humana is probably very happy right about now.

The insurer emerged from negotiations with Medicaid officials as one of the winners in the contest to deliver health care to poor, elderly and disabled Floridians over the next five years.

Florida officials on Tuesday announced the names of the nine health plans the state wants to ink contracts with to provide health care to nearly four million poor, elderly and disabled residents.

Health insurance companies Aetna and Humana have called off their planned merger, citing a federal court ruling last month that blocked the deal.

"While we continue to believe that a combined company would create greater value for health care consumers through improved affordability and quality, the current environment makes it too challenging to continue pursuing the transaction," Aetna CEO Mark Bertolini said in a statement.

Humana, Florida’s largest Medicare managed-care company, says it will lay off hundreds of employees in April, including 328 in Florida.

Of those, 260 are in the Tampa Bay area, according to Humana spokeswoman Nancy Hanewinckel.

A federal judge has ruled against the proposed acquisition of the health insurance company Humana by its larger rival, Aetna.

The decision is a victory for former President Obama's Justice Department, which sued Aetna last year to block the $34 billion merger, NPR's Yuki Noguchi reported.

The suit alleged that the merger would hurt competition in the health care market, leading to higher prices for consumers and fewer services for Medicare patients.

Florida Joins Legal Fight Against Aetna-Humana Merger

Jul 22, 2016

Pointing in part to concerns about the Medicare Advantage market for seniors, Florida Attorney General Pam Bondi on Thursday joined the U.S. Department of Justice and other states in filing an antitrust lawsuit seeking to block a $37 billion merger between the health insurers Aetna Inc. and Humana Inc.

Humana became the latest health insurer to serve notice that it might leave some Affordable Care Act exchanges next year, creating more uncertainty for customers ahead of this fall's enrollment window and presidential campaign, during which the law is sure to remain a hot debate topic.

Insurance giant Humana Inc., which operates some of the nation's largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit.

Florida regulators have approved Aetna’s bid to buy Humana’s health insurance companies in Florida – with conditions.

Florida’s Pam Bondi is one of 15 state attorneys general helping federal officials investigate two pending mega-mergers in the health insurance industry, Reuters News Service reported this week.

Lottie Watts / WUSF

The latest numbers from federal health officials show Florida is continuing to lead in enrollment on HealthCare.gov, with nearly 600,000 who have signed up so far.

Cigna CEO: Marketplace Is Still ‘Version 1.0’

Dec 8, 2015
Associated Press

Cigna CEO David Cordani says the individual market created by the 2010 health law would be better off if insurers were given more flexibility in designing coverage, as well as a more compressed, focused open enrollment period.

Just days after UnitedHealth Group’s CEO said their move into the new marketplace was a mistake, Cordani reaffirmed that Cigna remains committed for 2016, although the firm is so far losing money on that business.

Florida insurance regulators this week will scrutinize two major health plan mergers.

Humana.com

A recent federal court decision in Miami may help health care providers who are suing plans that have slashed Medicare Advantage payments, Modern Healthcare reports.

Hospital Corporation of America hospitals will remain “in-network” under Humana health insurance plans, the Tampa Bay Times reports.The HCA chain is one of the largest nationally and has 22 hospitals and surgery centers in the Tampa Bay area.

Florida consumers face the risk of higher insurance rates if the merger of health care giants Humana and Aetna goes through, the Tampa Bay Times reports.

A Health Management, Policy and Innovation analysis of an insurance company merger in Nevada saw consumer costs increase 14 percent, the Times reports.

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Aetna, one of the biggest health insurance companies in the U.S., has announced a $37 billion deal to buy its rival Humana. This is a merger that could impact Medicare patients around the country, as NPR's Hansi Lo Wang reports.

In what could prove the largest-ever merger in the insurance industry, Aetna has announced a $37 billion deal to acquire rival Humana.

The agreement, announced by the Hartford, Conn.-based Aetna, "would bolster Aetna's presence in the state- and federally funded Medicaid program and Tricare coverage for military personnel and their families," according to The Associated Press.

Humana has sent letters to its Florida customers alerting them that as of July 10, HCA hospitals will no longer be part of the insurer’s network.  

When it comes to insurance disputes, this is the heavyweight division. Humana, based in Louisville, has close to 1 million Medicare patients in Florida plus hundreds of thousands of business and individual customers who sign up through insurance agents or the federal Marketplace for subsidized plans under the Affordable Care Act.

Humana has pulled out of a major health care conference and said it will not comment on rumors of a merger, actions that will likely fuel Wall Street speculation that the insurer is part of a developing deal.

Shares of the Medicare Advantage coverage provider, which hit an all-time high late last month, rose Monday while broader indexes slipped.

 Humana shares soared well beyond all-time high prices Friday afternoon on speculation that the company, one of the nation's biggest health insurers and Florida's largest Medicare HMO company, might be up for sale.

Analysts have been discussing for a few weeks the possibility that large health insurers flush with cash may be hunting for a big acquisition. Deal-friendly low interest rates and expectations for another wave of consolidation also are fueling the speculation.

Several of the nation's biggest health insurers have hiked earnings expectations for 2015 after blowing past first-quarter forecasts and heading into a much more stable future than they faced this time last year.

Lottie Watts / WUSF

  

Back in November, Phil Ammann of St. Petersburg was figuring out what he was going to do for health insurance. He found himself having to select a new plan, since the plan he bought on HealthCare.gov, was no longer going to be an option in 2015.

He wasn't the only Floridian going back to re-enroll in a plan.  According to federal health officials, 51 percent of the 673,255 Floridians who enrolled during the first weeks of enrollment were returning customers. 

The general surgery residency program at Halifax Health will be losing its accreditation as of July 2016, according to the Daytona Beach News-Journal

Following in the footsteps of Cigna, Coventry Health Care has agreed to a deal with the Florida Office of Insurance Regulation to limit the costs of some HIV treatment drugs for consumers to $200 a month, the Miami Herald reports.

Just in time for Medicare's open enrollment season, a Florida-based HMO has won the federal government's coveted  five-star rating, a rare honor that brings more than bragging rights. Such plans receive the freedom to enroll new members all year long. 

The winner, CarePlus Health Plans Inc., is a subsidiary of Humana Inc., Florida's largest Medicare vendor. Humana did well in the quality ratings, too,  but was outscored by the little plan it bought in 2005.

Insurers: 2015 Exchange Rates Could Spike

Jul 31, 2014

State insurance officials are preparing to release figures next week on how much health plans will cost under the Affordable Care Act for 2015, and rate increases seem inevitable as insurers say their new consumers are older and sicker than anticipated.

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