- The CMS barred three Medicare health plans operated by UnitedHealth Group Inc. and another owned by Anthem Inc. from enrolling new members next year because they didn’t spend the minimum amount required on medical benefits. The federal Medical Loss Ratio (MLR) regulation requires Medicare health plan to spend at least 85 percent premium revenue on medical claims, which, according to the CMS, the plans failed to meet for three years in a row. UnitedHealth said the COVID-19 pandemic led to some members deferring medical care, leading to it miss the threshold in a handful of markets. (Article here)
- Blues insurer CareFirst launched CloseKnit – a new virtual one-stop shop for primary and integrated care delivery. Numerous health care services –including preventive care, urgent care, behavioral health care, care coordination and insurance navigation – will be available through an app and are built to be affordable and transparently priced. Local providers will provide in-person care. (Press release here)
September 16, 2021
Payers