Here are four observations:
1. Many claim the mega-mergers will stifle competition and raise costs for consumers, yet the payers says mergers will help them eliminate unnecessary costs and provide more affordable benefits. An Aetna executive told regulators the company’s merger with Humana should yield $1.25 billion in savings by 2018 at a state hearing last week.
2. In the state, two insurance regulators have been conducting public hearings to examine the mega-mergers and more hearings are expected to ensue in the coming weeks.
3. U.S. Justice Department antitrust officials are reviewing the deals, however states usually are in charge of regulating health insurers and enforcing consumer protections.
4. California’s Department of Managed Health Care found Aetna’s rates have been unreasonable since 2013. Despite the agency’s findings, Aetna keeps raising their rates. “Aetna has shown a pattern of moving forward with premium rate increases the DMHC has found to be unreasonable or unjustified,” said Shelley Rouillard, director of California’s Department of Managed Health Care, “I can assure you rates are something that we will be looking at and considering as part of our review.”
More articles on coding & billing:
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