Volume II, Issue 30
July 27, 2015

Anthem to acquire Cigna, leaving only 3 big insurance companies

WH

In a July 24, 2015 post, CNN reports:  

 

In another merger of health insurance giants, Anthem has agreed to acquire Cigna in a $54 billion deal.

 

Anthem (ANTM), a Blue Cross and Blue Shield insurer, said it would buy all of Cigna's (CI) shares in a cash and stock transaction.

 

The deal is expected to close in the second half of 2016, if it passes state regulatory approvals and other requirements. The merged insurer would cover 53 million members.

 

The merger would leave only three major players in the insurance industry.

 

WIM 

The author of the article, Aaron Smith, further states:

 

Some doctors are concerned that the mergers will put too much power in just a handful of insurance companies. The American Medical Association said the mergers will "reduce competition and decrease choice."

 

There are also worries that costs for customers will go up because of less competition.

 

But the health insurers are defending their move. "This will actually improve efficiencies and reduce costs for consumers down the line," said Cigna spokesman Matt Asensio.

 

Editor's Note: Consolidation does typically reduce costs. Whether or not those cost reductions are passed on to the consumer remains to be seen.

Miami pharmacy owner pleads guilty to $1.8M Medicare fraud    

WH

Nina Lincoff reporting for the SFBJ on July 24, 2015 states:

Miami resident and pharmacy owner Evelio Fernandez Penaranda pleaded guilty Thursday for his involvement in an $1.8 million Medicare fraud scheme, according to the U.S. Attorney for the Southern District of Florida.

 

Penaranda pleaded guilty to one count of health care fraud. He was indicted in June as part of a nationwide Medicare fraud takedown authorities called the largest in U.S. history.

 

Penaranda was the owner of Naranja Pharmacy, and between May 2013 and March 2014, submitted fraudulent claims to Medicare for drugs that were not prescribed, not needed, and not given to Medicare patients.

 

WIM  

South Florida residents were well represented in the takedown and we can expect the government to continue its close scrutiny of healthcare providers in the region.

Possible delay of MU Stage 3?    

WH  

Virgil Dickson, in a 7.23.15 Modern Healthcare post, reports: 

 

The Senate Health, Education, Labor and Pensions Committee is asking to delay Stage 3 Meaningful-Use Rules, its chairman, Lamar Alexander (R-Tenn.), said during a news conference Thursday.

 

WIM

This will be one of several recommendations his committee will make to the Obama administration in a push to expand the use of electronic health records, which some providers say are costly and time-consuming. Sen. Alexander expressed hope that healthcare would not "go backwards on EHRs," but discussed the possibility of delaying MU3 to ensure the process goes smoothly.

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Florida Health Industry Week in Review is published every Monday by FHIcommunications

Each Monday morning we share the top healthcare headlines of the previous week and summarize What Happened (WH) and Why It Matters (WIM).

To learn how you can join our team of editorial contributors, contact Jeffrey Herschler.

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