Healthcare Dive: Top Payer News | Weekly edition | Sept. 12, 2018 - FibroFlutters Patient Advocacy Organisation

Healthcare Dive: Payers land win with MA ruling | Michigan could nix Medicaid expansion without waiver | Weekly edition | Sept. 12, 2018

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In big payer win, court sides with UnitedHealth on MA overpayment rule

A federal judge vacated the rule, which the insurers said created additional burdens for Medicare Advantage plans not consistent with traditional Medicare regulations.

Michigan threatens to repeal Medicaid expansion if work requirements not approved

Two JAMA studies bolster critics of work requirements who say most Medicaid recipients who are able to work are already doing so, and tracking compliance will heap more administrative burden onto an already-taxed system.

California law brings more scrutiny of payer mergers

Payers must get approval from the state for any transaction that affects a “significant number of enrollees,” “involves a material amount of assets” or adversely affects “the stability of the health care delivery system.”

Managed care companies, providers would benefit from Medicaid expansion

Four states with ballot initiatives this fall to expand Medicaid could boost bottom lines of big-name payers and health systems, according to a new report.

Modest ACA plan premium changes expected for 2019

Following a year of concern about hefty rate increases and the possibility of some counties not having any ACA plan options, 2019 is shaping up to be a stable year for the exchanges.

Montana co-op wins $5.3M CSR lawsuit

The judge ruled that the federal government didn’t fulfill its obligation under the ACA when it stopped the cost-sharing reduction payments last year.

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