Health Plans’ Use of Policies and Guidelines to Reduce Coverage and Reimbursement - A technique we have seen payers use more commonly in recent months than in the past is to unilaterally implement policies or “clinical...more
The Antitrust Division recently issued its 2017 annual spring update. The update emphasizes the Division’s recent litigation victories, particularly in the merger context. In his introductory remarks, Assistant Attorney...more
During the summer of 2015, within a matter of days, Aetna announced an intention to merge with Humana and Anthem announced an intention to merge with Cigna. The deals, among the largest insurance industry combinations ever...more
In July 2016, following a lengthy review, the Antitrust Division of the Department of Justice (DOJ), together with several states, sued to block two proposed health insurer mergers: Aetna/Humana and Anthem/Cigna. On January...more
Securing the Safety Net for America's Vulnerable Populations - Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more
On February 8, 2017, the United States District Court for the District of Columbia granted a request filed by the U.S. Department of Justice’s Antitrust Division for an injunction blocking Anthem, Inc.’s (Anthem) proposed $54...more
In the past month, the DOJ and several state governments scored two trial wins in their challenges to mergers among some of the country’s largest health insurers. First, Judge Bates of the District of Columbia blocked the...more
In a continuation of recent Department of Justice (DOJ) successes challenging mergers, the U.S. District Court for the District of Columbia recently enjoined two more proposed mergers brought and litigated under the Obama...more
While the election of Donald Trump as the nation's next president is clearly the biggest news in Washington over the last two months, for the insurance industry, big news has also been made at the federal district courthouse....more
The trial over Aetna and Humana's $37 billion proposed merger kicked off today in a Washington, D.C. federal court. At issue is whether the companies' merger would substantially lessen competition in the market for...more
In late July, the DOJ Antitrust Division filed actions in federal district court seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In each case, the DOJ contended that consumers would face higher insurance...more
Following more than a year of regulatory review, in late July 2016 the Department of Justice (DOJ) Antitrust Division and a number of states filed actions seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In...more
In July 2015, health insurer mergers were announced between Anthem and Cigna and between Aetna and Humana. The effect of these mergers would elevate Anthem/Cigna to the #1 rank in size among national health insurers. ...more
The U.S. Department of Justice (DOJ), joined by attorneys general from several states, filed a lawsuit last Thursday in the U.S. District Court for the District of Columbia seeking to block two major mergers between health...more
In July 2015, Aetna announced its intention to acquire Humana, followed later that month by Anthem's announcement that it was acquiring Cigna. The deals are the largest insurance mergers ever proposed, and if consummated,...more
The proposed merger between major health insurers Aetna Inc. and Humana Inc. continues to inch closer to finalization. In a recent press release, Aetna announced that 10 states have now signed off on its proposed acquisition...more
Often considered the primary obstacle to telemedicine implementation, reimbursement changes are now better viewed as one of the most prominent drivers of telemedicine expansion. Payers are finally beginning to realize what...more
While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more
In the wake of Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana, providers are lining up to be heard. Take the American Medical Association (AMA), for example, which is urging federal and...more
In the last few months, several of the largest commercial health insurers in the nation have announced their intentions to merge. First, Aetna (currently the nation’s third largest health insurer by revenue) announced its...more
A recent flurry of activity in the health insurance industry would seem to indicate that investors can expect significant consolidation in the managed care sector....more