For Insurance Industry, A Time Of Upheaval
Some universities that took a financial hit after being forced to shut down during the pandemic are suing FM Global, saying their insurance policies included coverage for losses due to "communicable diseases." Also in the news: Humana, Medicare Advantage, price transparency rules and more.
Universities, Other Institutions Suing Insurers For Not Covering COVID-19 Losses
As the novel coronavirus pandemic spread across the country last year, Rockhurst University in Kansas City faced an unprecedented financial crisis. With students suddenly being sent home and major school events canceled, the virus halted the major revenue stream that kept the university afloat. After the university refunded more than $2 million in room and board expenses for last year's spring semester, the school continued to suffer significant financial losses and added expenses related to the virus. (Romero, 4/27)
Humana Pays $5.7 Billion For Remaining Share Of Kindred At Home, Could Take Business Public
Humana will pay $5.7 billion to buy the remaining shares of Kindred at Home, bringing its total investment in the nation's largest home care and hospice provider to $8.1 billion. While the proposed acquisition covers the totality of Kindred's business, Humana eventually plans to integrate just the home health side into its Home Solutions business line, with the aim that it will eventually provide care to those insured outside Humana, and be rebranded to CenterWell Home Health, taking on the name of Humana's recently-launched healthcare services company. (Tepper, 4/27)
Inpatient Pay Rule Would Give Hospitals $2.5 Billion Boost
CMS on Tuesday proposed eliminating its plan for providers to disclose their contract terms with Medicare Advantage insurers, one of a slew of high ticket changes in its Hospital Inpatient Prospective Payment System rule. In the proposed rule, CMS said hospitals would no longer be expected to report the median payer-specific negotiated charge with MA insurers on its Medicare cost reports retroactive to Jan. 1, 2021. The change would eliminate more than 63,000 burden hours for providers. Hospitals have long challenged the agency's attempts to impose price transparency requirements, maintaining they wouldn't help consumers or lower healthcare costs. (Brady, 4/27)
Georgia Health News:
How Are Hospitals Dealing With Price Transparency Rule?
Jan. 1 marked the launch of a federal rule on medical prices that the hospital industry fought hard to stop. For the first time, each hospital was required to publish a website file showing the payment rates it had negotiated with insurers, and another post that would let consumers search for hundreds of “shoppable’’ medical services. The Trump administration rule drew a lawsuit from the American Hospital Association, a suit that was rejected by a federal appeals court. (Miller, 4/27)
Watch: What Happens When Car And Health Insurance Collide
“CBS This Morning,” in collaboration with KHN and NPR, tells the story of Mark Gottlieb, a marketing consultant in Little Ferry, New Jersey, who faced more than $700,000 in medical bills after surgery on his spine. Gottlieb was injured in a car accident, and, despite having the maximum amount of personal injury protection in his car insurance policy, his medical bills exceeded it. His health insurance could not help much, because his surgeon was out-of-network. In an interview with Anthony Mason of CBS, KHN Editor-in-Chief Dr. Elisabeth Rosenthal describes some of the pitfalls accident victims can try to avoid as they seek care. (4/27)