How Medicare Advantage Plans Factor Into Aetna-Humana Proposed Mega-Merger
CNBC reports that if the acquisition gets a regulatory green light, the combined company's Medicare Advantage enrollment would be nearly 4.5 million members, which is about 25 percent of this year's national enrollment. Also in the news, compounding pharmacies are increasingly under scrutiny as a new frontier for Medicare fraudsters.
Medicare Plans May Be More Competitive Than The DOJ Thinks—Here's Why It Matters
The Department of Justice is widely expected to be nearing a decision on Aetna's $34 billion deal with Humana and Anthem's $54 billion agreement to buy Cigna, one year after the mega-health insurance mergers were announced. For months, analysts thought the Anthem-Cigna deal was the more challenged of the two when it comes to regulatory approval, because of the potential impact their combination would have on competition in the commercial large-employer market. Now, investors are increasingly concerned regulators could block Aetna and Humana's merger because of the potential dominance the combined company would have in the market for private Medicare health plans known as Medicare Advantage. (Coombs, 7/17)
The Fiscal Times:
A New Source Of Medicare Fraud Emerges: Handmade Drugs
The somewhat murky world of pharmacy drug compounding was rocked by scandal in 2012 with the disclosure that 64 people had died and nearly 800 others had been sickened by a multi-state outbreak of fungal meningitis and other infections caused by a New England company’s sale of mislabeled and contaminated medications. After years of criminal prosecutions, civil suits and huge financial settlements, that controversy finally began to fade. But a recent report by the Department of Health and Human Services Inspector General’s Office has sparked a new concern that the compounded drug industry, which provides specialized mixed drugs tailored to consumers’ needs, is rife with fraud and may be overcharging Medicare and other health care providers hundreds of millions of dollars. (Pianin, 7/18)
Earlier, related KHN coverage: Fraud Concerns Emerge As Compounding Drug Sales Skyrocket (Appleby, 7/18).