HEALTH INSURANCE
DOJ sues three Medicare Advantage insurers
Here’s some news not about UnitedHealthcare, which already dominates the Medicare Advantage market. The Department of Justice just sued CVS Health’s Aetna, Elevance Health’s Anthem, and Humana, alleging a scheme in which the health insurers bribed insurance brokers to steer older adults to their policies, Bob Herman and Tara Bannow report. Those three insurers together cover nearly 40% of the Medicare Advantage market. The brokers named in the lawsuit are eHealth, GoHealth, and SelectQuote. (The DOJ is still pursuing a long-running fraud case against UnitedHealth Group that alleges the company illegally collected billions of dollars from the Medicare Advantage program.)
The taxpayer-funded alternative to traditional Medicare run by private insurers, which now covers most Medicare enrollees, has garnered millions of signups in recent years because retirees enjoyed its out-of-pocket cost caps and coverage of extra benefits. But that coverage also came with narrow networks of providers and unexpected denials of care. What’s more, over the past year, upcoding by MA insurers such as UnitedHealthcare has come to light — as STAT’s award-winning series Health Care’s Colossus documented. Read more about the nation’s leading health insurer in a new STAT Report, “From Insurer to Industry Titan: Inside UnitedHealth’s Empire.”
infectious disease
Why a government lab for dangerous pathogens was ordered to stop work
A U.S. government laboratory that works on dangerous pathogens such as Ebola and Eastern equine encephalitis was abruptly instructed to cease operations this week. While news of the stop work order first broke on Wednesday, the reason for it was not initially made clear. That changed yesterday.
In response to queries from STAT, HHS communications director Andrew Nixon said he could confirm the details of a newly published Fox News story. It alleged that serious safety violations occurred at the NIH’s Integrated Research Institute at Fort Detrick, Md. — specifically that one member of the staff poked holes in a colleague’s protective equipment in what was described as a lover’s spat. Lab director Connie Schmaljohn, who reportedly did not immediately document the incident, has been put on administrative leave. STAT briefly reached Schmaljohn, who declined to be interviewed. — Helen Branswell
CONGRESS
Lawmakers urge return of public comment on HHS rulemaking
After health secretary Robert F. Kennedy Jr. decided in late February to suspend public comment on much of the business that HHS conducts, numerous patient groups came out in opposition, but members of Congress were largely mum.
Yesterday, though, Democratic lawmakers pushed back and introduced two resolutions calling on the administration to reverse course, Isa Cueto reports. The House and Senate resolutions were supported by the National Rural Health Association, Children’s Hospital Association, American Academy of Family Physicians, Planned Parenthood Federation of America, and the United Steelworkers, among others. Former federal health officials are also calling for HHS to restore comment. “What is HHS so afraid of that they don’t want to hear from people impacted by government policies?” Chiquita Brooks-LaSure, former CMS administrator, said in a statement. Read more from Isa on the Richardson Waiver.
