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  Other Claims News

California tax officials blast Blue Shield in audit
On Los Angeles Times - July 5, 2015

In a scathing audit, state tax officials slammed nonprofit health insurer Blue Shield of California for stockpiling "extraordinarily high surpluses" — more than $4 billion — and for failing to offer more affordable coverage or other public benefits.
The California Franchise Tax Board cited those reasons, among others, for revoking Blue Shield's state tax exemption last year, according to documents related to the audit that were reviewed by The Times. These details have remained secret until now because the insurer and tax board have refused to make public the audit and related records.

Aetna To Buy Humana For $35 Billion
On Los Angeles Times - July 3, 2015

Aetna will spend about $35 billion to buy rival Humana and become the latest health insurer bulking up on government business as the industry adjusts to the federal healthcare overhaul.
The proposed cash-and-stock deal, announced early Friday, would make Aetna a sizable player in the rapidly growing Medicare Advantage business, which offers privately run versions of the federally funded healthcare program for the elderly and some people with disabilities.
Humana has nearly 3.2 million people enrolled in Medicare Advantage plans, a total that falls just sort of market leader UnitedHealth Group Inc.

Medical care inflation could increase workers comp costs
On Business Insurance - July 2, 2015

With medical care inflation expected to rise, workers compensation payers should take steps to control higher medical costs per claim, sources said.
“Increased pressure” on medical costs per workers comp claim is expected as medical care inflation picks up, the National Council on Compensation Insurance Inc. said in a quarterly briefing published this week.

Health Insurer Centene Adds Muscle With $6.3 Billion Deal For Rival
On Business Insurance - July 2, 2015

(Reuters) — U.S. health insurer Centene Corp. will buy smaller rival Health Net Inc. for $6.3 billion, underscoring the health care industry’s rush to bulk up to negotiate better prices with suppliers and hospitals, and attract new customers.

Health Net’s shares touched a record high of $76.67 on Thursday, but stayed shy of Centene’s offer of $78.57, which is at a 21% premium. Centene shares were down 3% at $78.42.

The deal comes a week after the U.S. Supreme Court upheld subsidies for individuals under President Barack Obama’s signature healthcare law, keeping a large chunk of patients intact under the Medicare and Medicaid programs.

More Other Claims News

July 2, 2015 - Anthem, Cigna in new round of talks, source says

July 1, 2015 - ACE To Acquire Chubb For $28.3 Billion. Combined company to assume the Chubb name, in second major M&A deal this week.

June 30, 2015 - Marijuana ruled reasonable and necessary for injured workers pain relief

June 26, 2015 - Washington Man Used Seahawks’ Names to File Fake Workers’ Comp Claims

June 26, 2015 - California is on a bumpy road to workers’ compensation recovery

June 25, 2015 - Employer snooping cuts comp claim costs

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