Healthcare Lawsuits Galore
A good article from Modern Healthcare on various Medicare Advantage (MA) and Affordable Care Act (ACA) lawsuits.
Aetna, Elevance Health, and Humana are being sued by the federal government ove alleged kickback schemes to marketing organizations to steer beneficiaries to their plans.
Democratic-controlled states are suing the Trump administration over a new Exchange rule that tightens enrollment processes in the Exchanges.
There is an ongoing suit over the dispute resolution process under the No Surprises Act. The suit in part involves how the median in-network rate is calculated.
The Supreme Court largely sided with the government on the legality of free preventive services under the ACA but returned some issues to a lower court.
(Article may require a subscription.)
#aca #obamacare #medicareadvantage #exchanges #prevention #preventiveservices #nsa #nosurprisesact #marketing #fwa
https://www.modernhealthcare.com/politics-regulation/mh-medicare-advantage-aca-lawsuits-regulation
BCBSMA Reports Q2 Loss
Blue Cross and Blue Shield of Massachusetts reported a net loss of $129.7 million on revenue of $2.6 billion, which is a -4.9% net margin in Q2 2025. Its year-to-date loss is $92.6 million on revenue of $5.2 billion, or a -1.8% net margin. The Big Blue reported a net loss of $223.6 million and a -4.3% operating margin in 2024.
#bcbsma #margins
https://www.beckerspayer.com/payer/bcbs-massachusetts-posts-130m-loss-in-q2
— Marc S. Ryan
