PwC: Mental Health, Telehealth Sectors Spur Robust Deal Activity Despite COVID-19

PwC: Mental health, telehealth sectors spur robust deal activity despite  COVID-19 | FierceHealthcare

Source: Fierce Healthcare, by Robert King

Even though the COVID-19 pandemic continues to roil the healthcare landscape financially, mergers and acquisitions remain robust thanks to heavy interest in the mental health and telehealth sectors, one expert says.

Providers have faced major declines in patient volume since the onset of the pandemic. But experts at the firm PwC say financial constraints haven’t cooled deals in the healthcare space.

“This is an interesting recession with a tremendous amount of liquidity in markets,” said Manoj Mahenthiran, head of the private equity sector practice at PwC, in an interview with Fierce Healthcare. “What we are still seeing is that for the right assets, prices really haven’t gone down.”

A prior report from PwC released in July found that the number of deals among provider and payer industries declined in the first half of the year by 21% compared to the same period in 2019.

But there has been a major shift among certain sectors of the healthcare industry.

One of the hottest sectors is in behavioral health that has taken advantage of new flexibilities for telehealth.

“This whole pandemic has shone a spotlight on some of the mental health issues in the country that may have been taboo in the past,” Mahenthiran said.

Digital behavioral health startups raised $588 million in funding in the first half of this year, according to a report from venture capital fund Rock Health. That was on top of the record $5.4 billion in startup funding for digital health investments overall, the report found.

Investors are still very interested in the telehealth space even though there is uncertainty over what the regulatory outlook will be after the COVID-19 pandemic.

The Centers for Medicare & Medicaid Services gave more flexibility for providers to get Medicare reimbursement from telehealth, and providers embraced the technology to grant access for patients afraid of going to an office or hospital due to the pandemic.

But those flexibilities last through the COVID-19 public health emergency, which was recently extended.

“There is apprehension on what will this post-COVID environment look like and what will happen with reimbursements,” Mahenthiran said of investors in telehealth. “If things are delivered over this medium versus the office medium for sure that is definitely something that weighs on a lot of PE funds that are thinking about entering this space.”

But he countered that the popularity of telehealth will outweigh any changes in reimbursement rates.

“Their view so far is that the volume growth is going to far outweigh any such rate reductions,” Mahenthiran said. “It is definitely part of the calculus.”

Attorney General Becerra Takes Action to Ensure Californians Have Access to Mental Health Care

California joins legal challenge over USPS reductions - Los Angeles Times

Source: EIN Presswire

California Attorney General Xavier Becerra today urged California’s four largest health insurance providers: Anthem Blue Cross, Blue Shield of California, Health Net of California, and Kaiser Permanente, to demonstrate their compliance with state and federal mental health parity laws. In letters addressed to each of the managed care insurance companies, the Attorney General requested information that would help determine if they are providing coverage for mental health benefits and services without putting limitations or conditions on the coverage that are more restrictive than permitted by the law. Equal treatment for mental health conditions in insurance plans is mandated by state and federal laws, including the California Mental Health Parity Act, the federal Mental Health Parity and Addiction Equity Act of 2008, and the Affordable Care Act (ACA). The plans have until November 16, 2020, to voluntarily comply with the information request.

“One out of every six Californians experiences some type of mental illness, which is why it is important to ensure our mental health laws are being followed,” said Attorney General Becerra. “It is the job, mandated by the law, of health insurance providers to make access to care for mental health conditions as accessible as care for a medical illness. Now, when people are seeing their mental health worsen as they navigate the COVID-19 pandemic, is a critical time to ensure those who need it have access to care.”

Despite multiple laws, including the California Mental Health Parity Act and the ACA, which expanded access to mental health treatment across the country, many Californians still struggle to find appropriate mental health treatment. Many Californians with insurance are also exponentially more likely to go out of network for mental health treatment than for medical services. According to a survey by the Kaiser Family Foundation/California Health Care Foundation, two-thirds of the individuals surveyed reported that they or one of their family members sought but were unable to locate mental health services.

In order to investigate mental healthcare coverage, the Attorney General requested documents and information that would ensure Anthem Blue Cross, Blue Shield of California, Health Net of California, and Kaiser Permanente are following mental health parity laws.

A copy of the letter to Anthem Blue Cross is available here. A copy of the letter to Blue Shield of California is available here. A copy of the letter to Health Net of California is available here. A copy of the letter to Kaiser Permanente is available here.

Mercer Forecasts 4.4% Increase In Benefit Costs For 2021

Mercer forecasts 4.4% increase in benefit costs for 2021 | BenefitsPRO

Source: BenefitsPRO, by Danielle Andrus

A new study from Mercer shows that employers are committed to providing their employees with benefits, despite the economic challenges they may be facing.

In a survey of 1,113 employers, Mercer found benefit costs are expected to grow 4.4% on average next year, but uncertainty is driving “wide variations” in estimates.

“Different assumptions about cost for COVID-related care, including a possible vaccine, and whether people will continue to avoid care or catch up on delayed care, are driving wide variations in cost projections for next year,” Tracy Watts, a senior consultant with Mercer, said in a statement.

The projected cost increase is in line with annual growth over the past six years, Mercer found, but far exceeds the Consumer Price Index and wage growth, which are sitting close to zero.

Still, only 18% of employers said they’re shifting some of those costs to workers, according to Mercer. In fact, unlike in the Great Recession, most employers (57%) aren’t making any changes at all.

“This is different from what we saw at the start of the economic recession in 2008, which drove many employers to trim health benefits,” Watts said. “Given all the turmoil employees have been through this year, employers are putting big changes on hold, looking to balance economics with empathy.”

Of the quarter of employers who are planning changes, here’s what they’re considering:

  • * 27% are adding or improving digital health care and telemedicine services, including virtual visits, AI-based triage and texting services.
  • * 22% are enhancing voluntary benefits like critical illness insurance.
  • * 20% are adding or improving behavioral health care benefits.
  • * 16% offer a financial subsidy for in-home child care and 12% have a back-up benefit for child care.

“Many employers are avoiding health plan changes that impact employees this year, but they know managing cost must remain a priority,” Watts noted. “Plan member stress and care avoidance in 2020 may result in higher utilization in 2021, and struggling health systems may seek to recoup lost revenue through higher prices.”

Gov. Newsom Signs Law To Grow Mental Health Coverage

California Governor Gavin Newsom signs signs law to grow mental health  coverage - ABC7 Los Angeles

Source: ABC News

Gov. Gavin Newsom signed a law on Friday that for the first time in California defines “medical necessity,” a move aimed at requiring private health insurance plans to pay for more mental health and drug addiction treatments.

State and federal laws already require health insurance companies to handle mental health treatments the same as physical health treatments. The California Health Benefits Review Program says 99.8% of people enrolled in private health insurance plans have coverage for mental health and substance abuse disorders on par with other medical conditions.

But those laws don’t define what is “medically necessary” to determine which treatments get covered. Because of that, advocates say private insurers often deny coverage for some mental health and drug abuse treatments based on their own restrictive definitions.

The law requires all private insurers to cover medically necessary mental health and drug addiction treatments. The law says when insurance companies decide whether a treatment is medically necessary, they must follow the most recent criteria and guidelines developed by nonprofit professional associations, like the American Society of Addiction Medicine.

State Sen. Scott Wiener, a Democrat from San Francisco and the author of the bill, said many insurance companies refuse mental health or drug addiction treatment for people “by saying it’s not serious enough.” He said that’s like telling a stage one cancer patient they can’t get treated until they are at stage four.

“We would never tolerate that with physical health. Yet we tolerate it with addiction,” he said.

The California Association of Health Plans called it a “misconception” that private insurers wait until people are in crisis before they cover their treatment for mental health or drug addiction. They had asked Newsom to veto the bill, arguing it “recklessly defines medical necessity in a way that will undermine the ability of providers to determine what is clinically appropriate for their patients.”

Newsom acknowledged that pressure during a virtual bill signing ceremony on Friday, saying “not everybody is happy with us.”

“I got a lot of folks that wanted to pull the plug on this Zoom call today, but we’re doing it because we’re zooming into the future,” Newsom said.

The new law takes effect Jan. 1, and it comes as Californians are dealing with a coronavirus pandemic, a reckoning over racial injustice and massive wildfires that have destroyed homes and businesses while turning the air toxic.

Arthur Evans, CEO of the American Psychological Association, says the group’s annual “Stress in America” survey has shown the highest stress levels since the survey began in 2007.

“All of that really emphasizes the need to have access to not only adequate care but to really have access to excellent care just because we know the need is significant right now,” he said.

Joe Parks, medical director for the National Council on Behavioral Health, called the law the first comprehensive reform in the country. He said he hoped it would “encourage other states to fill the gaps that they have with this legislation.”

The bill was one of more than a dozen health-related measures Newsom signed on Friday. The bills included one authored by Sen. Jim Beall, a Democrat from San Jose, that sets standards for peer support specialists – people who have suffered from mental health or drug addiction and want to counsel others experiencing the same problems. The bill also authorizes the state’s Medicaid program to seek permission from the federal government to cover peer support specialists.

Similar bills have been vetoed twice before by previous governors. It’s one of the final bills authored by Beall to become law as the senator is leaving office this year because of term limits.

“The pandemic has really changed the public’s view on this. We now have a pandemic of despair going on,” Beall said, adding that the bill “adds proven mental health resources when we need it most.”

California Bills Would Make Insurers Cover More Mental Health

Image result for California Bills Would Make Insurers Cover More Mental Health images

Source: San Francisco Chronicle, by Catherine Ho

California legislators on Tuesday introduced two bills aimed at improving access to mental health and addiction treatment by requiring health insurance companies to authorize some forms of treatment more quickly and to cover more comprehensive mental health services.

State Sens. Jim Beall, D-San Jose, and Scott Wiener, D-San Francisco, co-authored Senate Bill 854 and Senate Bill 855 — which both would apply to private health insurance plans only, and not to public insurance programs such as Medi-Cal, the joint federal and state health insurance program for low-income residents. The bills do not address how uninsured residents seek care.

SB854 would prohibit insurance companies from directing patients with substance use disorders to first try other forms of treatment — such as group therapy or step therapy — before covering medication-assisted treatment, or MAT, if MAT is what their doctor recommends. MAT is becoming a more common form of treatment for opioid addiction, in which patients are prescribed opioid medication — at lower doses that don’t induce a high — to wean them off of stronger opioids. It is done under the supervision of a physician and in conjunction with counseling and other behavioral health services.

SB855 would require insurance companies to cover all forms of mental health and substance use treatment that a patient’s doctor deems “medically necessary” — not just emergency or urgent services that existing federal and state parity laws require insurers to cover. The bills’ authors and health advocates say existing laws don’t do enough to ensure Californians get timely and comprehensive enough care for mental health conditions.

The California Mental Health Parity Act of 1999 requires insurers to cover services for severe cases of some mental health conditions, but not all types of treatments for all conditions, or substance use disorders.

“We have a huge, huge challenge in California, not just with our homeless population but with everyone, and we need better access (to mental health care),” Wiener said. “These bills will move us in that direction.”

The California Association of Health Plans, which represents public and private health insurers, said that the proposed legislation would create new mandates and that insurers already work with state regulators to comply with current parity laws.

“Mental health care is a high priority for health plans and we are fully committed to ensuring patients are getting the mental health services they need that are on par with medical and surgical care,” the group’s spokeswoman Mary Ellen Grant said in a statement. “Mental health parity is already the law of the land in California and California currently has regulators who are capable of overseeing our compliance with the law. The bills introduced today are less about mental health parity and more about creating new mandates. It is hard to understand how SB855 could be called a mental health parity bill when it sets forth a new system for medical necessity that is at a higher level than other medical services.”

3 ways employers will support mental health in 2020

Image result for 3 ways employers will support mental health in 2020 imagesLarge employers in 2019 made strides in destigmatizing mental health and wellness at work and in 2020 they are expected to go further, writes Susan Wyatt of Lyra Health. Expected trends include more emphasis on quality mental health care for millennials, offering proven, flexible benefits and providing an accepting culture in the workplace.

Employee Benefit News (free registration) (12/20)

Californians Aren’t Getting the Mental Health Care They’re Legally Guaranteed. Why Not?

Image result for Californians Aren’t Getting the Mental Health Care They’re Legally Guaranteed. Why Not? images

Source: CalMatters, by Jocelyn Wiener

State Sen. Jim Beall is angry.

Four times now, he has introduced legislation to better enforce state and federal “parity” laws, which require equal treatment of mental and physical health problems. Four times, that legislation has failed.

As he enters his final year in the Legislature, the San Jose Democrat plans what he calls a “full-frontal assault”.

“I’m going to put even more effort into next year,” Beall said, “because I’m madder than hell about it.”

California’s parity mandate was signed into law in 1999, and a federal parity law followed in 2008. But the state has struggled to ensure those laws work‚ which helps explain why parity feels like an empty promise to so many Californians. More than half believe that most people with mental health conditions can’t get the services they need, according to a poll conducted last year by the Kaiser Family Foundation and the California Health Care Foundation.

Those who do get services often have to search hard and pay extra for them: California patients were more than five times more likely to have office visits for mental health or addiction problems from providers outside of their insurance plan’s network than patients seeking medical or surgical care, according to a new analysis by healthcare consultants Milliman Inc. Insurers here paid primary care providers 15 percent more than they paid behavioral health providers.

“We need stricter enforcement of mental health parity laws,” Gov. Gavin Newsom declared during his campaign. That didn’t happen again this year, although Dr. Tom Insel, Newsom’s top mental health advisor, recently told CalMatters the administration intends to take “a fresh look at parity enforcement.”

“Instead of doing this topic by topic, let’s step back and find an overall plan, a blueprint, that tells us what’s the system we want,” Insel said. “I don’t think the state’s done that for a long, long time.”

What state officials have been doing: rebuffing many attempts to tighten parity enforcement.

The most recent failure: Beall’s 2019 bill to ramp up requirements for health plans to report parity compliance data to state agencies each year instead of every three years, as it does now. The bill would have required the agencies to report results to the Legislature, and to post them on their websites to make them easily accessible to the public. Beall says that would help make the state less reliant on patient complaints to trigger enforcement.The bill also would have prohibited insurers from requiring prior authorization and “step therapy”— or making patients first try lower cost medications before receiving other prescriptions to treat substance abuse.

With a public desperate for better mental health services, what is keeping the state from ensuring that health insurers and plans comply with state and federal parity laws?

Some note the lack of the kind of broad, emotionally affecting campaign that has moved the needle in other states. There’s also disagreement among mental health advocates about whether Beall’s proposals would best address the problem.

The senator, for his part, has another explanation:

“The insurance companies have too much power in Sacramento on the subject of mental health,” he said. “Whatever support I’ve gained has been countered by them effectively…They’re the best lobbyists in Sacramento that money can buy.”

Industry representatives maintain that a crackdown is unnecessary, saying the real challenges relate not to compliance but to a well-documented statewide shortage of mental health providers.

“Health plans in California have made mental health a top priority, going above and beyond what the mental health laws are requiring,” said Mary Ellen Grant, spokeswoman for the California Association of Health Plans. Many plans are putting behavioral health providers in primary care offices and using more telemedicine, she said.  “We’re not aware of any legislation that would improve whatever it is that Senator Beall thinks is the issue.”

Leanne Gassaway, a senior vice president for America’s Health Insurance Plans, warned “there will be 50 different flavors of auditing and reporting” if each state creates its own parity reporting tool. Instead she recommended the federal government create a single one.

“We don’t have a problem with reporting,” she said.

States aren’t asking the right questions or getting granular enough data, said Dr. Henry Harbin, former CEO of the managed behavioral health care company Magellan Health. The result: California’s approach “has not produced the change you would expect it to have.”

Once a problem is identified, is the state doing enough to enforce it?

Beall doesn’t think so, and neither does Meiram Bendat, a Los Angeles attorney and psychotherapist who won a much-touted case this spring. In that case, a Northern California federal court found that United Behavioral Health had wrongly restricted treatment for patients with mental health and substance abuse disorders in order to cut costs.

Bendat said that, over the years, many patients had asked the state Department of Managed Health Care for help with mental health claims denied by United Behavioral Health. But he said the department, which oversees health plans that receive monthly fees to provide health care for their members, has failed to inform the public of any systemic, corrective action against the insurer.

He uses the terms “toothless and ineffective” to describe the department’s parity enforcement.

California allows plans to decide, for themselves, what makes a treatment “medically necessary” based on clinical standards. Critics, such as Bendat, contend plans often apply the wrong standard of care. Some other states require the use of medical necessity criteria determined by non-profit, clinical specialty organizations.

“California is behind the curve in this regard,” Bendat said. “The abuses that we see by managed care are widespread and ruinous and they need to be stopped,” he said.

Bendat and others do praise the work of the Department of Insurance, which covers a small fraction of the state’s health plans.

The Department of Managed Health Care said in an email that it “works diligently to ensure that health plans comply with state and federal requirements regarding mental health services.”

This includes surveying all licensed plans every three years, interviewing plan staff, reviewing enrollee files, and tracking complaints. In recent years, the department added two staff members and conducted focused comprehensive reviews of 25 health plans’ methodologies for providing mental health services. It then required those plans to eliminate impermissible day and visit limits, revise prior authorization requirements, and reimburse enrollees a total of more than $517,000. In the last decade, it has cited health plans dozens of times for mental health-related violations, resulting in more than $4 million dollars in fines— most levied against Kaiser in 2013.

The department says if patients feel they have been denied medically necessary treatment by their health plans, they can appeal to the state for an independent medical review. But critics say the vast majority of patients never appeal.

Sen. Beall is outraged by the swelling numbers of untreated individuals residing under doorways and overpasses.

“It sounds horrible, doesn’t it?” he said. “That’s because that’s what it is. It’s a horror.”

Beall was an undergrad studying urban planning and political science at San Jose State in the early 1970s, when Gov. Ronald Reagan began shuttering the state’s mental hospitals at the same time traumatized veterans returned from Vietnam.

Years later, as a Santa Clara County Supervisor and liaison to the county mental health commission, Beall learned how mental health and substance abuse impacted all corners of society: housing, criminal justice, health, education, foster care.

“We kept seeing people ending up in our system because private insurance wouldn’t cover them adequately,” he said.

After Beall was elected to the Legislature in 2006, he began trying to pass laws to strengthen mental health parity. One made it through the Assembly and died in the Senate. Another made it through the Senate and died in the Assembly. A third, which would have allowed additional penalties of $2,500 per patient per day for each parity violation, was vetoed by Gov. Jerry Brown, who said the state insurance commissioner already had “broad authority” on enforcement. The most recent bill never left the Senate.

“I’m in a lot of pain right now. It hurts,” Beall said at a Sacramento forum on mental health organized by CalMatters, a few days after the latest bill died. He has spoken publicly in the past about having a family member with schizoaffective disorder. “I tried four times and it’s actually getting harder to get it passed. …My own colleagues killed it.”

The industry has opposed parity laws for a long time. Health insurers “fought tooth and nail” against California’s state parity law, stopping it twice in the 1990s before it ultimately became law, said the law’s sponsor, former state Assemblywoman Helen Thomson of Davis. A psychiatric-nurse-turned-legislator, she said the law was eventually pared back to cover just nine serious mental illnesses because of this pushback.

In the case of Beall’s most recent bill, he says he had to remove the parity provisions because staff and members of the Senate Health Committee didn’t agree with them. But he also insists that some of his colleagues are too connected to health insurers, allowing former staff members and legislators who work for the industry to use these relationships to stop his bills.

In the years that Beall has been trying to pass parity legislation, health insurers have contributed almost $10 million directly to winning candidates and industry lobbyists have spent more than $85 million. 

Other states did pass parity-related bills last year, among them Colorado, Connecticut, Delaware, Illinois, New Jersey and Tennessee. A massive publicity effort featuring compelling personal stories, combined with negotiations, may be part of the equation — and part of what’s been missing in California. Often, health insurers dropped their opposition after intensive negotiations and media and education campaigns, said Tim Clement, director of legislative development at the American Psychiatric Association,

Clement, who was at the negotiating table in many of those states, but not California, called it “pretty close to impossible to get a bill passed if insurance industry opposed.” He blamed California’s inaction partly on the lack of  “a cohesive, boots-on-the-ground movement” for parity.

In Colorado — which just passed  an expansive parity bill that will close loopholes, improve transparency and enforcement, and strengthen mental health prevention and screening — “we just were relentless,” said Lauren Snyder, state policy director with the advocacy organization Mental Health Colorado. That included working with media outlets to share personal stories of individuals harmed by lack of mental health care, and ads urging people to contact their legislators.

Such a movement was part of what eventually worked in California in the 1990s, said former Assemblywoman Thomson. She said she had a full-time public relations person working on the effort to pass a parity law, that major newspapers in the state editorialized in its favor, and that many legislators gave personal testimonies about how lack of mental health care had impacted their loved ones.

That law now has strong provisions for the coverage of medically necessary treatments for serious mental illnesses like schizophrenia and bipolar disorder, but does not cover a wide range of other mental health conditions or substance abuse disorders. Some parity advocates say California needs to ensure medically necessary treatment for more individuals, including those with substance abuse disorders.

Dr. Richard Pan, a Sacramento pediatrician who chairs the Senate Health Committee, wants to give plans more incentives to serve people with serious mental illnesses.

“No one wants to be known as the health plan with the best mental health coverage or diabetes or asthma,” he said. His idea: a shared risk pool to reward plans that provide quality care for people with chronic conditions.

For a long time, Sen. Beall has “carried the mantle on (mental health parity), kind of alone,” said Sacramento Mayor Darrell Steinberg, a former state senate leader who founded the Steinberg Institute to advocate for mental health policies.

Beall calls his inability to pass parity legislation thus far “my biggest failure as a legislator.”

Earlier this year, the state Assembly passed a resolution calling on all relevant state agencies and the Attorney General to ensure that all health insurers are complying with federal and state parity laws. But a resolution, while it may raise awareness, is akin to a suggestion.

Beall says he’d like to introduce one more parity bill before he terms out –though he’s still working out the details.

“My style is to keep fighting and fighting and fighting,” he said with a laugh. “I don’t give up.”

California Names Former Google Scientist as the State’s ‘Mental Health Czar’

Image result for California Names Former Google Scientist as the State’s ‘Mental Health Czar’ images

Source: Stat

Noted psychiatrist and former Verily leader Dr. Tom Insel is going to be the “mental health czar” for the state of California, Democratic Gov. Gavin Newsom announced Tuesday.

Insel, the former National Institute of Mental Health director, will also continue his work with Mindstrong, a startup that is working on a mental health app, a company spokesperson confirmed. Insel joined the company in 2017 after leaving Verily, Google’s life sciences arm.

Insel’s new job will be to “inform the state’s work as California builds the mental health system of tomorrow, serving people whether they are living in the community, on the streets or if they are in jails, schools or shelters,” according to a press release from the governor’s office.

In a press conference, Newsom said Insel was “volunteering” his time as an adviser. “I’m calling him the mental health czar in the state of California,” he said.

Mindstrong, which is focused on using data on how people use their smartphone to detect trends in their mental health, already has a relationship with public officials in California. One of Mindstrong’s first large-scale rollouts was slated to happen in the state through county-level public mental health systems, STAT reported in October.

A spokesperson for Mindstrong said that Insel would recuse himself from conversations about the company, and noted that he will have “no fiscal or regulatory authority and will have no oversight of current programs in this voluntary role.”

The spokespeople for Newsom and for California Health and Human Services Secretary Mark Ghaly, with whom Insel will be working, did not immediately reply to a request for comment.

Mindstrong raised $31 million in an expanded Series B round in January led by General Catalyst, bringing the company’s total funding to about than $60 million.

“Our excitement over Mindstrong’s technology is bolstered by our inspiration in the core founding team,” an associate and the managing partner of General Catalyst wrote in a blog post in January about the investment.

Californians Want Leaders to Expand Access to Mental Health Care, Kaiser Survey Finds

Image result for Californians Want Leaders to Expand Access to Mental Health Care, Kaiser Survey Finds images

Source: Sacramento Bee

Californians indicated In a survey released Thursday that they want state leaders to put a priority on ensuring that people with mental health conditions can get access to treatment, with 49 percent saying it’s extremely important and 39 percent saying it’s very important.

The Kaiser Family Foundation and California Health Care Foundation designed and conducted the poll of 1,404 Californians in November and December, looking to gauge health care priorities and experiences in a state considered a leader in health-care trends. The study’s author noted that, while on the campaign trail, Gov. Gavin Newsom made health care a priority and announced sweeping plans for change in health care.

Survey findings offer a view of what state residents want, the survey authors said, as the new governor takes the reins and a new legislative session begins. Asked to rank what they felt state leaders should make their top priorities, poll respondents put improving public education in the top spot, but following closely behind was making health care more affordable.

While 86 percent of those surveyed considered improving public education very or extremely important, health care affordability ranked highly with 80 percent. Coming in third was making housing more affordable at 75 percent. The findings had an error rate of plus or minus 3 percentage points.

Asked to assess what aspects of health care mattered most to them, survey respondents ranked expanding access to mental health care as most crucial. Next on the list was making sure all Californians have access to health care and third, lowering the cost of health care for Californians.

“About half — 52 percent — of Californians say their community does not have enough mental health providers to serve the needs of local residents, compared to 27 percent who say it does have enough and 21 percent who say they don’t know enough to say,” survey authors said.

DOJ Approves $69B CVS-Aetna Merger with Part D Divestiture

Image result for DOJ Approves $69B CVS-Aetna Merger with Part D Divestiture images

Source: Fierce Healthcare

The Department of Justice (DOJ) approved a $69 billion CVS-Aetna merger on Wednesday after Aetna agreed to sell off its Part D business.

The Part D divestiture was a condition of the merger’s approval, according to the DOJ. Late last month, Aetna agreed to sell its 2.2 million Part D business to WellCare.

Antitrust regulators said the divestiture would “fully resolve the Department’s competitive concerns.” The DOJ along with attorneys general in five states filed a proposed settlement that approves the deal on the condition that Aetna sell off its Part D plans.

“Today’s settlement resolves competition concerns posed by this transaction and preserves competition in the sale of Medicare Part D prescription drug plans for individuals,” Assistant Attorney General Makan Delrahim of the Justice Department’s Antitrust Division said in a statement. “The divestitures required here allow for the creation of an integrated pharmacy and health benefits company that has the potential to generate benefits by improving the quality and lowering the costs of the healthcare services that American consumers can obtain.”

In a complaint filed to U.S. District Court for the District of Columbia, DOJ attorneys argued that without the divestiture, the combined company would cause “anticompetitive effects, including increased prices, inferior customer service, and decreased innovation” in the 22 states where Aetna sells Part D plans. The court must approve the settlement in order for it to move forward.

“DOJ clearance is an important step toward bringing together the strengths and capabilities of our two companies to improve the consumer healthcare experience,” CVS Health President and Chief Executive Officer Larry J. Merlo said in a statement. “We are pleased to have reached an agreement with the DOJ that maintains the strategic benefits and value creation potential of our combination with Aetna. We are now working to complete the remaining state reviews.”

Part D consolidation was the primary issue raised among groups opposing the merger, including the American Medical Association and the California Insurance Commissioner.

Last Updated 11/18/2020

Arch Apple Financial Services | Individual & Family Health Plans, Affordable Care California, Group Medical Insurance, California Health Insurance Exchange Marketplace, Medicare Supplements, HMO & PPO Health Care Plans, Long Term Care & Disability Insurance, Life Insurance, Dental Insurance, Vision Insurance, Employee Benefits, Affordable Care Act Assistance, Health Benefits Exchange, Buy Health Insurance, Health Care Reform Plans, Insurance Agency, Westminster, Costa Mesa, Huntington Beach, Fountain Valley, Irvine, Santa Ana, Tustin, Aliso Viejo, Laguna Hills, Laguna Beach, Laguna Woods, Long Beach, Orange, Tustin Foothills, Seal Beach, Anaheim, Newport Beach, Yorba Linda, Placentia, Brea, La Habra, Orange County CA

12312 Pentagon Street - Garden Grove, CA 92841-3327 - Tel: 714.638.0853 - 800.731.2590
Email:
Jay@ArchApple.com
Copyright @ 2015 - Website Design and Search Engine Optimization by Blitz Mogul