Catherine @ Benefit MiMS

Catherine @ Benefit MiMS

@benefitmims.bsky.social

Making your employee benefits make sense, especially provider network contracts. Mostly posting article links. All opinions are my own. https://benefitmims.com // Personal: @novenella.bsky.social

263 followers56 following3.2K posts

Catherine @ Benefit MiMS
@benefitmims.bsky.social

While the legislation wouldn't guarantee anyone extra money, an ownership stake could give some workers another way to stay on track for #retirement. #RetireThroughOwnershipAct #Bipartisan #Legislation buff.ly/KsXBNqm

buff.lyRepublicans and Democrats Just Teamed up on a Retirement Wealth Bill - Here’s What Workers Should KnowA bipartisan bill could make employee stock ownership plans easier to offer, giving more workers a chance to build retirement wealth through company shares.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

#Brokers On Notice: A new report found that 87% of employers are likely to switch their pharmacy benefit manager #PBM at contract renewal. Three out of four have changed their benefits adviser in the past 12 months or plan to do so in the next year. buff.ly/znc4JWs

buff.lyWhy employers are reconsidering their pharmacy benefit managers  | Employee Benefit NewsAs employers scrutinize pricing and rebates, a new RxBenefits report outlines what HR leaders should ask about drug costs, GLP-1 coverage and clinical reviews.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

The ban on new sales by Atlantic Coast Life Insurance takes effect November 1. The company can, however, renew existing policies that are guaranteed renewable or noncancellable. #LifeInsurance #Virginia buff.ly/GHGuHXe

buff.lyLife insurer ordered to stop selling policies in VirginiaA life insurance company, one of the investors reportedly hit by a more-than- $500 million financial fraud, must stop selling policies in Virginia, the State Corporation Commission has ordered. The…
Catherine @ Benefit MiMS
@benefitmims.bsky.social

Houston’s largest health system announced last month that it will stop offering its private insurance alternative to Medicare beginning in 2027. #MemorialHermann #MedicareAdvantage buff.ly/xLK4GiC

buff.lyMemorial Hermann ends Medicare Advantage plan amid insurance industry struggles, experts sayMemorial Hermann Health System’s decision to close its Medicare Advantage plan at year's end comes as many healthcare providers and insurers struggle with financial and regulatory challenges, experts said.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

Insurance Commissioner Mike Chaney said the agents were selling health insurance policies, including some Medicare plans, and falsifying reports to earn commissions. #InsuranceFraud #EnrollmentFraud #AI #Mississippi #RogueAgents #BadApples buff.ly/TCv4vxZ

buff.lyMississippi revokes licenses of rogue insurance agents in fraud schemeThe Mississippi Insurance Department has revoked the licenses of dozens of out-of-state insurance agents accused of fraud this week.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

#Insurers and #lawmakers are looking into ways to curb the practice of charging hospital #FacilityFees for routine care or for care that was not in #hospitals. But it’s been going on for years with little progress made to stop it. [Gift Article] buff.ly/3alnCRE

buff.lyDoctors’ offices are charging patients 10 times more by claiming to be hospitalsEven when patients never step into a hospital, they may be charged hospital “facility fees,” and their care may be billed at higher rates.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

The Medicaid contract between Ochsner Health System and Louisiana Healthcare Connections expires on November 30, 2026; however, negotiations appear headed for success. #NetworkContractWatch #CaseUpdate #Louisiana benefitmims.com?p=4297

benefitmims.comLouisiana Healthcare Connections vs Ochsner Health System – Making it Make SenseThe Medicaid contract between Ochsner Health System and Louisiana Healthcare Connections expires on November 30, 2026; however, negotiations appear headed for s
Catherine @ Benefit MiMS
@benefitmims.bsky.social

#Horizon joins a growing number of #BCBS plans that have moved into care delivery in recent years in an effort to compete with national insurers like UnitedHealthcare and Elevance. #VerticalIntegration #MergersAcquisitions buff.ly/T9fANyc

buff.lyHorizon BCBS to acquire Summit Health’s New Jersey businessHorizon Blue Cross Blue Shield of New Jersey has agreed to acquire multispecialty physician group Summit Health’s New Jersey operations, including CityMD urgent care sites in the state, the insurer confirmed.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

The alliance released a report that counts more than 1,900 accredited #SpecialtyPharmacy locations, with health systems operating 553, or 28%. It says no national count of specialty pharmacy users exists. #SpecialtyPharmacyAlliance buff.ly/VDKFP98

buff.lyPatients, physicians form coalition on specialty pharmacy accessA new coalition of patients, caregivers, physicians and pharmacy experts is advocating for access to specialty pharmacies, according to the group, the Specialty Access Alliance. It says it wants to educate policymakers about patients with complex, chronic and rare conditions and the pharmacies that serve them.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

Medicare Advantage contracts between White River Health and UnitedHealthcare expires on December 31, 2026, although there is some discrepancy about which ones. #NetworkContractWatch #CaseUpdate #Arkansas benefitmims.com?p=4062

benefitmims.comUnitedHealthcare vs White River Health – Making it Make SenseMedicare Advantage contracts between White River Health and UnitedHealthcare expires on December 31, 2026, although there is some discrepancy about which ones.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

Under current fee-for-service incentives, #AdministrativeAI use by #providers entrenches inefficient workflows and fuels inflationary billing instead of cutting waste. #MedicalCosts #Upcoding buff.ly/jg5wJ3u

buff.lyAI scribes, billing tools drive up healthcare costs: ReportAI documentation and billing tools are driving up healthcare costs without improving patient outcomes, according to an Oct. 14 report from the Peterson Health Technology Institute.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

BJC HealthCare facilities (including Barnes-Jewish Hospital and St. Luke's Healthcare) will be out-of-network for Aetna Medicare Advantage members after December 31, 2026. #NetworkContractWatch #NewCase #Illinois #Kansas #Missouri benefitmims.com?p=4387

benefitmims.comAetna vs BJC HealthCare – Making it Make SenseBJC HealthCare facilities (including Barnes-Jewish Hospital and St. Luke's Healthcare) will be out-of-network for Aetna Medicare Advantage members after Decembe
Catherine @ Benefit MiMS
@benefitmims.bsky.social

UCM AdventHealth (in Illinois) will no longer be in-network for UnitedHealthcare Medicare Advantage and Group Retiree members after December 31, 2026. #NetworkContractWatch #NewCase #Illinois benefitmims.com?p=4384

benefitmims.comUnitedHealthcare vs UChicago Medicine AdventHealth – Making it Make SenseUCM AdventHealth (in Illinois) will no longer be in-network for UnitedHealthcare Medicare Advantage and Group Retiree members after December 31, 2026.
Catherine @ Benefit MiMS
@benefitmims.bsky.social

Oswego Health Medical Practice is exiting the UnitedHealthcare network after November 30, 2026. However, most other Oswego Health services will remain in-network. #NetworkContractWatch #NewCase #NewYork benefitmims.com?p=4316

benefitmims.comUnitedHealthcare vs Oswego Health Medical Practice – Making it Make SenseOswego Health Medical Practice is exiting the UnitedHealthcare network after November 30, 2026. However, most other Oswego Health services will remain in-networ
Catherine @ Benefit MiMS
@benefitmims.bsky.social

The complaint, filed in Maryland’s federal court, claimed multiple violations of the #AdministrativeProcedureAct. #Litigation #AgentFreeze #CMS #ACA #Brokers #NABIP buff.ly/MCPO5GG

buff.lyAgent, broker group sues CMS to block ACA registration freezeThe National Association of Benefits and Insurance Professionals filed a lawsuit against CMS and HHS on Oct. 15 concerning a temporary freeze on new agent and broker registrations with federally facilitated exchanges for 2027.