Law360 (August 31, 2020, 10:51 AM EDT) — Neither Cigna Corp. nor Anthem Inc. can recover on claims for billions in damages after the collapse of their proposed $54 billion merger in 2017, a Delaware vice chancellor concluded Monday in a 311-page opinion on the multiyear, multicourt saga.

Vice Chancellor J. Travis Laster, who oversaw a 10-day trial in late February and early March 2019, found that a federal antitrust injunction in 2017 triggered a failure of a deal-killing, no-injunction provision, eliminating obligations to close on either side.

“Although Anthem proved that Cigna breached the [merger] efforts covenants, Anthem failed to prove that Cigna’s breaches led to causally related damages,” the vice chancellor wrote, noting that Cigna’s opposition to the deal grew so obvious that a federal judge referred to it as “the elephant in the courtroom” during antitrust proceedings.

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By: Sarah Jane Tribble

NPR

8/22/20

Jerome Antone says he is one of the lucky ones.

After becoming ill with COVID-19, Antone was hospitalized only 65 miles away from his small Alabama town. He is the mayor of Georgiana — population 1,700.

“It hit our rural community so rabid,” Antone says. The town’s hospital closed last year. If hospitals in nearby communities don’t have beds available, “you may have to go four or five hours away.”

As COVID-19 continues to spread, an increasing number of rural communities in the U.S. find themselves without their hospital or on the brink of losing already cash-strapped facilities.

Eighteen rural hospitals closed last year and the first three months of 2020 were “really big months,” says Mark Holmes, director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill. Many of the losses are in Southern states, including Florida and Texas, he says, and more than 170 rural hospitals have closed nationwide since 2005, according to data collected by the Sheps Center.

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US’s largest health insurer, UnitedHealth Group, reported $6.7bn in profits compared with $3.4bn for the same quarter last year.

The enormous medical response in America to the coronavirus pandemic has not put a drain on US health insurers, which doubled profits in the second quarter of 2020 compared with the same time last year.

The US fight against the virus has been marked by overwhelmed hospitals, testing delays and personal protective equipment (PPE) shortages, but the high profits reported by some insurers have underlined concerns about America’s for-profit healthcare model.

Consumers are probably entitled to millions of dollars in rebates under Obamacare rules that cap companies’ profits.

By: Reed Abelson

New York Times

08/05/2020

The nation’s leading health insurers are experiencing an embarrassment of profits.

Some of the largest companies, including Anthem, Humana and UnitedHealth Group, are reporting second-quarter earnings that are double what they were a year ago. And while insurance profits are capped under the Affordable Care Act, with the requirement that consumers should benefit from such excesses in the form of rebates, no one should expect an immediate windfall.

But the amounts that insurers are retaining have caught the attention of the Trump administration. The Health and Human Services Department advised companies to consider speeding up rebates, and on Tuesday suggested that they reduce premiums to help consumers through the economic downturn caused by the pandemic.

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The answer largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits once coronavirus outbreaks subside.

By: Reed Abelson

New York Times

Telemedicine is having its moment. Over the last few months, millions of people have relied on video or telephone calls to talk to their doctors. But as the pandemic moves across the United States, and eventually recedes in some places, how long will the moment last?

While patients used virtual visits to avoid overcrowded and potentially infectious doctor’s offices or emergency rooms, many are returning to face-to-face appointments in cities where the threat has subsided.

And insurance payments for telehealth services, especially at full cost, may only be temporary.

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