Author Archives: Admin

BY: KEN COLEMAN – JUNE 14, 2022 8:56 AM

bout three dozen activists from the Defend Black Voters Coalition rallied on Detroit’s riverfront on Monday to criticize what they described as voter suppression efforts backed by corporate entities, while General Motors’ Board of Directors met in the nearby Renaissance Center.

It was the second public demonstration in the last two weeks for a coalition of social action organizations that have come together to fight for African-American voting rights. Activists argue that major Michigan corporations back GOP lawmakers who back voting restriction legislation as well as the “voter suppression effort called the Secure MI Vote initiative.” 

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By Bob Herman

06/15/2022

The Blue Cross Blue Shield system of health insurance companies boasts on its website, “We take corporate responsibility seriously.” The insurers have offered “a neighborly helping hand as Americans weathered the crisis” of the coronavirus pandemic.

But that helping hand has also received billions of dollars from the federal government over the past four years as part of a tax system that has favored, and has been partly molded by, Blue Cross Blue Shield.

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• Blue Cross sank $3 billion into ill-fated Structured Alpha
• It blames adviser Aon, but Aon blames Blue Cross executives

By: David Voreacos and Neil Weinberg

Bloomberg

No one seemed to buy the sales pitch coming out of Allianz Global Investors US more than Jamey Sharpe. 

Over the years, Sharpe helped steer billions into several hedge funds inside an affiliate of Allianz SE that claimed they’d thrive in any market. In time, no investor was in deeper than his employer, the Blue Cross and Blue Shield Association. 

Now, Sharpe — a retired pension functionary who operated far from the glare of Wall Street — has been thrust into an uncomfortable legal spotlight. He’s one of a cast of characters enmeshed in the drama over who’s to blame in the fallout from the multibillion-dollar Allianz Structured Alpha funds collapse.  

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Memorial Hermann Health System (Memorial Hermann) filed suit against defendant Blue Cross Blue Shield of Texas on Thursday in the Southern District of Texas. The complaint claims that the defendant health insurance company was “prioritizing profits over patient well-being and its obligation to pay for emergency and subsequent care.”

The plaintiff asserts that the defendant lost hundreds of millions of dollars due to Affordable Care Act Exchange plans and individual market plans in 2013 and 2014. In an effort to make up for these losses, BCBS allegedly began a practice of “wrongly denying hundreds of valid Blue Advantage and MyBlue Health claims for emergency services and post-stabilization care,” including those that the plaintiff had filed.

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By: Susan Kelly

Health Care Dive

• Vermont residents who buy private health insurance through the state’s marketplace could face sharp increases next year in the premiums they pay. Insurers MVP Health Care and Blue Cross Blue Shield of Vermont are asking the state to approve the boosts, with both citing medical and drug cost pressures.
• MVP Health Care has asked state regulators to sign off on a 17% average rate increase for individual and family plans offered in 2023 through the Vermont Health Connect marketplace. Blue Cross Blue Shield of Vermont is seeking a 12% jump, according to its recent filing with the state.

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by Isabelle Taft and Kate Royals

Mississippi Today

April 25, 2022

Janah Garriga’s 12-year-old daughter, Joshlyn, was diagnosed with T-cell leukemia in February. Joshlyn loves her doctors and nurses at the University of Mississippi Medical Center. 

But when Garriga took her daughter to an appointment in early April, she was asked to sign a letter accepting full financial responsibility for all the costs of her daughter’s treatment because the hospital recently went out of network with Blue Cross and Blue Shield of Mississippi, her insurance company. 

The letter turned out to be a mistake on the hospital’s part. Because Medicaid is her daughter’s secondary insurer, Garriga fortunately won’t be on the hook for out-of-pocket cancer treatment — unlike many other families across the state.  

But after so much confusion, she still worries something could go wrong, complicating her daughter’s cancer treatment. 

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Anthem, Inc. reported strong profits of $2.4 billion for the first quarter of 2022, an increase of 13.2% over the prior year quarter. Anthem’s operating revenues were also sharply up, growing 18% over the prior year quarter to $37.9 billion. Anthem’s adjusted net income was $8.25 per share, beating analysists’ expectations.

In addition, Anthem reported strong membership growth, which increased by 3.3 million members year-over-year to 46.8 million members. Much of that membership growth was in the government business sector. Anthem also reported a 3.3% growth in BlueCard membership business compared with the first quarter 2021, which represents members from areas outside of its licensed territories.

Based on these stronger than expected first quarter results, Anthem increased it earnings expectations for 2022, now projecting full-year adjusted net income to be greater than $28.40 per share.

In the press release announcing its first quarter earnings, Anthem’s President and CEO Gail K. Boudreaux characterized Anthem’s earnings as showing “strong momentum across all our businesses…”

Anthem is one of the nation’s largest health insurers, providing health benefits to one in eight Americans through a number of subsidiary and affiliated companies. Anthem is the largest Blue Cross and Blue Shield licensee, operating Blues plans in fourteen states.

Anthem’s strong first quarter profits followed a highly profitable 2021.

Anthem’s press release announcing its first quarter earnings results is linked here. Whatley Kallas, LLP’s article summarizing Anthem’s fourth quarter and annual 2021 earnings is linked here.

For years, WRAL News has reported on Blue Cross Blue Shield of North Carolina’s finances, rising premiums and executive bonuses. Despite the lingering impact of the pandemic, 2021 turned out to be very healthy year for the insurer’s bottom line.

“We had a good year, and I’m very proud of our year,” Chief Financial Officer Mitch Perry told WRAL News. He says the state’s largest insurer stands on solid ground for its increasing membership base and employees.

Perry says the worldwide, two-year year battle with COVID-19 is proof that insurance companies always need to be prepared, “I think the pandemic is an unfortunate example, but it’s also a very strong example of why it’s important for us to be financially stable,” he said.

According to an annual report filed with the state’s Department of Insurance, BCBSNC had $10.7 billion in annual revenue in 2021, including nearly $570 million in net revenue, often considered profit for a non-profit company. That’s a 118% jump from 2020 and a 16% increase from pre-pandemic 2019.

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Health insurers Anthem (NYSE:ANTM), UnitedHealth Group (NYSE:UNH), and Centene (NYSE:CNC) all reached all-time highs on Friday.

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By: Dylan Carson and Antonio Pozos

Law360

Criminal antitrust enforcement in health care has picked up significantly in recent years and remains in sharp focus for companies and executives today. The U.S. Department of Justice Antitrust Division has made enforcement in health care a top priority, as the prosecution of alleged conspiracies to fix the wages of health care workers and agreements not to compete for their services is playing out in courtrooms across the country.

For example, the trial in U.S. v. DaVita, the DOJ’s prosecution of kidney dialysis company DaVita Inc. and its former CEO regarding an alleged no-poach agreement, began in the U.S. District Court for the District of Colorado on April 4.

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