Anthem (Elevance) Sued for Alleged ERISA Violations

A class action lawsuit has been filed against Anthem (now known as Elevance) claiming that ERISA was violated when Anthem “denied plan claims access due to mismanagement of funds.”

The plaintiff claims that Anthem breached ERISA when it denied them access to their plan claim data, which Anthem claims is proprietary information. As the plaintiffs researched their data on their own they discovered the plans had significantly and consistently overcharged the rates publicly posted by a hospital.

Source: BenefitsPro.com

 

Amazon Shifts Healthcare Strategy, Shuts Down Alexa HIPAA Apps

Amazon is shifting its healthcare strategy and is eliminating support for HIPAA-compliant programs for hospitals and payers.

The program allowed patients of a select group of healthcare providers including Swedish Health Connect, Livongo, Express Scripts, Cigna, Boston Children’s Hospital, and Atrium Health check prescriptions and schedule doctor visits with Alexa.

Amazon announced that it would no longer be investing in general-purpose voice assistants for HIPAA data. Amazon is also closing Amazon Care at the end of the year. However, the tech giant is planning to purchase primary care provider One Medical and add 188 medical clinics in 29 markets.

Source: Fierce Healthcare

 

Post-Pandemic Benefits Strategies

The pandemic changed not only how we work, but the benefits we value. According to BenefitsPro.com employees want their employees to prioritize:

  • Wellbeing and purpose
  • Flexibility
  • Competitive Pay
  • Good Working Conditions
  • Skills development

Self-insured employers have raised health care benefits premiums spends 4% to make themselves more competitive.

While employers are spending more on health care, they also want to be strategic about where they spend money and where they can cut costs. Identifying pain points can help your company create a plan that will cut costs and make healthcare more efficient. For example, if employees are visiting the ER for routine health care versus true emergency care, telehealth benefits may be a good way to meet their needs, while reducing costs.

Source: BenefitsPro

 

Mark Cuban's PBM Partnership

Mark Cuban is again making headlines with a new partnership with EmsanaRX, the only employer-built pharmacy benefit manager, to create a drug discount program specifically for employers. Cost Plus Drugs has been working exclusively in the direct-to-consumer market, however, employer-based benefit coverage is still the most prevalent model people use for medications.

When employees use discount card plans such as GoodRx, employers lose access to the types of medications employees are using that fall outside their health plan deductible or out-of-pocket maximums. The new program, EmsanaRX Plus, will provide big discounts on medications and won’t require the employee to go outside their health plan. The prevailing thought is that there will be greater continuity of care with this new model.

Source: Globe Newswire

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