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CSEPS joins fight against health plan mega-mergers

Posted By Administration, Tuesday, May 3, 2016

Four of the five largest health plans in the state have announced their intentions to merge and CSEPS is actively opposed. Last year Aetna announced that it intends to merge with Humana, and Anthem gave the nod to buy Cigna. The effect of these health plan mega-mergers will be profound on the Colorado marketplace. The CSEPS board of directors recently reviewed the proposed mergers and after deliberation unanimously voted to oppose the deals on the grounds of their anti-competitive nature and the adverse impacts that they would have on patient care and ophthalmology practices.

Regulators both locally and nationally are reviewing the mergers and have varying powers to block them. Nationally the Department of Justice is actively reviewing both deals. The Colorado Division of Insurance has already determined that the Aetna-Humana does not violate state anticompetitive standards. This ruling came without public hearings and raised concerns across the health care system. The DOI intends to hold hearings and conduct an independent analysis of the Anthem-Cigna merger. Once Anthem-Cigna submits formal paperwork a regulatory clock starts and it will be essential for ophthalmologists across the state, especially in already overly concentrated health insurance markets to share their stories about why this deal is bad for patients, eyeMDs and the state. It is unclear when exactly that filing will actually occur and the formal DOI process will start, so please be on the look out for a CSEPS member alert. Please send us a note about why you’re concerned about the mergers and how they may impact your care of patients and your practice. Staff will compile these stories for use during upcoming DOI public hearings. CSEPS joins a number of other state specialty societies, the Colorado Medical Society and consumer groups in opposition to the mergers


Tags:  advocacy  health plans  payer issues 

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