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One of California’s largest health insurance plans has distinguished itself, and not in a good way.

The state Department of Managed Health Care hit Anthem Blue Cross with $9.6 million in fines from January 2014 through early November 2019, according to a California Healthline analysis of agency data. That is about 44% of the $21.7 million in penalties the department issued against full-service health plans during that period.

And yet, Anthem covered only 10% to 13% of Californians with department-regulated plans. An annual average of 3.8 million Californians wer...

Anthem Blue Cross filed a lawsuit against the federal government to recoup $100 million in payments under the ACA, according to Bloomberg Law.

In the Nov. 18 lawsuit filed in the U.S. Court of Federal Claims, Anthem argued it sold plans on the ACA individual exchange because the government said it would offset expected losses on the policies through the risk corridors program. 

Risk corridors payments, which expired in 2016, aimed to protect insurers from large deficits as they enrolled sicker members into their new individual exchange policies. While the program int...

Felicia Morrison is eager to find a health plan for next year that costs less than the one she has and covers more of the medical services she needs for her chronic autoimmune disease.

Morrison, a solo lawyer in Stockton, Calif., buys coverage for herself and her twin sons through Covered California, the state’s Affordable Care Act insurance marketplace. Morrison, 57, gets a federal subsidy to help pay for her coverage and she said that her monthly premium of $167 is manageable. But she spends thousands of dollars a year on deductibles, copayments and care not cover...

Doctors fighting a reimbursement battle with one of the biggest U.S. health insurers want to make sure that ending surprise medical bills doesn’t come at the expense of their pay.

Anthem Inc. cut payments to some California physicians last month as part of what it called a routine adjustment to fees. Physicians say the move was the result of a 2016 state law that keeps patients from being forced to pay the difference when insurance companies and care providers clash over health costs.

California is one of several states that have acted to halt so-called surprise medi...

Have you ever stepped up to the pharmacy cash register only to learn your new prescription will cost you hundreds of dollars — instead of your typical $25 copay — because your insurance doesn’t cover it? Or received a painfully high bill for a medical test because your health plan didn’t think it was necessary?

Most people have, but only a tiny fraction ever appeal such decisions. In 2017, for example, enrollees in federally run Affordable Care Act marketplace plans appealed fewer than one-half of 1% of denied medical claims, according to an analysis by the Kaiser F...

Anthem Blue Cross and Blue Shield has agreed to allow its Pathway health plan members to visit WellStar Health System doctors at network rates through the end of the year.

The consent order, announced Wednesday, partially ends the long-running dispute over the health insurance exchange plan run by Anthem.

The agreement over physician network care, announced by the state insurance department, does not apply to Pathway members seeking hospital services.

The controversy erupted earlier this year, when the Anthem-WellStar contract for the Pathway plan ended without a new...

Health care provider class attorneys on Tuesday alerted an Alabama federal judge to recent Anthem Corp. testimony in Delaware that they say contradicts Blue Cross Blue Shield Association denials that the group’s rules, including nationwide limits on member revenues from “non-Blue” businesses, are anticompetitive.

The concern appeared in a notice filed in a multidistrict litigation antitrust case against BCBS companies in the U.S. District Court for the Northern District of Alabama. The notice recapped developments during a 10-day Chancery Court trial over dueling da...

Cigna Corp. officials did everything they could to sabotage a $48.9 billion merger with Anthem Inc., including refusing to consider divestitures that would have helped the deal win regulatory approval, Anthem’s general counsel told a judge.

Cigna refused to turn over data Anthem executives needed to convince U.S. Justice Department attorneys of the merger’s value to customers, Thomas Zielinski, Anthem’s top lawyer, testified Monday in the opening of a damages trial tied to the transaction’s collapse.

After Cigna Chief Executive Officer David Cordani expressed unhappi...

Cigna Corp. officials did everything they could to sabotage a $48.9 billion merger with Anthem Inc., including refusing to consider divestitures that would have helped the deal win regulatory approval, Anthem’s general counsel told a judge.

Cigna refused to turn over data Anthem executives needed to convince U.S. Justice Department attorneys of the merger’s value to customers, Thomas Zielinski, Anthem’s top lawyer, testified Monday in the opening of a damages trial tied to the transaction’s collapse.

After Cigna Chief Executive Officer David Cordani expressed unhappi...

The parties in an excessive fee lawsuit filed against the committee that oversees the Anthem 401(k) plan have reached a settlement agreement.

A February 19 docket entry in the case of Bell v. Anthem says, “The parties have reached a resolution subject to class approval.” The judge ordered that on or before March 15, 2019, the parties are to file a motion for preliminary approval of class settlement. Details of the settlement will be available then.

In the complaint, it is alleged that plan fiduciaries allowed unreasonable expenses to be charged to participants f...

An Atlanta-based law firm filed a federal class-action lawsuit Tuesday against Anthem Inc./Blue Cross and Blue Shield of Georgia Inc.

The Doss Law Firm, representing two Cobb County residents, charged the insurance giant with misleading thousands of Georgia consumers during last fall's open-enrollment period into believing they would continue to have access to the doctors and specialists of WellStar Health Systems Inc.

The case involves Georgians who enrolled in Anthem's Pathways health insurance plan, which is offered on the individual health insurance exchange crea...

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