State news: Calif. opposes Anthem-Cigna merger, Ore. doctors’ union announces labor deal

Here’s a roundup of the latest healthcare news from California, Oregon, Illinois, Ohio and New York.

Calif. insurance chief asks feds to block Anthem-Cigna merger

California Insurance Commissioner Dave Jones urged the U.S. Justice Department to stop the merger between Anthem and Cigna, arguing the deal would drive up prices in the state.

In a 22-page letter, Jones said the $53 billion merger would give the combined Anthem and Cigna a market share exceeding 50 percent in 28 California counties, and argued the companies haven’t provided guarantees that savings from the merger would be passed along to customers.

“More competition in California's consolidated health insurance markets is needed, not less,” Jones wrote.

Anthem responded in a statement saying the opinion wasn’t based on “the true merits of the transaction.”

While Jones has no legal authority to stop the deal, the opposition of state regulators may influence federal approval. Missouri’s insurance department has taken a similar stance against the proposed merger of Aetna and Humana.

Ore. hospital docs represented by teachers’ union reaches labor deal

The first union of hospital physicians to be affiliated with the American Federation of Teachers (AFT) has reached an agreement on a new labor contract.

The Pacific Northwest Hospital Medicine Association represents 30 hospitalists at the Sacred Heart Medical Center at RiverBend in Springfield, Ore. It had planned an “informational picket” for June 23 before announcing a tentative agreement.

“While it took a year and a half of negotiations with management, the doctors have used the power of collective bargaining to regain voice and respect on the job to ensure that they can better serve their patients and community and be treated as the highly skilled professionals they are,” AFT President Randi Weingarten said in a statement.

The Eugene Register-Guard reported the group is the first and only hospitalists union in the U.S.  

FTC files appeal to stop merger of Chicago-area hospitals

After its objection to a proposed merger of Advocate Health Care and NorthShore University Health System was denied, the Federal Trade Commission has filed an appeal in another attempt to block what it considers to be an anticompetitive deal.

The Daily Herald reported the merger would create a 16-hospital system, mainly clustered around the Chicago suburbs. The FTC opposed the move arguing it would consolidate 50 percent of acute inpatient care services in Chicago’s north and northwest suburbs, creating the 11^th-largest not-for-profit health system in the U.S.

Advocate and NorthShore countered that the FTC overestimated their combined market share, placing the number closer to 30 percent, according to Crain’s Chicago Business.

The court ruling was the second straight defeat for the FTC in attempt to block hospital consolidation. It lost a bid for an injunction against a merger in Pennsylvania in May.

Sen. Portman wants to know CMS’ plans on failed Ohio ACA co-op

Sen. Rob Portman, R-Ohio, has written to CMS asking for details on the agency’s plans to handle the 22,000 enrollees of Ohio-based co-op InHealth who now have to look for new coverage.

Enrollees can keep their current coverage through the end of the year, similar to customers of insurers which are choosing to leave certain state exchanges. But for InHealth customers, they wouldn’t be eligible for ACA subsidies anymore, potentially making the option unaffordable.

“Now they have to find new insurance or risk paying a penalty to the IRS, Portman wrote. Worse, many of them have already paid high deductibles for their CO-OP coverage, yet they are about to lose credit for those payments and incur more out-of-pocket costs if they chose a new insurance plan mid-year. That’s just not fair, and the Administration owes these Ohio families a solution to a problem it created.”

Portman asked in the letter if it would be possible to offer a credit to InHealth customers towards the deductible in their new coverage.

InHealth was ordered to be liquidated in May, leaving only 10 of the original 23 nonprofit plans set up by the Affordable Care Act in business.

N.Y. legislation would require payment parity for telehealth

A new bill in the New York Senate would require health insurers to cover telehealth services at the same rates for in-person services.

New York’s existing telehealth law, which went into effect in the beginning of 2016, didn’t include any payment parity language, mainly serving to prevent insurers from excluding telehealth from their plans.

According to the National Law Review, the lack of a parity standard has resulted in insurers paying as little as half of the rate providers would receive for an identical in-person service.

Currently, 29 states have telehealth laws with payment parity provisions included.