All articles tagged with #aetna
North Carolina’s State Health Plan board voted to restore Blue Cross Blue Shield of North Carolina as the plan’s manager (and for a separate pharmaceutical benefits contract) starting in 2028, reversing the 2023 move to Aetna. The switch could influence premiums, covered services, and who’s in-network, and may spark legal disputes as political priorities shift under Treasurer Brad Briner.
CVS Health beat Q1 estimates across all segments, delivering adjusted earnings of $2.57 per share on $100.43 billion in revenue and raising full-year guidance to $7.30–$7.50 per share and at least $405 billion in revenue, driven by improving performance in Aetna and ongoing cost cuts, store closures, and leadership changes as part of its turnaround; shares rose in premarket trading.
Aetna will pay $117.7 million to settle False Claims Act allegations that it submitted or failed to withdraw inaccurate diagnosis codes to inflate Medicare Advantage payments, including morbid obesity codes for 2018–2023, and related issues from a 2015 chart-review program; a whistleblower, a former Aetna risk-adjustment coder, will receive about $2.01 million. The case was pursued by the DOJ Civil Division, Fraud Section, and HHS-OIG with the U.S. Attorney’s Office for the Eastern District of Pennsylvania.
Lawyers for Luigi Mangione allege that Aetna mistakenly sent prosecutors 120 pages of confidential medical records after an unlawful subpoena, raising concerns about privacy violations and procedural misconduct in his case involving murder charges. They seek judicial review and remedies for potential legal violations.
CVS Health has appointed new leadership under CEO David Joyner, including Steve Nelson from UnitedHealth to lead its struggling Aetna insurance division, as part of efforts to revive the company's performance. Despite a 6.3% rise in revenue to $95.43 billion, CVS reported a 96% drop in third-quarter profit due to restructuring charges, missing earnings expectations. The company faces challenges from rising Medicare Advantage claims and Medicaid pressures, prompting criticism from shareholders and a need for strategic improvements.
Aetna and New York-Presbyterian are in contract negotiations, and if an agreement isn't reached by the end of March, tens of thousands of Aetna-insured New Yorkers could lose coverage for New York-Presbyterian's hospitals and physician networks. The dispute revolves around reimbursement rates, with both sides blaming each other for the impasse. This situation reflects a broader trend of large health insurers and major hospital networks clashing over payment rates, potentially disrupting patients' care and limiting their options.
CVS is set to lay off 520 employees at its Aetna headquarters in Connecticut by the end of the year, with 306 of them physically based in the state. The layoffs, which were announced in compliance with a WARN notice, will not affect the location of Aetna's headquarters. However, some local Republican politicians have criticized CVS for not maintaining the promised number of jobs in Connecticut. The layoffs come as CVS continues its cost-cutting efforts and shift towards providing healthcare services.
CVS Health is laying off over 300 corporate employees, primarily at the Hartford headquarters of Aetna, as part of its plan to cut 5,000 jobs nationwide. The layoffs, effective from October 21, are a setback for Hartford's efforts to bring workers back to the office post-pandemic. Concerns about the future of Aetna's large campus on Farmington Avenue have also been raised. CVS stated that it will have around 9,000 employees in Connecticut after the job cuts. The layoffs are seen as a move to increase competitiveness and invest in health care delivery and technology.
CVS Health has begun issuing layoff notices to corporate employees at Aetna, its Hartford-based health insurer subsidiary, as part of its plan to cut 5,000 jobs nationwide this year. The parent company is focusing on cutting expenses and investing in healthcare delivery and technology. The exact number of job cuts in Hartford and the effective date have not been disclosed. CVS has assured that customer-facing colleagues in stores, pharmacies, clinics, and customer service centers will not be affected, and impacted employees will receive severance pay and benefits. CVS acquired Aetna in 2018 and made commitments to maintain employment levels and keep Aetna's headquarters in Hartford.
CVS Health plans to cut 5,000 corporate jobs nationwide, including positions at its subsidiary Aetna, as part of an effort to reduce expenses and focus on healthcare delivery and technology. The majority of CVS corporate jobs in Connecticut are located in Hartford, where Aetna's headquarters are based. The job cuts represent about 2% of CVS's overall workforce, and the company has stated that customer-facing roles will not be affected. The impact on Aetna's Hartford workforce is uncertain, but local officials hope to attract new companies if layoffs occur. CVS's annual earnings report is expected to provide more details on the cost savings from the workforce reduction.
The ongoing dispute between Baton Rouge General and Aetna over reimbursement rates is causing difficulties for ExxonMobil retirees who are struggling to see their preferred doctors. The lack of a reimbursement contract between Aetna and Baton Rouge General has forced retirees to seek care elsewhere, disrupting critical care for patients who have long used the health system's doctors and providers. The situation has resulted in delays in treatment and potential negative outcomes, as seen in the case of a retiree who died due to insurance-induced setbacks. Roughly 5,000 patients have been impacted by the negotiations, and the union is urging Aetna patients to seek alternative plans that include Baton Rouge General.
Health insurer Oscar Health has announced that Mark Bertolini, former CEO of Aetna, will become its new CEO next month. The move comes as Oscar Health aims to become a profitable insurance business. Bertolini, who sold Aetna to CVS Health Corp in 2018 for nearly $70bn, will succeed Oscar Health co-founder Mario Schlosser, who will take on the new role of president of technology and report to Bertolini. The announcement sent Oscar Health's shares up by about 24%.