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American Medical News

American Medical News

 
BUSINESS

News in brief - July 2, 2001


Coventry acquiring Aetna's La. commercial HMO business - Executives focus on rising costs - Florida bans all-products clauses - North Carolina gets prompt-pay law

Coventry acquiring Aetna's La. commercial HMO business

Coventry Health Care Inc. is acquiring Aetna Inc.'s commercial HMO business in Louisiana. Coventry, based in Bethesda, Md., also acquired Aetna's commercial HMO business in St. Louis.

Aetna recently announced that it is also pulling its commercial HMO from certain counties in central and southern California where its business has been unprofitable.

Executives focus on rising costs

The softening economy and surging health care costs are the top issues facing managed care executives, said Cap Gemini Ernst and Young's recent survey of managed care executives. Managed care executives are also focused on cutting administrative paperwork of managed care, improving relations with doctors and getting patients more involved in managing health benefits.

Florida bans all-products clauses

A ban on all-or-nothing contract clauses took effect July 1 in Florida. The law prohibits insurers from making it a condition of participating in any health plan that a physician sign up for all of the health plan's current or future products.

North Carolina gets prompt-pay law

New prompt-pay legislation took effect July 1 in North Carolina, after being passed during a short session last year.

Under the law, insurers must pay physicians, deny claims or request more information within 30 days of a claim being filed. Insurers can ask for more information once, then must respond within 30 days or face an 18% charge.

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Copyright 2001 American Medical Association. All rights reserved.
 
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