Tuesday, September 4, 2018

MEDICARE TERMINATION LETTERS SENT OUT IN ERROR


By Britta Arendt Herald-Review
Sep 1, 2018 Updated Sep 1, 2018

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For those among the many who recently received letters from Medicare stating their cost plan won’t be available in 2019, local insurance agents want them to know the letters were sent out in error.
Individuals in 21 open counties, including Itasca, Aitkin, St. Louis and Koochiching, were mailed the letters from the Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS), dated August 2018. The letters are prefaced: “IMPORTANT NOTICE: Your Medicare Cost Plan won’t be available in 2019.” The letter continues to state, “You must take action before December 31, or you’ll only have Original Medicare starting January 1, 2019,” and lists two options for continued Medicare coverage.
As Bill Mager, a Certified Financial Planner (CFP) and agent who represents both Blue Cross Blue Shield MN and Medica, explains, “Blue Cross and Blue Shield MN markets Cost Plans under the name of Platinum Blue and Medica under the name of Prime Solutions. Cost Plans will continue to be available in 21 counties in Minnesota.”
Mager encouraged people who received the letters to contact their insurance agent.

Now That You Have Your First Job, Labor Day Has a Deeper Meaning

woman holding phone and smiling Labor Day is usually associated with cookouts, the end of summer, and going back to school. Now that you have your first job, you’re learning the true meaning behind this holiday. From today on, when Labor Day rolls around, you’ll think of the hard work you put in during the year. What you should also think of is how the fruit of that labor will one day translate into Social Security benefits for you and your family.
Social Security is here with benefits, tools, and information to help you secure today and tomorrow. Here’s some things you should know:
  1. When you work, two types of federal taxes are deducted from your wages: 6.2% of your gross wages goes toward Social Security taxes and 1.45% goes to Medicare taxes. These are FICA FICA stands for “Federal Insurance Contributions Act.” This is the law that funds both Social Security and Medicare through payroll taxes. Employees share this cost with their employer.
  2. Your FICA contributions earn Social Security credits. You can earn up to four credits a year. Most of today’s workers need at least 40 credits to be eligible for retirement benefits. That’s about ten years of work.
  3. These mandatory contributions are there to protect you. Disability could happen at any moment in our lives. If it does, Social Security is there for you, and your family, or future family.
Social Security is much more than a retirement program. We pay benefits to workers who become severely disabled, and to certain surviving family members when a worker dies. The number of credits you need to qualify for these benefits depends on your age when you become disabled or die.
Do you have a personal my Social Security account? If not, open yours today. With a personal my Social Security account, you can get your Social Security Statement to review estimates of your future retirement, disability, and survivors benefits; review your earnings to verify the amounts posted are correct; and see estimated Social Security and Medicare taxes you’ve paid. You’ll find it’s easy, convenient, and secure.
Your contributions help to provide benefits that improve the quality of life for generations to come. Visit our website and learn how Social Security is with you throughout life’s journey.
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WellCare Completes Acquisition Of Meridian


Company Release - 9/4/2018 6:00 AM ET
TAMPA, Fla., Sept. 4, 2018 /PRNewswire/ -- WellCare Health Plans, Inc. (NYSE: WCG) ("WellCare") announced today that, effective September 1, 2018, it completed its acquisition of Meridian Health Plan of Michigan, Inc., Meridian Health Plan of Illinois, Inc., and MeridianRx, a pharmacy benefit manager (PBM) (collectively, "Meridian") following the receipt of all required regulatory approvals. With the closing of the acquisition, Meridian is now a wholly-owned subsidiary of WellCare.
(PRNewsfoto/WellCare Health Plans, Inc.)
"We are excited to complete our acquisition of Meridian," said Ken Burdick, WellCare's CEO. "This transaction grows and diversifies our Medicaid membership by nearly 40 percent, increases our Medicare Advantage presence in new markets, adds a proprietary PBM platform, and enhances WellCare's integrated dual-eligible and Marketplace capabilities, positioning us for further growth within government-sponsored programs."
"WellCare and Meridian have a shared commitment to quality - with Meridian maintaining high quality and accredited Medicaid plans in both Michigan and Illinois. We look forward to leveraging best practices across the entire company in order to improve quality for all of our members," continued Burdick. "We also want to welcome Meridian associates, members, agents, and providers to WellCare."
The transaction is expected to produce $0.40 to $0.50 of accretion to WellCare's adjusted earnings per share in 2019, $0.70 to $0.80 of accretion in 2020, and $1.00+ of accretion in 2021, inclusive of $30 million to $40 million in synergies that will ramp up over the next few years and exclusive of one-time transaction-related expenses of $75 million to $85 million and cumulative integration-related expenses of $50 million to $60 million.
Meridian was one of the largest privately-held, for-profit managed care organizations in the U.S. and served approximately 1.1 million Medicaid, Medicare Advantage (MA), integrated dual-eligible and Health Insurance Marketplace members as of June 30, 2018 in Michigan, Illinois, Indiana and Ohio. Meridian dedicated more than 20 years to providing compassionate and quality care to its members as demonstrated by achieving high quality ratings from the widely respected National Committee for Quality Assurance (NCQA) for its Medicaid health plans in Michigan and Illinois.
About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The Company served approximately 4.4 million members nationwide as of June 30, 2018. For more information about WellCare, please visit the Company's website at www.wellcare.com.
Basis of Presentation
In addition to results determined under GAAP, WellCare provides certain non-GAAP financial measures that management believes are useful in assessing the company's performance. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP.
Earnings per share have been adjusted for the effect of certain expenses, and as appropriate, the related tax effect, related to previously disclosed government investigations and related litigation and resolution costs ("investigation costs"); amortization expense associated with acquisitions ("acquisition-related amortization expenses"); and certain one-time transaction and integration costs related to the acquisition of Universal American and Meridian ("transaction and integration costs").
Although the excluded items may recur, WellCare believes that by providing non-GAAP measures exclusive of these items, it facilitates period-over-period comparisons and provides additional clarity about events and trends affecting its core operating performance, as well as providing comparability to competitor results. The investigation costs are related to a discrete incident which management does not expect to reoccur. WellCare has adjusted for acquisition-related amortization expenses as these transactions do not directly relate to the servicing of products for our customers and are not directly related to the core performance of its business operations. The transaction and integrations costs are related to a specific 2017 and 2018 events, which do not reflect the underlying ongoing performance of the business.
The company is not able to project at the time of this news release the amount of expenses associated with investigation costs, the timing of transaction and integration costs and, therefore, cannot reconcile projected non-GAAP measures affected by these items to projected GAAP measures.
Cautionary Statement Regarding Forward-Looking Statements
This news release contains "forward-looking" statements that are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as "expects," "anticipates," "intends," "plans," "believes," "estimates," "will," and similar expressions are forward-looking statements. For example, statements regarding the company's financial outlook and financial impact of the transaction contain forward-looking statements. Forward-looking statements involve known and unknown risks and uncertainties that may cause WellCare's actual future results to differ materially from those projected or contemplated in the forward-looking statements. These risks and uncertainties include, but are not limited to, the ability to achieve expected synergies within the expected time frames or at all, the ability to achieve accretion to WellCare's earnings, revenues or other benefits expected, disruption to business relationships, operating results, and business generally of WellCare and/or Meridian and the ability to retain Meridian employees, WellCare's progress on top priorities such as improving health care quality and access, ensuring a competitive cost position, and delivering prudent, profitable growth, WellCare's ability to effectively estimate and manage growth, WellCare's ability to effectively execute and integrate acquisitions, potential reductions in Medicaid and Medicare revenue, WellCare's ability to estimate and manage medical benefits expense effectively, including through its vendors, its ability to negotiate actuarially sound rates, especially in new programs with limited experience, the appropriation and payment by state governments of Medicaid premiums receivable, the outcome of any protests and litigation related to Medicaid awards, the approval of Medicaid contracts by CMS, any changes to the programs or contracts, WellCare's ability to address operational challenges related to new business, and WellCare's ability to meet the requirements of readiness reviews. Given the risks and uncertainties inherent in forward-looking statements, any of WellCare's forward-looking statements could be incorrect and investors are cautioned not to place undue reliance on any of our forward-looking statements.
Additional information concerning these and other important risks and uncertainties can be found in the company's filings with the U.S. Securities and Exchange Commission, included under the captions "Forward-Looking Statements" and "Risk Factors" in the company's Annual Report on Form 10-­K for the year ended December 31, 2017,  and in the company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2018, which contain discussions of WellCare's business and the various factors that may affect it. Subsequent events and developments may cause actual results to differ, perhaps materially, from WellCare's forward-looking statements. WellCare's forward-looking statements speak only as of the date on which the statements are made. WellCare undertakes no duty, and expressly disclaims any obligation, to update these forward-looking statements to reflect any future events, developments or otherwise.
SOURCE WellCare Health Plans, Inc.

Updated Affordable Care Act Federal upper limits (FUL)


Medicaid.gov
The updated Affordable Care Act Federal upper limits (FUL) calculated in accordance with the Medicaid Covered Outpatient Drug final rule with comment are now available on the Medicaid.gov website at https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html. States will have up to 30 days from the September 1, 2018  effective date to implement these updated FULs.  
For further information on the FUL program, please see the Federal Upper Limits page at https://www.medicaid.gov/medicaid/prescription-drugs/federal-upper-limits/index.html.

Trump to ease retirement regulations with executive order


Associated Press August 31, 2018 
WASHINGTON (AP) — President Donald Trump is set to sign an executive order to make it easier for small businesses to group together to provide their workers with retirement plans.
The White House says Trump will direct the Labor and Treasury departments to issue regulations to help businesses join together to offer Association Retirement Plans. Administration officials say high costs discourage employers from offering plans like 401(k)s at a time when surveys show workers worry about being able to live comfortably in retirement.
Trump is expected to deliver remarks and sign the directive at an event Friday at the Harris Conference Center in Charlotte, North Carolina.
Trump will also headline a fundraiser for Republican congressional candidates Mark Harris and Rep. Ted Budd while he is in town.

Aretha Franklin didn't have a will — and she's not the only celebrity

By InvestmentNews
Aretha Franklin isn't the only celebrity who didn’t have a will or testament documents when they died. She is just the most recent example.

In the cases of these celebrities, legal battles lasted decades over who was involved in the celebrities’ estates, and how their assets were managed.
Prince
Because Prince failed to leave a will behind when he died from a drug overdose in 2016, the wishes he had for his music were ignored, according to a Bloomberg News story.
Amy Winehouse
The English singer and songwriter did not have a will when she died in 2011, according to Forbes. The money went to her parents.
Sonny Bono
The former "The Beat Goes On" singer did not have a will when he died in a skiing accident, according to a 1999 People article. A man claimed to be the singer-turned-congressman’s son after his death, the publication reported.
Bob Marley
Even though this iconic singer knew he had cancer, he too never had a will, according to Forbes. And as is the case with many other celebrities’ estates, court battles went on for years following his death in 1981.
Howard Hughes
Mr. Hughes’ estate was first divided among his relatives, when he died in 1976 with no will, according to the Wall Street Journal but that number rose to more than 1,000 people by 2009.
Jimi Hendrix
The late guitarist died intestate, or without a will, in 1970, according to a 2004 New York Times story. Battles over his estate lasted for more than three decades.
Martin Luther King Jr.
Legal feuds continued for years after the civil rights activist was assassinated in 1968. He did not have a will, according to Reuters. His wife and four children received inheritances, but feuds subsequently erupted over what to do with his Nobel Peace Prize and bible.
Abraham Lincoln
No will was found for the 16th president of the United States and lawyer, Abraham Lincoln, before his assassination, according to Forbes. His estate was later divided between his wife and two children.
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Another setback for AstraZeneca as lupus drug fails phase 3 test


by Phil Taylor | Aug 31, 2018
Despite encouraging midstage data for AstraZeneca’s drug for systemic lupus erythematosus (SLE), anifrolumab has missed the target in the first of two ongoing phase 3 trials, putting its future in doubt.
The antibody, which binds to and inhibits the subunit 1 of the type I interferon receptor and is designed to dampen down the activity of inflammatory cytokines, was unable to achieve a significant reduction in disease activity compared to placebo over the one-year TULIP 1 trial.
AZ isn’t making a decision on its future just yet, as a second study—called TULIP 2—is still being run and is due to deliver results before the end of the year. However, the company’s terse statement on the disappointment suggests prospects are looking bleak.
autoimmune disease with significant unmet need among patients who struggle to achieve meaningful disease control,” said AstraZeneca Chief Medical Officer Sean Bohen. “The result of this trial is disappointing for patients and the lupus community.”
Anifrolumab is also in two midstage trials, one looking at a subcutaneous formulation and another zeroing in on kidney damage caused by lupus. If it turns out to be defunct, the failure strips out a big chunk of AZ’s clinical pipeline of drugs for autoimmune diseases, which is otherwise headed by phase 2 Sjogren’s syndrome candidate prezalumab, and leaves the company ever more dependent on its core respiratory, cardiovascular/metabolism and cancer assets.
TULIP 1 recruited adult patients with moderate-to-severe SLE who were given one of two doses of anifrolumab (150mg or 300mg) or placebo by intravenous infusion every four weeks. The design of TULIP 2 is very similar but is pitting only the 300mg dose against the control group.
For AstraZeneca, news of the disappointing data comes shortly after it announced another trial failure for MEK 1/2 inhibitor selumetinib in thyroid cancer after an earlier miss in non-small cell lung cancer, the termination of phase 3 trials for its Eli Lilly-partnered BACE inhibitor lanabecestat for Alzheimer’s disease, and setbacks for atopic dermatitis candidate tezepelumab and asthma drug tralokinumab.
It’s a big disappointment for AZ, which at one time was pitching anifrolumab as a potential rival to GlaxoSmithKline’s subcutaneous formulation of Benlysta (belimumab), an antibody approved for SLE in 2011 with sales of around $275 million in the first half of this year. The company previously said anifrolumab was a blockbuster prospect when the pharma giant was fighting off an unwelcome megamerger offer from Pfizer three years ago.
At the time, AZ CEO Pascal Soriot estimated that a combination of anifrolumab and another now-dropped candidate called sifalimumab could achieve $1 billion in annual revenue in SLE.