Health Insurance

Anthem Blue Cross Blue Shield came under scrutiny for planning to put time limits on anesthesia care in Missouri, Connecticut and New York. The original move, which would have started next year, alarmed doctors and policymakers.

The two companies announced early Wednesday that they had resolved contract disputes that began earlier this year.

Anthem officials claim Mercy is asking the insurer to pay too much money to cover procedures. Mercy officials said Anthem is putting too many administrative barriers in its contract. If the two sides cannot reach an agreement by the end of the year, Anthem patients won't be able to receive in-network rates at Mercy locations.

Missouri has removed roughly 136,000 kids from its Medicaid rolls since June 2023. But the state's worst-in-nation processing delays make it difficult to re-enroll — causing many to miss doctor’s appointments and critical prescriptions.

The Health Care Protection Act bars the use of a restriction known as “step therapy" requiring a patient to try and fail on one or more treatments preferred by the insurance company before they can access a doctor-recommended treatment.

Missouri officials told the federal government the reason for the delays is that several social services programs are competing for limited resources.

Organizers of a protest planned for Friday say the pharmacy benefits manager steers patients to its own pharmacies and drives up prescription prices for consumers.

The Healthcare Protection Act passed the Illinois House last week. Now, it's headed to the Senate. Gov. J.B. Pritzker and state lawmakers say the legislation will put power in the hands of patients and their doctors.

Illinois Gov. J.B. Pritzker celebrated a partial legislative victory late last week when the House passed his initiative to end some practices health insurance companies use to control the amount and cost of health care services individual patients receive.

In Missouri, legislation introduced by State Rep. Melanie Stinnett, R-Springfield, aims to establish a gold carding program for medical treatment and prescriptions.