This is Jacob Emerson with the Becker pair issues podcast podcasts. Here's your bi weekly industry news briefing for July 20. Second. Former employees with United Health Group's Opt and its subsidiaries took to social media beginning July eighteenth regarding another reduction in force within recent months that those employees say occurred across parts of the company.
Social media posts from terminated employees indicate that positions at landmark health have been affected, including behavioral health and social workers, along with nurse practitioners that In 20 22, Landmark became a part of Op home and community division, the Huntington Beach, California based company specializes in how calls, and medical behavioral, social and pal care for individuals with multiple chronic conditions across more than 35 states.
Opt demand its subsidiaries have conducted workforce reductions multiple times over the past year, including at provider facilities in Seattle with Virginia and San Antonio. In August, Med express, clinics, a chain of urgent care clinics, eliminated all registered nursing positions at nearly a hundred and fifth facilities, med express is owned by Opt. In April, Opt shutter its telehealth
division. And in May, the company said would close the change healthcare facility in Toledo, Ohio, resulting in the termination of 129 employees. Would Well, United Health group Ceo said the company was over optimistic about how quickly business would return to normal following the cyber attack on change health care. The February ransom attack delayed payment and claims processing for health care providers around the country as change handles an estimated 1 in 3 health transactions.
United Health Ceo, Andrew Witty said in a July sixteenth earnings call with investors that the company was a little optimistic in hindsight at the pace in which we thought people would come back in terms of putting their flow through the system once it was reconnected. He said I think as we've looked at to the last several weeks, that momentum and pace in particular as we look at new clients come in as well as returning clients. We
feel good about where we are now. So I think we were probably a little over optimistic 3 months ago. Executive said, change, changes It systems are mostly restored and that the company continues to catch up on its claims backlog. While medical costs are on the rise within El health Medicaid business. On the company's second quarter earnings call with investors on July seventeenth. Cfo, Mark Kaye said the company is seen signs of increased within outpatient home health radiology and other areas.
Medicaid red termination have left elements with a higher acuity Medicaid membership. In 20 23, states began the process of dis enrolling Medicaid enroll these for the first time since 20 20. As of July twelfth, more than 24000000 people have have been dis through the red process. And those who remain enrolled tend to have more health needs thereby driving up costs in the program.
According to El second quarter earnings reports, its Medicaid membership drop to 23 percent from 06/23/2023 to 9000000 people. Mister Kay said that some Medicaid beneficiaries who know they will be ineligible for the program, maybe seeking care before they lose their benefits, which is also driving up utilization. L reported a medical loss ratio of 86.3 percent in the second quarter. That's down from 86.4 percent in 20 23.
The company expects its a full year a loss ratio to land to the top end of its projected range. Well Florida has awarded more Medicaid contract to 3 additional payers. On July eighteenth, Ae, United Healthcare and Molina were all awarded Medicaid contracts after originally being denied by state. In April, Florida awarded 6 year contracts to Florida Community care, Human, El, community care plan and Cent. At No Molina, United Health and Am health
Ke held existing contracts. And were not originally chosen for new ones. Center, Carol Alliance and imagine care also submitted bids, but we're not selected. Florida's Medicaid managed program provides health coverage to more than 3400000.0 people, and those current contracts expire at the end of this year. Well, if Gl p 1 drugs are approved to treat sleep apnea, insurers and self insured employers may be more likely to cover those costs.
That's according to a Wall Street Journal report from July sixteenth. Eli Lilly, which manufacturers z bound, said it plans to seek wider approval for the drug after study showed it could alleviate symptoms of sleep apnea. Lilly is working to build a quote wall of evidence to prove to ensure that the drugs have benefits beyond just weight loss. More than 30000000 Americans have sleep apnea, which can lead long term complications such as heart
problems. If that bound is approved to treat sleep apnea, sales could rise by 5000000000 dollars a year. Gl 1 drugs approved for weight loss cost upwards of a thousand dollars a month without insurance coverage. And some employers and ensure have dropped coverage of the drugs in recent months, citing their high cost. Federal law prevents medicare from pain for drugs for weight loss only, though, it can cover the drugs if are used to treat other
conditions. The Fda could issue a decision on is that bounds used to treat a sleep apnea by the end of this year. Well Cms has issued new policies aimed at blocking unauthorized changes from brokers when enrolling individuals on the state and federal health insurance exchanges. Effective of immediately, Cms said July nineteenth it is blocking agents and brokers through making changes to an individual's exchange enrollment status, unless they
are already associated with that enrollment. Una associated or new agents and brokers will need to conduct a 3 way call with the consumer and an call center to make any changes or direct the enroll lead to make those changes themselves.
Cms said in the first 6 months of this year, it has received nearly 74000 complaints, about a plan being changed without the enroll lee's consent, and another a hundred and 35000 complaint received by the agency, alleged that individuals were enrolled in a plan without their consent. Since June 20 first, Cms has suspended 200 marketplace agents for reasonable suspicion of fraud or abusive conduct related to enrollment issues.
And finally, Human has acquired a minority stake in health pilot, which is an Ai powered Medicare enrollment platform. Health pilot was founded in 20 20 and is an online Medicare Advantage broker platform. The company uses an Ai powered platform to recommend beneficiaries, the best plans based on their health needs, choices for physicians, drug utilization and cost preferences. It will remain payer agnostic after Human investment in the financial due terms of the deal was not disclosed.
Other Medicare advantage insurers have also invested in online platforms to help beneficiaries enroll in their plans recently. In April, Cvs acquired Hello Health, a Medicare Advantage broker platform. If you'd like the latest health insurance industry news delivered straight inbox, subscribe to Becker payer issues e newsletter are on our website, at becker payer dot com.