Updates About Health Insurance

Michigan Attorney General Dana Nessel recently announced a federal lawsuit against insurer Blue Cross Blue Shield of Michigan (BCBSM). The suit accuses BCBSM of violating antitrust laws in order to monopolize as Michigan’s largest health insurance carrier.

According to Nessel, BCBSM controls 65% of the Michigan health insurance market and 79% of the Preferred Provider Organization market. Nessel argued that Blue Cross’s dominance was caused by anti-competitive agreements that restricted competition and allowed the insurer to drive provider reimbursement rates down, forcing some providers to cut services, close facilities, or leave Michigan. She also claimed that the practices used by BCBSM has resulted in millions of consumers paying inflated prices for their health insurance and medical coverage.

The lawsuit will be filed in the U.S. District Court for the Eastern District of Michigan. Nessel will leave office in January, meaning her yet-to-be-elected successor, Democrat Eli Savit or Republican Doug Lloyd, will choose to either continue or drop the lawsuit.

The Michigan Department of Health and Human Services (MDHHS) announced that they will be hosting the Medicaid Health Plan Common Formulary over Zoom on Tuesday, Oct. 27, from 9:30 a.m. to noon. The purpose of the meeting will be to discuss the list of prescription drugs covered under Michigan Medicaid health plans.

During the meeting, the public community partners, and other interested parties will have an opportunity to provide comments on the prescription drug list. The common formulary was created in 2016 to streamline prescription drug coverage policies and ensure consistent coverage across contracted Medicaid health plans.

To view the full press release and how to RSVP for the Zoom call, click here.

The Michigan Department of Health and Human Services (MDHHS) recently announced that they are preparing to implement the federally required Medicaid changes that were passed under H.R. 1. This includes the new work requirements and more frequent eligibility reviews for certain Healthy Michigan Plan (HMP) beneficiaries.

Beginning in January 2027, some HMP enrollees ages 19 to 64 may need to complete approved activities. The list of approved activities includes employment, education, volunteer work, or work programs. Some enrollees can qualify for an exemption to maintain their coverage. The department will be reviewing federal guidance, updating systems, and developing outreach materials to help beneficiaries understand and comply with the new requirements.

The changes will be implemented gradually, and MDHHS has stated that beneficiaries will receive additional information and notices as the transition moves forward.