MAG plays key role in making CVS-Aetna merger conditional
The Medical Association of Georgia (MAG) played a key role convincing Georgia Insurance Commissioner Ralph Hudgens to make the CVS-Aetna merger contingent on fulfilling a number of important conditions.
“These are essential safeguards for both patients and physicians,” explains MAG Executive Director Donald J. Palmisano Jr. “It is also worth noting that Georgia was one of just several states to include these kinds of conditions.”
Palmisano reports that…
– CVS must submit an annual report that addresses how consumers benefit as a result of the merger – including medical and pharmaceutical costs, the quality of care, and health outcomes – for three years.
– CVS must submit an annual report that addresses “the aggregate amount of all rebates that [CVS] received from pharmaceutical manufacturers; the aggregate amount [of] administrative fees [CVS] received; and the aggregate rebates [CVS] received from pharmaceutical manufacturers that did not pass through to the insurer” for three years.
– CVS and Aetna must comply with the Georgia ‘Any Willing Provider’ law (O.C.G.A. § 33-20-16) in every provider contract, which means that patients can use the provider of their choice as long as the provider is “appropriately licensed to practice, is in good standing with the state, and is willing to accept the same pricing and terms and conditions that CVS or Aetna have established for other participating providers or pharmacies serving Georgia patients.”
The merged entity will also be required to maintain adequate networks.
“CVS-Aetna will be required to solicit non-CVS pharmacies and providers to participate in its networks,” says Palmisano. “The new company will also be required to allow its customers to choose their pharmacies and physicians within their network.”
Palmisano assures physicians that MAG will take steps to ensure that CVS/Aetna fulfills the aforementioned conditions.
MAG members can contact Bethany Sherrer at firstname.lastname@example.org with questions related to the merger.
Click for Georgia OIC CVS-Aeta merger final order