Jane Antonio

Biography for Jane Antonio

Jane Antonio is the editor of FierceHealthPayer: AntiFraud. She joined the FierceHealthPayer team after a 27-year career in health insurance, where her most recent role was director of corporate compliance and ethics. Jane worked closely with Special Investigations Units designing and delivering employee anti-fraud training. This followed years of investigating Medicare fraud, waste and abuse cases and recovering program overpayments. Jane holds an M.A. in substance abuse counseling from Rhode Island College and a B.A. in English from Stonehill College in Easton, Mass. She enjoys reading and long outdoor walks. Contact Jane at [email protected]

Articles by Jane Antonio

Feds release guidance on reference pricing, network adequacy in ACA group plans

The U.S. Departments of Labor, Treasury and Health and Human Services released a frequently-asked question document offering guidance on the use of reference pricing in non-grandfathered large group employer plans. This may be the first time the departments have tried to regulate group health plan network requirements under the Affordable Care Act according to a Health Affairs blog post by attorney Timothy Jost.

Wal-Mart scales back health insurance benefits

Wal-Mart Stores, Inc., the nation's largest private employer, announced yesterday that it will stop offering health insurance coverage in January to about 30,000 part-time employees who work fewer than 30 hours a week, the New York Times reported.  

Study: Payment models that curb costs may thwart coverage of new medical technologies

A new study by the Analysis Group examined the relationship between insurers' adoption of provider payment models to curb costs and approval of coverage for new items and services made possible by advances in medical technology.

Wal-Mart expands insurance education efforts for customers

Wal-Mart Stores Inc., the Arkansas-based discount retailer and world's largest private employer, is launching an in-store program to help customers navigate the health insurance maze, the company announced today.  Wal-Mart is partnering with DirectHealth.com to set up counters in 2,700 stores where customers can speak to licensed insurance agents about product choices.

Treating and preventing opioid abuse saves money in the long run

Rising rates of prescription painkiller addiction have led to spikes in claims for drug abuse treatment and renewed emphasis on prevention, according to Healthcare Payer News.

Kaiser Permanente leaders share success strategies and advice

Kaiser Permanente chairman Bernard Tyson recently interviewed with Forbes about what's been called the "Kaiserfication" of healthcare, or rather, attempts by others to replicate Kaiser's success as an integrated hospital, physician and insurance organization that saw $53 billion in revenues last year.

Feds, payers and states brace for ACA open enrollment

The second enrollment period for coverage made possible by the Affordable Care Act is approaching fast, and this brings two major challenges for states, insurers and the Obama administration: How do marketplaces retain enrollees while bringing respectable numbers of new people into the tent?  

More insurers will enter the marketplace next year

The health insurance marketplace will include 25 percent more insurers next year, according to a Department of Health and Human Services report released yesterday, and the agency says the added competition will mean more choice and lower costs for consumers.

Holes in the argument for reference pricing

Reference pricing has been touted as a way to create provider competition in healthcare, but a recent Federal Trade Commission article argued this isn't the case.

Survey: Firms shift ACA costs to employees

Employees of Fortune 500 companies can expect to pay more for health insurance as their employers try to manage the costs of complying with the Affordable Care Act, a survey by the University of South Carolina found.