Good morning ... Situational awareness: Activist investor Carl Icahn says he "no longer intend[s] to solicit proxies to vote against" the merger between Cigna and Express Scripts.
Surprise hospital bills are remarkably common, my colleague Caitlin Owens reports. A new Kaiser Family Foundation brief finds that, among people with employer-based coverage, almost 1 in 5 patients admitted to the hospital end up getting a bill from an out-of-network provider.
Why it matters: Patients have to pay more out of their own pockets for out-of-network care.
Balance billing — the practice of providers billing patients for the difference between their charges and insurance payments — is often responsible for these situations.
By the numbers:
The Trump administration isn't out of the woods yet on the ACA's risk adjustment program. New Mexico Health Connections — a small insurance co-op that's been fighting this fight for years — filed a new lawsuit yesterday against the administration's latest effort to carry out the program.
Flashback: The Centers for Medicare & Medicaid Services froze risk adjustment payments last month, citing a New Mexico judge's ruling on the formula it had used to calculate how much insurers owed.
The big picture: Whatever happens in this lawsuit, the insurance industry overall seems to feel confident that CMS is trying to make this work.
North Carolina is officially accepting bids for private health insurers to start running its Medicaid program. It could be a big profit center for the companies that get picked, Axios' Bob Herman reports.
By the numbers: North Carolina is privatizing its Medicaid program in stages, but analysts at Barclays gave these estimates:
Why it matters: North Carolina is the largest state that has yet to embrace Medicaid managed care, and some states like Iowa have reported rocky rollouts of recent privatization efforts.
What to watch: Proposals are due Oct. 12, and North Carolina will pick winners Feb. 4, 2019.
A group of tech firms including Alphabet, Amazon and Microsoft say they're "jointly committed to removing barriers for the adoption of technologies for healthcare interoperability," CNBC's Christina Farr reports.
Patients often have a hard time accessing their own records, and providers' systems often don't communicate well. Those are widely recognized problems in the health care world, but solutions are few and far between.
Between the lines: Don't expect everything to start working seamlessly now. Better tech is part of the answer, or at least it probably can't hurt, but a lot of the problem here lies with providers and broader structural issues, too.
What we're watching this week: The Senate is expected to consider a combined Defense/HHS appropriations bill. The House is still on recess.
What else are you watching? I always welcome your tips: email@example.com.