Following an extensive investigative report from the New York Times, the AHA is calling for the Labor Department to probe into the business practices of data analytics firm MultiPlan. The report revealed that MultiPlan works with major payers to negotiate reduced reimbursements for out-of-network medical providers — and that this practice ends up costing patients and employers.
Through a new partnership, up to 12 million members of Cigna’s employer customers will gain access to HelloFresh’s meals at a discounted rate. Cigna and HelloFresh are also partnering to provide free meal kits to those battling food insecurity in local communities.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Despite Cigna and Humana ditching their pursuits to combine in December, one industry expert believes there's still a chance after Cigna announced its plan to sell its Medicare Advantage business to Health Care Service Corp.
With Cigna mostly focused on the commercial market and Humana mostly focused on the Medicare Advantage market, the rumored combination rumors check out, according to one industry expert.
Cigna recently agreed to pay $172 million to resolve allegations that it violated the False Claims Act. One expert said this is just a small part of the problem, while another called for more clarity from the government.
Cigna removed 25% of medical services from prior authorization requirements. This represents more than 600 codes, and includes 100 surgical codes, nearly 200 genetic testing codes, durable medical equipment, orthoses and prosthetics and other services, said Dr. Scott Josephs, chief medical officer of Cigna Healthcare.
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
In a recent interview, Dr. Jesse Ehrenfeld, the president-elect at the American Medical Association, outlined how the major pain point of physicians has gone from the EHR to prior authorizations requests. But none of the individual efforts that payers are making is enough.
Express Scripts released several new solutions last week that aim to improve drug price transparency, including a cap on out-of-pocket costs for prescription drugs for consumers. The news comes amid increasing scrutiny against pharmacy benefit managers.
The complaint alleges multiple violations of the Valentine Act, Ohio’s antitrust law, which prohibits price fixing, controlled sales and other agreements that restrain trade and hurt competition. David Yost, the attorney general decried the practices of PBMs saying that they hurt everyday Ohioans dependent on life-saving drugs like insulin.
By joining Cigna’s network, ReKlame’s services are now available to members in New York, New Jersey and Florida. The company is focused on serving underrepresented communities and treats several conditions, including depression, anxiety, addiction, ADHD, trauma and mood disorders.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Brightline’s services are now available to all of Evernorth’s employer clients across all 50 states, as well as Cigna’s customers who receive health coverage through their employer or marketplace exchange plans. These services include educational content about mental health concerns, interactive exercises, one-on-one coaching and care with therapists and psychiatrists.
The Evernorth report also found that there is a higher prevalence of flu medication prescriptions among children and people living the South. Employers and payers have a responsibility to encourage people to get vaccinated, said Urvashi Patel, vice president of the Evernorth Research Institute.
Following an investigation, the AG claimed Express Scripts, “billed and obtained payment for prescription drugs from payers of workers' compensation claims in excess of amounts permitted by Massachusetts laws and regulations,” according to court documents.
Centene is swapping CVS Caremark with Express Scripts. A recent survey that measured benefit leaders' satisfaction with their PBMs found that Express Scripts performed better than CVS Caremark.
Israeli medical device company BrainsWay earned a positive coverage policy from Cigna for its deep transcranial magnetic stimulation to treat adult patients with OCD. Cigna joins the ranks of other major insurers who cover the device for OCD treatment — including Centene, Highmark, Blue Cross Blue Shield, Tricare and Palmetto GBA.