Cigna will face trial over a provider group’s allegations that the insurer did not pay $6 million in COVID-19 testing costs, according to a May 8 ruling in a Connecticut federal court. Murphy Medical ...
Optum Rx, UnitedHealth Group’s pharmacy benefit manager, said it will roll out a fee-based structure to customers in the coming years. A May 11 news release from Optum said Optum Rx’s agreements have ...
Maine is installing a mandatory nutrition program for state employees using GLP-1s for weight loss, according to the state’s Office of Employee Health, Wellness and Workers’ Compensation. As GLP-1 ...
The Medicaid and CHIP Payment and Access Commission approved recommendations to boost transparency with Medicaid prior authorization automation and AI use. MACPAC advises Congress on Medicaid and CHIP ...
CMS has fined 13 health plans a combined $1.5 million for Medicare Advantage program violations spanning cost-sharing rules and Part D drug benefit administration. The penalties, issued May 1, stem ...
Elevance Health has named 45 primary care practices and health systems to its annual Care Provider Recognition Program, recognizing the top 1% of primary care providers for excellence in delivering ...
The largest insurers spent the first quarter navigating continued Medicare Advantage funding pressures, a slow and uneven path back to Medicaid profitability, a rapidly evolving prior authorization ...
The Cigna Group is “exploring strategic alternatives” for Evernorth’s EviCore, a subsidiary that works with health plans on utilization management, including prior authorization. During an April 30 ...
CVS Caremark will update its commercial formularies to expand use of lower-cost biosimilars and prefer certain interchangeable products over reference brands. The changes, effective July 1, include ...
UnitedHealthcare is paring down prior authorizations for 30% of applicable services, according to a May 5 news release. The cuts will take place by the end of 2026, with the insurer rolling back ...
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Adventist ...
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