CIGNA
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Cigna Cuts 25% of Medical Services from Prior Authorization Requirements
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.
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Payers Can Reform Prior Authorization to Make it Faster, Smoother But Will It Satisfy the AMA?
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.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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Express Scripts Launches New Solutions To Advance Drug Price Transparency
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.
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Health Services, Payers, Legal
Ohio Sues Express Scripts, Cigna, Prime Therapeutics and Humana Calling PBMs “Modern Gangsters”
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.
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Cigna Adds ReKlame Health to Network to Advance Mental Healthcare for BIPOC Communities
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.
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Evernorth Adds Brightline to Network to Advance Behavioral Health Services for Families
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.
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Evernorth Discovers 314% Year-over-year Increase in Flu Med Prescriptions
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.
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Express Scripts Must Pay State AG $3.2M for Allegedly Overcharging for Prescriptions
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.
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With PBM satisfaction on the decline, Centene switches to Express Scripts
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.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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Devices & Diagnostics, Health Tech, SYN
Cigna extends coverage for BrainsWay’s brain stimulation device to treat OCD
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.
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Network with healthcare executives at MedCity INVEST
In our first in-person event in two years, the MedCity INVEST conference March 28-30 at the Ritz Carlton Hotel in Chicago, there will be many opportunities to connect with startups, investors and potential collaboration partners.
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Virtual physical therapy offered in-network to select Medicare Advantage customers
RecoveryOne will now offer their virtual physical therapy app for musculoskeletal (MSK) injuries as an in-network benefit to some Cigna Medicare Advantage Customers.
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Study: Prompt access to mental healthcare reduces longer-term care costs
An analysis by Evernorth found that access to outpatient mental healthcare can reduce an individual patient’s cost of care by $1,000 to $3,000 over two years.
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After buying MDLive, Cigna will launch its own virtual-first health plan
After UnitedHealthcare and Aetna announced plans to launch virtual primary care plans, Cigna is rolling out its own with select employers. It’s also offering a broader suite of telehealth services to everyone enrolled in employer-sponsored plans.
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Report: MA plans struggling to boost member engagement, communication
A little over half (55%) of Medicare Advantage plan members actively managed their care in the past year — a nine-percentage-point drop from 2019, according to a new report. This indicates that MA plans are faltering with regard to member engagement.
Promoted
Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
Promoted
Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
