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CMS is considering proposals that would cut the number of procedures that are subject to prior authorization, Bloomberg reported April 29.  Five things to know: 1. People familiar with the discussions told Bloomberg that CMS is exploring making prior authorization…

Humana recorded a net income of $1.2 billion in the first quarter of 2025, up from a net income of $741 million during the same period last year, according to its April 30 financial report.  Total revenue for the three…

Elevance Health will remove most of its Anthem  Medicare Advantage plans from online broker platforms.  According to a message sent to brokers, Anthem said most of its standard Medicare Advantage plans will be removed from online broker platforms May 1.…

Cigna Group Executive Vice President and Global CIO Noelle Eder will depart the company for a role at London-based international banking group Standard Chartered. Ms. Eder’s resignation from Cigna is effective May 16, according to an April 22 filing with…

CVS Health will lay off 55 employees who report to Aetna’s headquarters in Hartford, Conn., due to the closure of the payer’s CareFree insurance plan.  “We are sunsetting CareFree operations by the end of this year as part of our…

A package of California bills aiming to streamline the prior authorization process recently passed out of Senate and Assembly health committees, the California Medical Association said April 28. The four-bill “Prioritizing Patients, Empowering Physicians” package was unveiled April 10 by…

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. Akron Children’s Hospital seeks a director of reimbursement and payer analysis.  2. Albany…

Priority Health, the insurance arm of Grand Rapids, Mich.-based Corewell Health, has named Nick Gates as interim president, effective May 1.  He succeeds Praveen Thadani, who made the decision to step away from the role, according to a news release…

Nashville-based Meharry Medical College has purchased eight medical clinics from a joint venture between BlueCross BlueShield of Tennessee and Sanitas. The clinics, located in Nashville and Memphis, currently serve a total of 25,000 patients and employ 40 providers, according to…

For payers, drug formulary development and maintenance are essential for accurate reporting and tracking of prescription medications. An up-to-date and well-established classification resource can help payers and other stakeholders manage their drug formulary more efficiently. While several classification resources are…


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