The Cigna Group is facing a legal challenge to its prior authorization process and is expecting more pressure on its individual insurance margins.
Here are eight updates about the payer Becker's has reported since July 27:
- Riverdale, Ga.-based Southern Regional Medical Center sued Cigna, alleging the payer did not fully reimburse SRMC for medically necessary services as an out-of-network provider.
- Payers are cracking down on prescriptions for expensive GLP-1 drugs like Ozempic and Wegovy, but these drugs could provide a boost to the pharmaceutical benefit side of Cigna's business, executives told investors. Cigna CFO Brian Evanko said growing utilization of GLP-1 drugs is a "net positive" for Evernorth's earnings.
- The Cigna Group is the 35th largest company in the world by revenue, according to Fortune's "Global 500" list.
- Cigna is expecting smaller margins in its individual insurance business because of higher-than-expected risk adjustment payments, Cigna Group executives told investors.
- The Cigna Group raised its year-end revenue projections to $190 billion and reported a 6 percent decrease in shareholders' net income, according to the company's second quarter earnings report. Total revenues in the second quarter were $48.6 billion, up 7 percent year over year.
- The Cigna Group is among 15 payers named to Fortune's list of the best employers for women.
- Here are five executive departures from the Cigna Group over the last year, including its top attorney and the president of its PBM.
- Two Cigna members filed a class-action complaint against their insurer for allegedly denying large batches of members' claims without individual review, thereby denying them coverage for certain services. The company has pushed back on the lawsuit and a ProPublica report, calling it "riddled with factual errors and gross mischaracterizations."