Payer

The Cigna Group’s Evernorth division introduced a rebate-free pharmacy benefit model that it says will lower medication costs and simplify drug pricing. The model removes the traditional post-purchase rebate structure by applying negotiated drug discounts upfront, according to an Oct. 27…

The Cigna Group’s board of directors has declared a $1.51 per share cash dividend to be paid on Dec. 18.  The dividend will be paid to shareholders of record as of the close of business Dec. 4, according to an…

Today, the durable medical equipment management (DME) process can be fragmented, inefficient, and unreliable – leading to errors and delays that impact member health, inflate costs for health plans, and burden clinicians with administrative complexity. But what if the end-to-end…

Elevance Health is deepening its use of artificial intelligence enterprise-wide, focusing on enhancements to its member services, clinical workflows and provider operations as part of long-term efforts to simplify care delivery and reduce costs. Chief Digital Information Officer Ratnakar Lavu…

Oklahoma Attorney General Gentner Drummond challenged the state’s managed care Medicaid in an Oct. 22 letter to the Oklahoma Health Care Authority, the agency that oversees the program. Mr. Drummond said providers have concerns about pediatric patient care, such as…

James Brown, Montana state auditor and commissioner of securities and insurance, launched an investigation into Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., after a data breach that may have affected up to 462,000…

CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for [Medicare] open enrollment,” he said. “Medicare is…

While best known for our healthcare technology, InterSystems is a global leader in interoperability across multiple industries. One goal common to all of them is achieving the level data liquidity needed to unlock simultaneous breakthroughs in quality and efficiency. However,…

SCAN Health Plan and Costco Wholesale Corp., a preferred pharmacy for the insurer, are collaborating to offer older adults a rewards program, provide them with greater flexibility with spending benefits and educate them about Medicare. Senthu Arumugam, SCAN’s chief commercial…

Johnson City, Tenn.-based Ballad Health is suing UnitedHealth Group for alleged “Medicare Advantage manipulation” that has led to denied care and underpayment for services.  The lawsuit was filed Oct. 21 in a Tennessee federal court and claims that UnitedHealth’s actions…