Payer

Highmark announced that its Financial Investigations and Provider Review department saved the payer more than $245 million by identifying and addressing potential fraud, waste and abuse in 2021. 

Cigna is scrapping in court with three Florida-based labs over about $32 million in unpaid claims, but the payer claims it actually overcharged the labs due to a "fraudulent billing scheme," according to court filings. 

A Minnesota judge sided with UnitedHealth Group and OptumRx in a lawsuit alleging the companies overcharged on drugs because of a "scrivener’s error," according to Bloomberg. 

From a range of legal and regulatory conundrums to broad initiatives to reach more members where they are, here are five stories about UnitedHealth Group. 

The Texas Supreme Court is hearing arguments over whether Blue Cross Blue Shield of Texas should be awarded a $3 million tax refund, according to Law360.

An HHS Office of Inspector General audit found SCAN Health Plan received $54.3 million in overpaid Medicare Advantage claims. 

Payers across the country are giving members access to more virtual care platforms and building out their networks.

Physicians leaving Medicare accountable care organizations are undoing the quality improvements they saw after joining the groups, according to a University of Michigan study. 

Luis Torres, MD, Evernorth behavioral health medical director, was named a CEO Action for Racial Equity fellow for 2022. 

UnitedHealthcare and the Rhode Island Public Transit Authority received subpoenas from state Attorney General Peter Neronha Jan. 27 regarding a data breach that compromised the data of 22,000 people, according to The Boston Globe.